Treatment with IgM-enriched immunoglobulin in sepsis: a matched case-control analysis

被引:7
作者
Martinez, Jorge-Ignacio [1 ]
Sanchez, Hector-Fabio [2 ]
Velandia, Julio-Alberto [3 ]
Urbina, Zulma [4 ]
Florian, Maria-Cristina [5 ,6 ]
Martinez, Mauricio-Antonio [7 ]
Giamarellos-Bourboulis, Evangelos J. [8 ]
Pino-Pinzon, Carmen-Juliana [9 ]
Ortiz, Guillermo [10 ]
Celis, Edgar [11 ]
机构
[1] San Pedro Hosp Fdn, Crit Med & Intens Care Serv, Pasto, Narino, Colombia
[2] Dept Univ Hosp Narino, Intens Care Unit, Pasto, Narino, Colombia
[3] San Rafael Tunja Univ Hosp, Intens Care Unit, Tunja, Boyaca, Colombia
[4] Erasmo Meoz Univ Hosp, Intens Care Unit, Cucuta, Norte De Santan, Colombia
[5] Manizales Univ, Dept Hosp Santa Sofia Caldas, Intens Care Unit, Manizales, Caldas, Colombia
[6] Manizales Univ, Med & Intens Care Program, Manizales, Caldas, Colombia
[7] Serviclin Dromed Clin, Crit Med & Intens Care Serv, Bucaramanga, Santander, Colombia
[8] ATTIKON Univ Hosp, Dept Internal Med 4, Program Infect Dis, Athens, Greece
[9] El Bosque Univ, Av Cra 9,131A-02, Bogota 110121, Colombia
[10] El Bosque Univ, Internal Med, Bogota, Colombia
[11] Fdn Santa Fe Bogota, Bogota, Colombia
关键词
Sepsis; Septic shock; IgM-enriched immunoglobulins; SEPTIC SHOCK; INTRAVENOUS IMMUNOGLOBULIN; METAANALYSIS; TRIAL;
D O I
10.1016/j.jcrc.2021.03.015
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The therapeutic potential of IgM-enriched immunoglobulin preparations (IgGAM) in sepsis remains a field of debate. The use of polyclonal immunoglobulins as adjuvant therapy (Esen & Tugrul, 2009; Kaukonen et al., 2014; Molnar et al., 2013; Taccone et al., 2009) has been shown to improve clinical outcomes in terms of mortality. This study analyze the impact of IgM-enriched IgG (IgGM) as additional immunomodulation. Patients and methods: This is a retrospective registry of 1196 patients with severe sepsis and septic shock from nine Intensive Care Units in Colombia, from routine clinical practice; 220 patients treated with IgGAM were registered. Fully matched comparators for severity and type of infection selected among patients non-treated with IgGAM. Mortality after 28 days was 30.5% among IgGAM-treated patients and 40.5% among matched comparators. Results: Multivariate Cox regression analysis showed IgGAM treatment to be the only variable protective from death after 28 days (hazard ratio 0.62; 0.45-0.86; p: 0.004). Results reinforce the importance of IgGAM treatment for favorable outcome after septic shock and are in line with recent published meta-analyses. This study showed that treatment with IgGM in patients with sepsis was an independent modulator of the 28-day associated with a lower mortality. (c) 2021 Elsevier Inc. All rights reserved.
引用
收藏
页码:120 / 124
页数:5
相关论文
共 16 条
[1]   Intravenous immunoglobulin for treating sepsis, severe sepsis and septic shock [J].
Alejandria, Marissa M. ;
Lansang, Mary Ann D. ;
Dans, Leonila F. ;
Mantaring, Jacinto Blas, III .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2013, (09)
[2]   Immunoglobulins IgG1, IgM and IgA: a synergistic team influencing survival in sepsis [J].
Bermejo-Martin, J. F. ;
Rodriguez-Fernandez, A. ;
Herran-Monge, R. ;
Andaluz-Ojeda, D. ;
Muriel-Bombin, A. ;
Merino, P. ;
Garcia-Garcia, M. M. ;
Citores, R. ;
Gandia, F. ;
Almansa, R. ;
Blanco, J. .
JOURNAL OF INTERNAL MEDICINE, 2014, 276 (04) :404-412
[3]   Immunosuppression in Patients Who Die of Sepsis and Multiple Organ Failure [J].
