Effects of pentoxifyllin and PentaglobinO on TNF and IL-6 production in septic patients.

Pentoxifylline inhibited the TNF production of purified human white blood cells and whole blood cultures stimulated either by LPS or by Staphylococcus aureus. PTX did not influence the CD14 expression. The in vitro TNF and IL-6-producing capacities of septic patients were higher than in the control group. Administration of PTX to septic patients resulted in the normalization of TNF synthesis and in a moderate decrease in IL-6 production. It also subsequently led to an improvement in the clinical status. A further improvement in APACHE II score could be achieved by administration of PentaglobinO (Biotest). The prevention of in vitro TNF production by PentaglobinO could be demonstrated involving the use of whole blood rather than purified lymphocytes. The level of soluble ICAM-1 in the serum of septic patients was significantly higher than in normal individuals, but it decreased following PTX and PentaglobinO therapy. It is presumed that PTX and PentaglobinO can antagonize cytokine production at different levels, resulting in synergistic action that is beneficial in the treatment of sepsis.