Busani Stefano, Roat Erika, Tosi Martina, Biagioni Emanuela, Coloretti Irene, Meschiari Marianna, Gelmini Roberta, Brugioni Lucio, De Biasi Sara, Girardis Massimo
Intensive Care Unit, University Hospital Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
Infectious Diseases Unit, University Hospital Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
Front Med (Lausanne). 2021 Feb 18;8:616511. doi: 10.3389/fmed.2021.616511. eCollection 2021.
Septic shock still has a high mortality rate which has not hinted at decreasing in recent years. Unfortunately, randomized trials failed mainly because the septic patient was considered as a homogeneous entity. All this creates a sort of therapeutic impotence in everyday clinical practice in treating patients with septic shock. The need to customize therapy on each patient with sepsis has now become an established necessity. In this scenario, adjuvant therapies can help if interpreted as modulators of the immune system. Indeed, the host's immune response differs from patient to patient based on the virulence of the pathogen, comorbidity, infection site, and prolonged hospitalization. In this review, we summarize the rationale for using immunoglobulins as an adjunctive treatment. Furthermore, we would like to suggest a possible protocol to personalize treatment in the different clinical scenarios of the host's response to serious infectious events.
脓毒性休克的死亡率仍然很高，近年来并无下降趋势。不幸的是，随机试验大多失败了，主要原因是脓毒症患者被视为一个同质化的群体。所有这些都在日常临床实践中造成了治疗脓毒性休克患者时的某种治疗无力感。针对每位脓毒症患者定制治疗方案的需求现已成为既定的必要做法。在这种情况下，如果将辅助治疗理解为免疫系统的调节剂，那么辅助治疗会有所帮助。事实上，基于病原体的毒力、合并症、感染部位以及长期住院情况，宿主的免疫反应因人而异。在本综述中，我们总结了使用免疫球蛋白作为辅助治疗的基本原理。此外，我们想提出一个可能的方案，以便在宿主对严重感染事件的不同临床反应场景中实现个性化治疗。
