Barekzi N A, Poelstra K A, Felts A G, Rojas I A, Slunt J B, Grainger D W
Anthony G. Gristina Institute for Biomedical Research (formerly Medical Sciences Research Institute), Inc., Herndon, Virginia 20170, USA.
Antimicrob Agents Chemother. 1999 Jul;43(7):1609-15. doi: 10.1128/AAC.43.7.1609.
Infectious peritonitis results from bacterial contamination of the abdominal cavity. Conventional antibiotic treatment is complicated both by the emergence of antibiotic-resistant bacteria and by increased patient populations intrinsically at risk for nosocomial infections. To complement antibiotic therapies, the efficacy of direct, locally applied pooled human immunoglobulin G (IgG) was assessed in a murine model (strains CF-1, CD-1, and CFW) of peritonitis caused by intraperitoneal inoculations of 10(6) or 10(7) CFU of Pseudomonas aeruginosa (strains IFO-3455, M-2, and MSRI-7072). Various doses of IgG (0.005 to 10 mg/mouse) administered intraperitoneally simultaneously with local bacterial challenge significantly increased survival in a dose-dependent manner. Local intraperitoneal application of 10 mg of IgG increased animal survival independent of either the P. aeruginosa or the murine strains used. A local dose of 10 mg of IgG administered up to 6 h prophylactically or at the time of bacterial challenge resulted in 100% survival. Therapeutic 10-mg IgG treatment given up to 12 h postinfection also significantly increased survival. Human IgG administered to the mouse peritoneal cavity was rapidly detected systemically in serum. Additionally, administered IgG in peritoneal lavage fluid samples actively opsonized and decreased the bacterial burden via phagocytosis at 2 and 4 h post-bacterial challenge. Tissue microbial quantification studies showed that 1.0 mg of locally applied IgG significantly reduced the bacterial burden in the liver, peritoneal cavity, and blood and correlated with reduced levels of interleukin-6 in serum.
感染性腹膜炎是由腹腔细菌污染引起的。传统抗生素治疗因抗生素耐药菌的出现以及医院感染内在风险增加的患者群体增多而变得复杂。为了补充抗生素治疗,在由腹腔接种10(6)或10(7)CFU铜绿假单胞菌(菌株IFO - 3455、M - 2和MSRI - 7072)引起的腹膜炎小鼠模型(CF - 1、CD - 1和CFW菌株)中评估了直接局部应用混合人免疫球蛋白G(IgG)的疗效。与局部细菌攻击同时腹腔内给予各种剂量的IgG(0.005至10mg/小鼠)以剂量依赖方式显著提高了存活率。局部腹腔应用10mg IgG可提高动物存活率,而与所使用的铜绿假单胞菌或小鼠菌株无关。预防性给予10mg IgG局部剂量长达6小时或在细菌攻击时给予,可使存活率达到100%。感染后12小时内给予治疗性10mg IgG治疗也显著提高了存活率。给予小鼠腹腔的人IgG在血清中很快被全身检测到。此外,在细菌攻击后2小时和4小时,腹腔灌洗液样本中给予的IgG可积极调理并通过吞噬作用降低细菌负荷。组织微生物定量研究表明,局部应用1.0mg IgG可显著降低肝脏、腹腔和血液中的细菌负荷,并与血清中白细胞介素-6水平降低相关。