Intravenous immunoglobulin in sepsis: can we find the right dose?

Szakmány, Tamás

doi:10.23736/s0375-9393.18.13349-9

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Intravenous immunoglobulin is a therapeutic treatment with anti-infective, anti-inflammatory, and immunomodulatory effects ( Hamano et al, 2013 ; Di Rosa et al, 2014 ). Studies showed that intravenous immunoglobulin can serve as an important part of the adjuvant treatment of sepsis, but for 40 years the method is still controversial ( Hamano et al, 2013 ; Di Rosa et al, 2014 ; Szakmany, 2019 ; Jarczak et al, 2020 ). Esen et al found that the injection of immunoglobulin G or a combination of immunoglobulin A and M both exerted neuroprotective effects, which improved the integrity of the BBB, and alleviated the symptoms of sepsis in rats ( Esen et al, 2012 ) ( Figure 2 ).…”

Section: Bbb and Saementioning

confidence: 99%

Blood-Brain Barrier Disruption by Lipopolysaccharide and Sepsis-Associated Encephalopathy

Peng

Luo

et al. 2021

Front. Cell. Infect. Microbiol.

108

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As a complex multicellular structure of the vascular system at the central nervous system (CNS), the blood-brain barrier (BBB) separates the CNS from the system circulation and regulates the influx and efflux of substances to maintain the steady-state environment of the CNS. Lipopolysaccharide (LPS), the cell wall component of Gram-negative bacteria, can damage the barrier function of BBB and further promote the occurrence and development of sepsis-associated encephalopathy (SAE). Here, we conduct a literature review of the direct and indirect damage mechanisms of LPS to BBB and the relationship between these processes and SAE. We believe that after LPS destroys BBB, a large number of inflammatory factors and neurotoxins will enter and damage the brain tissue, which will activate brain immune cells to mediate inflammatory response and in turn further destroys BBB. This vicious circle will ultimately lead to the progression of SAE. Finally, we present a succinct overview of the treatment of SAE by restoring the BBB barrier function and summarize novel opportunities in controlling the progression of SAE by targeting the BBB.

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Section: Bbb and Saementioning

confidence: 99%

Blood-Brain Barrier Disruption by Lipopolysaccharide and Sepsis-Associated Encephalopathy

Peng

Luo

et al. 2021

Front. Cell. Infect. Microbiol.

108

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“…Sepsis remains a major cause of death worldwide. [1,2] Many studies have been performed to identify or evaluate potential biomarkers not only for early identification of patients with severe sepsis and their timely transfer to the intensive care unit (ICU) for early intervention but also for increasing the accurate prediction of their outcomes.…”

Section: Introductionmentioning

confidence: 99%

Nocturnal urine 6-hydroxy sulfate melatonin is associated with the outcome of subjects with sepsis

Chen

Pan

et al. 2022

Emerg Crit Care Med

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Background: It is imperative to identify potential biomarkers for early diagnosis and intervention of severe sepsis. This study investigated the relationship between melatonin secretion and outcome of sepsis after 28-day admission.Methods: Patients with sepsis were randomly divided into an eye mask group and a control group. Blood and urine samples were collected from day 0 to 4. Relevant clinical data and 28-day survival data were obtained. Serum melatonin and urine 6-hydroxy sulfate melatonin (6-SMT) levels were measured.Results: The outcome of sepsis did not differ between the eye mask and control groups. Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were significantly higher and monocyte human leukocyte antigen-DR (mHLA-DR), serum melatonin, nocturnal urine 6-SMT, and 24-hour urine 6-SMT levels were significantly lower in the nonsurvivors than in the survivors. The outcome at day 28 after admission was significantly associated with APACHE II and SOFA scores and mHLA-DR, nocturnal urine 6-SMT, and 24-hour urine 6-SMT levels. The areas under the receiver operating characteristic curve were 0.785, 0.740, 0.774, and 0.858 for APACHE II score, SOFA score, mHLA-DR expression, and nocturnal urine 6-SMT amount, respectively. The optimal thresholds for mHLA-DR and nocturnal urine 6-SMT were 30.13% and 43.60%, respectively. Nocturnal urine 6-SMT level was significantly and positively correlated with mHLA-DR expression.Conclusion: Nocturnal urine 6-SMT level may be a feasible biomarker to predict the outcome of patients with sepsis. The use of a night-time eye mask has no significant effect on the outcome of sepsis.Clinical trials: This study was registered at clinicaltrials.gov (NCT02304224).

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Outcomes of ICU patients treated with intravenous immunoglobulin for sepsis or autoimmune diseases

Tocut

Kolitz

Shovman

et al. 2022

Autoimmunity Reviews

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Intravenous immunoglobulin in sepsis: can we find the right dose?

Cited by 4 publications

References 11 publications

Blood-Brain Barrier Disruption by Lipopolysaccharide and Sepsis-Associated Encephalopathy

Blood-Brain Barrier Disruption by Lipopolysaccharide and Sepsis-Associated Encephalopathy

Nocturnal urine 6-hydroxy sulfate melatonin is associated with the outcome of subjects with sepsis

Outcomes of ICU patients treated with intravenous immunoglobulin for sepsis or autoimmune diseases

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