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中性粒细胞减少宿主实验性铜绿假单胞菌肺炎的被动免疫治疗

Passive immune therapy for experimental Pseudomonas aeruginosa pneumonia in the neutropenic host.

作者信息

Pennington J E, Small G J

出版信息

J Infect Dis. 1987 May;155(5):973-8. doi: 10.1093/infdis/155.5.973.

Abstract

Studies were conducted in guinea pigs, myelosuppressed by cyclophosphamide, for determination of whether passive immune therapy for Pseudomonas aeruginosa pneumonia would be useful in the setting of neutropenia. Groups of infected animals (14 per group) were treated with a single intravenous infusion of hyperimmune IgG antibody to P. aeruginosa (PA-IGIV; 500 mg/kg), tobramycin (1.7 mg/kg per 8 hr), ticarcillin (120 mg/kg per 6 hr), or combinations of these regimens. Control groups received intravenous albumin solution. Survival rates were 0% with albumin only, 0% with PA-IGIV, 43% with tobramycin (P less than .05), 86% with tobramycin plus PA-IGIV (P less than .05 vs. tobramycin alone), 7% with ticarcillin, and 43% with ticarcillin plus PA-IGIV (.05 less than P less than .10 vs. ticarcillin alone). Additive intrapulmonary killing of P. aeruginosa and prevention of bacteremia were observed in animals treated with tobramycin plus PA-IGIV compared with either treatment alone. Thus, passive immune therapy for P. aeruginosa pneumonia may be useful in the neutropenic host, but only when used in conjunction with antimicrobial agents.

摘要

在环磷酰胺导致骨髓抑制的豚鼠身上进行了研究,以确定针对铜绿假单胞菌肺炎的被动免疫疗法在中性粒细胞减少的情况下是否有用。将感染的动物分组(每组14只),分别用单次静脉输注针对铜绿假单胞菌的超免疫IgG抗体(PA-IGIV;500mg/kg)、妥布霉素(每8小时1.7mg/kg)、替卡西林(每6小时120mg/kg)或这些方案的组合进行治疗。对照组接受静脉白蛋白溶液。仅用白蛋白的存活率为0%,用PA-IGIV的存活率为0%,用妥布霉素的存活率为43%(P<0.05),用妥布霉素加PA-IGIV的存活率为86%(与单用妥布霉素相比,P<0.05),用替卡西林的存活率为7%,用替卡西林加PA-IGIV的存活率为43%(与单用替卡西林相比,0.05<P<0.10)。与单独使用任何一种治疗方法相比,用妥布霉素加PA-IGIV治疗的动物观察到肺内对铜绿假单胞菌的协同杀灭作用和菌血症的预防。因此,针对铜绿假单胞菌肺炎的被动免疫疗法在中性粒细胞减少的宿主中可能有用,但仅当与抗菌药物联合使用时。

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