Clinical, laboratory features and prognosis of children receiving IgM-enriched immunoglobulin (3 days vs. 5 days) as adjuvant treatment for serious infectious disease in pediatric intensive care unit: a retrospective single-center experience (PIGMENT study)

Abdullayev, Emin; Kılıç, Ömer; Bozan, Gürkan; Kıral, Eylem; Nepesov, Merve İşeri; Dinleyici, Ener Çağrı

doi:10.1080/21645515.2019.1711298

Cited by 5 publications

(2 citation statements)

References 34 publications

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“…The retrospective PIGMENT study, which included 254 pediatric patients with a median age of 13 months with either sepsis, septic shock or multi-organ failure, compared 3-day and 5-day treatment with IgM-enriched immunoglobulin adjunctive therapy (250 mg/kg/day) ( 55 ). Although the absence of a control group precluded its inclusion in the current analysis, the study reported a significant reduction in mortality rate with longer treatment durations.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of IgM-enriched immunoglobulin as adjunctive therapy in neonatal and pediatric sepsis: a systematic review and meta-analysis

et al. 2023

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BackgroundSepsis is a major cause of mortality and morbidity globally, with around one-quarter of all sepsis-related deaths occurring in children under the age of 5. We conducted a meta-analysis and systematic review of the literature to evaluate the clinical effectiveness of an IgM-enriched immunoglobulin preparation in pediatrics patients and neonates with sepsis.MethodsSystematic searches of PubMed, the Cochrane Library and Embase databases were performed in November 2022, with no date limitations, to identify studies in which IgM-enriched immunoglobulin was used as adjunctive therapy in neonatal and pediatric patients with sepsis.ResultsIn total, 15 studies fulfilled the eligibility criteria, 13 neonatal studies and 2 pediatric studies. Pooled estimates from all studies indicated that mortality rates were significantly lower in patients who received treatment with the IgM-enriched immunoglobulin compared with controls (OR 0.41; 95% CI 0.32–0.55). Further analyses in neonatal studies, alone, showed a significant benefit with longer treatment durations (>3 days) vs. the recommended treatment duration (3 days) (OR 0.32; 95% CI 0.22–0.47) vs. (OR 0.61; 95% CI 0.41–0.92). Treatment with IgM-enriched immunoglobulin was associated with a lower mortality risk compared with controls in prospective studies vs. retrospective analyses (OR 0.37; 95% CI 0.27–0.51) vs. (OR 0.73; 95% CI 0.41–1.30).ConclusionsThis systematic review suggests that adjunctive treatment with IgM-enriched immunoglobulin may reduce the risk of mortality in neonatal and pediatric populations. However, large randomized controlled trials are required to further substantiate and evaluate these findings.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of IgM-enriched immunoglobulin as adjunctive therapy in neonatal and pediatric sepsis: a systematic review and meta-analysis

et al. 2023

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“…Therefore, the supplementation of all three classes seems to be a promising strategy ( 161 ). Pentaglobin has been investigated in numerous clinical trials for the adjunctive therapy of sepsis in adult ( 141 – 143 ) and in several trials in paediatric patients and neonates with sepsis ( 180 – 183 ). As mentioned in several reviews the additional IgM- and IgA-components in Pentaglobin mediate beneficial effects in the treatment of inflammatory diseases compared to IVIg ( 100 , 126 , 151 , 161 , 177 , 184 ).…”

Section: Iga As Therapeutic Antibodymentioning

confidence: 99%

A new hope? Possibilities of therapeutic IgA antibodies in the treatment of inflammatory lung diseases

Bohländer

2023

Front. Immunol.

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Inflammatory lung diseases represent a persistent burden for patients and the global healthcare system. The combination of high morbidity, (partially) high mortality and limited innovations in the last decades, have resulted in a great demand for new therapeutics. Are therapeutic IgA antibodies possibly a new hope in the treatment of inflammatory lung diseases? Current research increasingly unravels the elementary functions of IgA as protector against infections and as modulator of overwhelming inflammation. With a focus on IgA, this review describes the pathological alterations in mucosal immunity and how they contribute to chronic inflammation in the most common inflammatory lung diseases. The current knowledge of IgA functions in the circulation, and particularly in the respiratory mucosa, are summarized. The interplay between neutrophils and IgA seems to be key in control of inflammation. In addition, the hurdles and benefits of therapeutic IgA antibodies, as well as the currently known clinically used IgA preparations are described. The data highlighted here, together with upcoming research strategies aiming at circumventing the current pitfalls in IgA research may pave the way for this promising antibody class in the application of inflammatory lung diseases.

