[Monoclonal antibodies in the treatment of sepsis caused by Gram-negative microorganisms].

In spite of the advances attained in the diagnosis and early intervention with antibiotics, morbidity and mortality associated with sepsis caused by Gram-negative bacteria are high. The mediators responsible for the pathogenesis of the sepsis are components derived from the own bacteria (endotoxins) and from the cells of the immune response of the host (tumor necrosis factor and some interleukins). The treatment traditionally used in sepsis is mainly directed against microorganisms by the use of increasingly potent antibiotics. However, it is clear that antibiotics are not a definitive solution, since even when they cause bacterial death, they have no effects on endotoxin and may increase their liberation when cellular lysis occurs. New and successful treatments for sepsis have been tried since the 1980's, including the use of polyclonal and monoclonal antibodies of murine and human origin, directed against the lipid A of the endotoxin, as well as monoclonal antibodies against the tumor necrosis factor. Although these molecules are not completely efficient for the interruption of the chain of undesirable events provoked by the endotoxin, it is valid to accept the appearance of immunotherapies as an adjuvant treatment for a condition that threatens life.