Use of Intravenous Immunoglobulin in Critically Ill Patients

Donovan, Summer; Bearman, Gonzalo

doi:10.1007/s11908-014-0447-4

Cited by 5 publications

(4 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Human IVIG is used as adjunctive therapy to treat toxic shock induced by staphylococcal and streptococcal superantigens (SAgs) with limited success 30–33 . This may relate to insufficient level of anti-toxin antibodies in IVIG.…”

Section: Resultsmentioning

confidence: 99%

“…Human immunoglobulin preparations have been used for treatment of streptococcal and staphylococcal TSS with limited success and their utility remains controversial 30–33 . We determined the concentration of anti-SEB antibodies in 28 lots of IVIG and found the median to be 121 μg/g IVIG (range 82–188).…”

Section: Discussionmentioning

confidence: 99%

“…Most people have been exposed to SA and have antibodies to SAgs and other SA toxins 29 . Intravenous immunoglobulin (IVIG) has been used to treat TSS caused by streptococcal and staphylococcal SAgs, however with limited success 30–33 . Thus, developing broadly cross-neutralizing vaccines and immunotherapeutics for SAgs is highly desirable.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

TBA225, a fusion toxoid vaccine for protection and broad neutralization of staphylococcal superantigens

Venkatasubramaniam

Adhikari

Kort

et al. 2019

Sci Rep

View full text Add to dashboard Cite

Superantigens (SAgs) play a major role in the pathogenesis of Staphylococcus aureus and are associated with several diseases, including food poisoning, bacterial arthritis, and toxic shock syndrome. Monoclonal antibodies to these SAgs, primarily TSST-1, SEB and SEA have been shown to provide protection in animal studies and to reduce clinical severity in bacteremic patients. Here we quantify the pre-existing antibodies against SAgs in many human plasma and IVIG samples and demonstrate that in a major portion of the population these antibody titers are suboptimal and IVIG therapy only incrementally elevates the anti-SAg titers. Our in vitro neutralization studies show that a combination of antibodies against SEA, SEB,and TSST-1 can provide broad neutralization of staphylococcal SAgs. We report a single fusion protein (TBA 225 ) consisting of the toxoid versions of TSST-1, SEB and SEA and demonstrate its immunogenicity and protective efficacy in a mouse model of toxic shock. Antibodies raised against this fusion vaccine provide broad neutralization of purified SAgs and culture supernatants of multiple clinically relevant S . aureus strains. Our data strongly supports the use of this fusion protein as a component of an anti-virulence based multivalent toxoid vaccine against S . aureus disease.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

TBA225, a fusion toxoid vaccine for protection and broad neutralization of staphylococcal superantigens

Venkatasubramaniam

Adhikari

Kort

et al. 2019

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Most previous trials have employed agents that neutralize pathogens or their products [e.g., intravenous immunoglobulin ( 123 ) and the anti-endotoxin antibody nebacumab ( 124 )], interfere with pathogen recognition by the host [e.g., the TLR4 antagonist eritoran ( 125 )], or target pro-inflammatory cytokines/mediators [e.g., the anti-TNF-α antibody afelimomab ( 126 ) and the recombinant TNF receptor p55–IgG1 Fc fusion protein lenercept ( 127 )] or their receptors [e.g., the IL-1 receptor antagonist anakinra ( 128 ) and the platelet-activating factor receptor antagonist lexipafant ( 129 )]. Pro-inflammatory cytokines sometimes exert redundant functions.…”

Section: Sepsismentioning

confidence: 99%

CD1d- and MR1-Restricted T Cells in Sepsis

et al. 2015

View full text Add to dashboard Cite

Dysregulated immune responses to infection, such as those encountered in sepsis, can be catastrophic. Sepsis is typically triggered by an overwhelming systemic response to an infectious agent(s) and is associated with high morbidity and mortality even under optimal critical care. Recent studies have implicated unconventional, innate-like T lymphocytes, including CD1d- and MR1-restricted T cells as effectors and/or regulators of inflammatory responses during sepsis. These cell types are typified by invariant natural killer T (iNKT) cells, variant NKT (vNKT) cells, and mucosa-associated invariant T (MAIT) cells. iNKT and vNKT cells are CD1d-restricted, lipid-reactive cells with remarkable immunoregulatory properties. MAIT cells participate in antimicrobial defense, and are restricted by major histocompatibility complex-related protein 1 (MR1), which displays microbe-derived vitamin B metabolites. Importantly, NKT and MAIT cells are rapid and potent producers of immunomodulatory cytokines. Therefore, they may be considered attractive targets during the early hyperinflammatory phase of sepsis when immediate interventions are urgently needed, and also in later phases when adjuvant immunotherapies could potentially reverse the dangerous state of immunosuppression. We will highlight recent findings that point to the significance or the therapeutic potentials of NKT and MAIT cells in sepsis and will also discuss what lies ahead in research in this area.

show abstract

The learning hospital: From theory to practice in a hospital infection prevention program

Hess

Srivastava

Pryor

et al. 2019

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

The learning hospital is distinguished by ceaseless evolution of erudition, enhancement, and implementation of clinical best practices. We describe a model for the learning hospital within the framework of a hospital infection prevention program and argue that a critical assessment of safety practices is possible without significant grant funding. We reviewed 121 peer-reviewed manuscripts published by the VCU Hospital Infection Prevention Program over 16 years. Publications included quasi-experimental studies, observational studies, surveys, interrupted time series analyses, and editorials. We summarized the articles based on their infection prevention focus, and we provide a brief summary of the findings. We also summarized the involvement of nonfaculty learners in these manuscripts as well as the contributions of grant funding. Despite the absence of significant grant funding, infection prevention programs can critically assess safety strategies under the learning hospital framework by leveraging a diverse collaboration of motivated nonfaculty learners. This model is a valuable adjunct to traditional grant-funded efforts in infection prevention science and is part of a successful horizontal infection control program.

show abstract

Use of Intravenous Immunoglobulin in Critically Ill Patients

Cited by 5 publications

References 77 publications

TBA225, a fusion toxoid vaccine for protection and broad neutralization of staphylococcal superantigens

TBA225, a fusion toxoid vaccine for protection and broad neutralization of staphylococcal superantigens

CD1d- and MR1-Restricted T Cells in Sepsis

The learning hospital: From theory to practice in a hospital infection prevention program

Contact Info

Product

Resources

About