Boomer, Jonathan S. ;
To, Kathleen ;
Chang, Kathy C. ;
Takasu, Osamu ;
Osborne, Dale F. ;
Walton, Andrew H. ;
Bricker, Traci L. ;
Jarman, Stephen D., II ;
Kreisel, Daniel ;
Krupnick, Alexander S. ;
Srivastava, Anil ;
Swanson, Paul E. ;
Green, Jonathan M. ;
Hotchkiss, Richard S. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2011, 306 (23) :2594-2605
[4]   The clinical efficacy of intravenous IgM-enriched immunoglobulin (pentaglobin) in sepsis or septic shock: a meta-analysis with trial sequential analysis [J].
Cui, Jie ;
Wei, Xuxia ;
Lv, Haijin ;
Li, Yuntao ;
Li, Ping ;
Chen, Zhen ;
Liu, Genglong .
ANNALS OF INTENSIVE CARE, 2019, 9 (1)
[5]  
DELLINGER RP, 2013, INTENS CARE MED, V39, P165, DOI [DOI 10.1007/s00134-012-2769-8, DOI 10.1097/CCM.0B013E31827E83AF]
[6]   Improving outcomes of severe infections by multidrug-resistant pathogens with polyclonal IgM-enriched immunoglobulins [J].
Giamarellos-Bourboulis, E. J. ;
Tziolos, N. ;
Routsi, C. ;
Katsenos, C. ;
Tsangaris, I. ;
Pneumatikos, I. ;
Vlachogiannis, G. ;
Theodorou, V. ;
Prekates, A. ;
Antypa, E. ;
Koulouras, V. ;
Kapravelos, N. ;
Gogos, C. ;
Antoniadou, E. ;
Mandragos, K. ;
Armaganidis, A. .
CLINICAL MICROBIOLOGY AND INFECTION, 2016, 22 (06) :499-506
[7]   Complex Immune Dysregulation in COVID-19 Patients with Severe Respiratory Failure [J].
Giamarellos-Bourboulis, Evangelos J. ;
Netea, Mihai G. ;
Rovina, Nikoletta ;
Akinosoglou, Karolina ;
Antoniadou, Anastasia ;
Antonakos, Nikolaos ;
Damoraki, Georgia ;
Gkavogianni, Theologia ;
Adami, Maria-Evangelia ;
Katsaounou, Paraskevi ;
Ntaganou, Maria ;
Kyriakopoulou, Magdalini ;
Dimopoulos, George ;
Koutsodimitropoulos, Ioannis ;
Velissaris, Dimitrios ;
Koufargyris, Panagiotis ;
Karageorgos, Athanassios ;
Katrini, Konstantina ;
Lekakis, Vasileios ;
Lupse, Mihaela ;
Kotsaki, Antigone ;
Renieris, George ;
Theodoulou, Danai ;
Panou, Vassiliki ;
Koukaki, Evangelia ;
Koulouris, Nikolaos ;
Gogos, Charalambos ;
Koutsoukou, Antonia .
CELL HOST & MICROBE, 2020, 27 (06) :992-+
[8]   Kinetics of circulating immunoglobulin M in sepsis: relationship with final outcome [J].
Giamarellos-Bourboulis, Evangelos J. ;
Apostolidou, Efterpi ;
Lada, Malvina ;
Perdios, Ioannis ;
Gatselis, Nikolaos K. ;
Tsangaris, Iraklis ;
Georgitsi, Marianna ;
Bristianou, Magdalini ;
Kanni, Theodora ;
Sereti, Kalliopi ;
Kyprianou, Miltiades A. ;
Kotanidou, Anastasia ;
Armaganidis, Apostolos .
CRITICAL CARE, 2013, 17 (05)
[9]   Use of polyclonal immunoglobulins as adjunctive therapy for sepsis or septic shock [J].
Kreyrnann, K. Georg ;
de Heer, Geraldine ;
Nierhaus, Axel ;
Kluge, Stefan .
CRITICAL CARE MEDICINE, 2007, 35 (12) :2677-2685
[10]   Survival benefit associated with clarithromycin in severe community-acquired pneumonia: A matched comparator study [J].
Kyriazopoulou, Evdoxia ;
Sinapidis, Dimitrios ;
Halvatzis, Stamatios ;
Velissaris, Dimitrios ;
Alexiou, Nikolaos ;
Kosmas, Vasilios ;
Adami, Maria-Evangelia ;
Kyprianou, Miltiades ;
Kyprianou, Aikaterini ;
Stefos, Aggelos ;
Lada, Malvina ;
Koutoukas, Pantelis ;
Pavlaki, Maria ;
Kyriakoudi, Anna ;
Makina, Anna ;
Gogos, Charalambos ;
Niederman, Michael S. ;
Giamarellos-Bourboulis, Evangelos J. .
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2020, 55 (01)