Felts A G, Giridhar G, Grainger D W, Slunt J B
Anthony G. Gristina Institute for Biomedical Research, USA.
Burns. 1999 Aug;25(5):415-23. doi: 10.1016/s0305-4179(99)00017-0.
The leading cause of morbidity and mortality in severe burn wound patients is infection. Treatment of burn wound infection is complicated by the emergence of antibiotic resistant organisms. A potential therapeutic alternative to antibiotic drugs is the local administration of polyclonal antibodies, termed passive local immunotherapy (PLI), directly to the burned tissue. A mouse burn wound infection model to simulate full thickness burn wound infection was used to evaluate the efficacy of passive local immunotherapy as a viable prophylactic or therapeutic agent. Pooled human immunoglobulins (IgG), delivered locally to the site of infection, are shown to be more effective at preventing fatal burn wound sepsis than treatment by intravenous infusion of IgG. A single 10 mg dose of human IgG administered locally to the burned, infected tissue site, either 24 hours prior to bacterial challenge, or within 3 hours after bacterial challenge, enhanced animal survival significantly (P < 0.001 and P < 0.05 respectively) compared to control animals. In addition, reduced levels of bacteria were found in local and systemic tissues of IgG-treated mice compared to control mice (P < 0.05). These data support the local use of polyclonal immunoglobulin preparations as an efficacious and cost effective means to prevent and treat burn wound infections.
严重烧伤创面患者发病和死亡的主要原因是感染。烧伤创面感染的治疗因抗生素耐药菌的出现而变得复杂。抗生素药物的一种潜在治疗替代方法是将多克隆抗体直接局部应用于烧伤组织，即被动局部免疫疗法（PLI）。使用模拟全层烧伤创面感染的小鼠烧伤创面感染模型来评估被动局部免疫疗法作为一种可行的预防或治疗药物的疗效。结果显示，局部给予感染部位的混合人免疫球蛋白（IgG）在预防致命性烧伤创面败血症方面比静脉输注IgG治疗更有效。在细菌攻击前24小时或细菌攻击后3小时，向烧伤感染组织部位局部给予单次10mg剂量的人IgG，与对照动物相比，显著提高了动物存活率（分别为P < 0.001和P < 0.05）。此外，与对照小鼠相比，在IgG治疗小鼠的局部和全身组织中发现细菌水平降低（P < 0.05）。这些数据支持局部使用多克隆免疫球蛋白制剂作为预防和治疗烧伤创面感染的有效且经济的手段。
