Intravenous immunoglobulins and haematopoietic growth factors in the prevention and treatment of neonatal sepsis: ground reality or glorified myths?

Abstract

Neonatal sepsis is a significant cause of morbidity and mortality in the neonatal intensive care unit. The epidemiology of neonatal infections is complex; however, they are in large part secondary to developmentally immature host defence mechanisms. These immunodeficiencies, which are exaggerated in premature and sick neonates, include quantitative and qualitative deficits in phagocytes, complement components, cytokines and immunoglobulins. Therapies that modulate or augment host defences may attenuate the virulence of neonatal infections. In this paper, we have reviewed immunotherapies that modulate the immune system of the neonate, including intravenous immunoglobulins and myeloid haematopoietic growth factors. Future studies should focus on investigating other abnormalities of neonatal host defence and/or combined immunotherapy approaches in an attempt to circumvent the immaturity of host defence and potentially reduce both the incidence and severity of neonatal sepsis.

Discussion issues and new strategies of intravenous immunoglobulins treatment in neonatal practice

“…К дополнительным эффектам препаратов ИГВВ можно отнести ограничение синдрома систем-ной воспалительной реакции, развивающегося вслед-ствие тяжелой инфекции [19].…”

Neonatal Meningitis

“…Neonatal sepsis may result in neutropenia, which is associated with a high mortality rate. 40,41 Because elevated concentrations of G-CSF are often detected in urine of infected infants, a lack of response may be due to dysfunction rather than quantity of endogenous G-CSF. 38,39 Granulocyte transfusions also have been found to be beneficial, but the lack of timely availability and donor screening has limited their routine use.…”

Immunoglobulins in the Prevention and Treatment of Neonatal Sepsis

“…The proteolytic enzymes released by the neutrophils are also damaging to the host tissue. Thus, immunoglobulins and neutrophils are responsible for both host defence and damage in the setting of overwhelming neonatal sepsis (6).…”