Chahin Abdullah, Opal Steven M, Zorzopulos Jorge, Jobes David V, Migdady Yazan, Yamamoto Michelle, Parejo Nicholas, Palardy John E, Horn David L
Infectious Disease Division, Memorial Hospital of Rhode Island and Alpert Medical School, Providence, Rhode Island, USA.
Infectious Disease Division, Memorial Hospital of Rhode Island and Alpert Medical School, Providence, Rhode Island, USA
Antimicrob Agents Chemother. 2015 Feb;59(2):1225-9. doi: 10.1128/AAC.03923-14. Epub 2014 Dec 15.
IMT504 is a novel immunomodulatory oligonucleotide that has shown immunotherapeutic properties in early preclinical and clinical studies. IMT504 was tested in a neutropenic rat model of Pseudomonas aeruginosa bacteremia and sepsis. This animal system recapitulates many of the pathological processes found in neutropenic patients with Gram-negative, bacterial infections. The research was conducted in the setting of an academic research laboratory. The test subjects were Sprague-Dawley rats. Animals were rendered neutropenic by administration of cyclophosphamide, colonized with P. aeruginosa by oral feeding, and then randomized to receive IMT504 over a range of doses and treatment regimens representing early and late therapeutic interventions. IMT504 immunotherapy conferred a significant survival advantage over the 12-day study period compared with the results seen with placebo-treated animals when the therapy was administered at the onset of neutropenia and even in the absence of antibiotics and after the onset of fever and systemic infection. Notably, even late salvage IMT504 monotherapy was highly effective (13/14 surviving rats with IMT504 therapy versus 2/14 controls, P=<0.001). Moreover, late salvage IMT504 monotherapy was as effective as antibiotic therapy (13/14 surviving rats versus 21/21 rats, P=0.88). In addition, no antagonism or loss of therapeutic efficacy was noted with combination therapy of IMT504 plus antibiotics. IMT504 immunotherapy provides a remarkable survival advantage in bacteremia and sepsis in neutropenic animals and deserves further study as a new treatment option in patients with, or at risk for, severe Gram-negative bacterial infections and sepsis.
IMT504是一种新型免疫调节寡核苷酸,在早期临床前和临床研究中已显示出免疫治疗特性。IMT504在铜绿假单胞菌菌血症和脓毒症的中性粒细胞减少大鼠模型中进行了测试。该动物系统概括了中性粒细胞减少的革兰氏阴性细菌感染患者中发现的许多病理过程。该研究在学术研究实验室环境中进行。测试对象为Sprague-Dawley大鼠。通过给予环磷酰胺使动物中性粒细胞减少,通过口服喂食使其感染铜绿假单胞菌,然后随机接受一系列剂量和治疗方案的IMT504,这些方案代表早期和晚期治疗干预。与安慰剂治疗动物的结果相比,当在中性粒细胞减少症发作时给予IMT504免疫治疗时,即使在没有抗生素以及发热和全身感染发作后,在12天的研究期内,IMT504免疫治疗也具有显著的生存优势。值得注意的是,即使是晚期挽救性IMT504单药治疗也非常有效(IMT504治疗组14只大鼠中有13只存活,而对照组为2/14,P<0.001)。此外,晚期挽救性IMT504单药治疗与抗生素治疗效果相同(13/14只存活大鼠与21/21只大鼠,P=0.88)。此外,IMT504加抗生素联合治疗未观察到拮抗作用或治疗效果丧失。IMT504免疫治疗在中性粒细胞减少动物的菌血症和脓毒症中提供了显著的生存优势,作为严重革兰氏阴性细菌感染和脓毒症患者或有风险患者的一种新治疗选择,值得进一步研究。