Monoclonal anti-endotoxin antibodies for the treatment of gram-negative bacteremia and septic shock
- 1 October 1990
- journal article
- conference paper
- Published by Springer Nature in European Journal of Clinical Microbiology & Infectious Diseases
- Vol. 9 (10) , 711-716
- https://doi.org/10.1007/bf02184682
Abstract
The role of anti-endotoxin antibodies in the management of gram-negative bacteremia and the experimental and clinical studies on the cross-protection afforded by core LPS antibodies are reviewed. These studies did not achieve clarification of the epitope(s) and effector mechanism(s) involved in protection. Recently, two anti-lipid A IgM monoclonal antibodies, designated E5 and HA-1A, have been investigated in patients with gram-negative bacterial infections and clinical manifestations of septicemia. E5 reduced the mortality of patients if they were not in shock, whether they were bacteremic or not. A confirmatory study has been initiated. In contrast to E5, HA-1A protected patients whether they were in shock or not, but only when they were bacteremic at randomization. Although these studies suggest beneficial effects, the type of patients who may benefit from this expensive therapy should be further defined. Further investigations are needed to clarify the mechanisms of protection of these antibodies.Keywords
This publication has 31 references indexed in Scilit:
- Structural Studies on the Hexose Region of the Core in Lipopolysaccharides from EnterobacteriaceaeEuropean Journal of Biochemistry, 2005
- Association between protective efficacy of anti-lipopolysaccharide (LPS) antibodies and suppression of LPS-induced tumor necrosis factor alpha and interleukin 6. Comparison of O side chain-specific antibodies with core LPS antibodies.The Journal of Experimental Medicine, 1990
- Specificity and Cross-Reactivity of Monoclonal Antibodies Reactive with the Core and Lipid A Regions of Bacterial LipopolysaccharideThe Journal of Infectious Diseases, 1989
- Treatment of Gram-Negative Septic Shock with Human IgG Antibody to Escherichia coli J5: A Prospective, Double-Blind, Randomized TrialThe Journal of Infectious Diseases, 1988
- Effect of High-Dose Glucocorticoid Therapy on Mortality in Patients with Clinical Signs of Systemic SepsisNew England Journal of Medicine, 1987
- A Controlled Clinical Trial of High-Dose Methylprednisolone in the Treatment of Severe Sepsis and Septic ShockNew England Journal of Medicine, 1987
- Monoclonal antibodies detecting novel structures in the core region ofSalmonella minnesotalipopolysaccharideFEMS Microbiology Letters, 1987
- NALOXONE VERSUS PLACEBO IN TREATMENT OF SEPTIC SHOCKThe Lancet, 1985
- Treatment of Gram-Negative Bacteremia and Shock with Human Antiserum to a MutantEscherichia coliNew England Journal of Medicine, 1982
- Bacteremia at Boston City Hospital: Occurrence and Mortality during 12 Selected Years (1935-1972), with Special Reference to Hospital-Acquired CasesThe Journal of Infectious Diseases, 1975