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Algorithm for predicting sepsis in newborns with respiratory pathology and perinatal lesions of the central nervous system on mechanical ventilation

Pukhtinskaya

Эстрин

2022

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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BACKGROUND: Predicting sepsis in ventilated neonates remains a challenge in neonatology. AIM: To increase the efficiency of predicting sepsis diagnosis in newborns by developing a decision rule for its development based on decision trees. MATERIALS AND METHODS: This clinical study retrospectively reviewed 200 full-term newborns with respiratory pathology that are admitted to the intensive care unit and are on mechanical ventilation without clinical signs of bacterial infection. Upon admission to the department on days 1, 35, and 20, an enzyme-linked immunosorbent assay determined the plasma concentration of interleukin (IL)-1, IL-6, IL-8, tumor necrosis factor-, granulocyte colony-stimulating factor, soluble Fas ligand, fibroblast growth factors, and nitric oxide (NO), and immunophenotyping method determined CD3+CD19, CD3CD19+, CD3+CD4+, CD3+CD8+, CD69+, CD71+, CD95+, HLADR+, CD34+, CD14+, CD3CD56+; lymphocytes expressing AnnexinV-FITC+PI, and AnnexinV-FITC+PI+. The possibility of diagnosing sepsis upon intensive care unit admission was assessed by statistical cluster analysis of the total studied immunological criteria. The method of decision trees in the statistical environment R formed a diagnostic rule for predicting sepsis. RESULTS: Visualization of the cluster analysis results of admitted patients did not exclude the presence of two clusters among them (with and without sepsis, which explain the 60.81% of the point variability). Sepsis prediction rule are as follows: disease progression occurs if on day 1 CD95 is 16.8% and NO is 9.6 mkmol/l or CD95 is 16.8%, CD34 is 0.2%, CD69 is 4.12% or CD95 is 16.8%, CD34 is 0.2%, CD69 is 4.12%, and lymphocytes expressing AnnexinV-FITC+PI is 12.3%. The diagnostic accuracy was 96.00%; sensitivity was 97.00%; specificity was 94.90%; the false-positive proportion of diagnoses was 5.10%; the false-negative proportion of diagnoses was 2.94%; the positive result accuracy was 95.19%; and the negative result was 96.88%. The disease was complicated by bacterial sepsis development on 45 days of observation in 45 newborns. CONCLUSIONS: Significant importance in sepsis development belongs to the prevalence of altered immunocompetent cells over proliferation and endogenous synthesis of nitric oxide. The cumulative determination of CD95+, CD69+, AnnexinV-FITC+PI, CD34+, and plasma nitric oxide concentration helped diagnose sepsis development at the preclinical stage. The obtained results indirectly confirm the relevance of studies on sepsis prevention and treatment by drug correction of apoptosis and inhaled NO.

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Clinical, laboratory features and prognosis of children receiving IgM-enriched immunoglobulin (3 days vs. 5 days) as adjuvant treatment for serious infectious disease in pediatric intensive care unit: a retrospective single-center experience (PIGMENT study)

Cited by 5 publications

References 34 publications

Clinical efficacy of IgM-enriched immunoglobulin as adjunctive therapy in neonatal and pediatric sepsis: a systematic review and meta-analysis

Clinical efficacy of IgM-enriched immunoglobulin as adjunctive therapy in neonatal and pediatric sepsis: a systematic review and meta-analysis

A new hope? Possibilities of therapeutic IgA antibodies in the treatment of inflammatory lung diseases

Algorithm for predicting sepsis in newborns with respiratory pathology and perinatal lesions of the central nervous system on mechanical ventilation

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