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Experimental Basis of New Therapeutic Approaches to Septic Shock

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Mediators of Sepsis

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 16))

Abstract

In 1982, the distinguished scientist, David Tyrrell, wrote a monograph entitled “ The Abolition of Infection: Hope or Illusion?” [1]. In it, he drew attention to the fact that the long-expected demise of infection as a “problem” was evidently not going to happen. Issues such as the development of antibiotic resistance in common bacteria, and the contribution of the host to the pathophysiological disease would, he said, require new and innovative approaches to the treatment of infection. The need for these new strategies was particularly apparent in the case of septic shock. Mortality was “stuck”, rising to 75% or more in established cases [2], and it was clear that this high mortality was not due simply to the inadequacy of antibiotics.

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References

  1. Tyrrell DA (1982) The abolition of infection. Hope or illusion? Nuffield Provincial Hospitals Trust, London, pp 1–66

    Google Scholar 

  2. Ispahani P, Pearson NJ, Greenwood D (1987) An analysis of community and hospital-acquired bacteraemia in a large teaching hospital in the United Kingdom. Q J Med 63:427–440

    PubMed  CAS  Google Scholar 

  3. Flohe L, Giertz H (1987) Endotoxins, arachidonic acid, Superoxide formation. Rev Infect Dis 9:553–561

    Article  Google Scholar 

  4. Hinshaw LB, Peduzzi P, Young E, et al. (1987) Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. N Engl J Med 317:659–665

    Article  Google Scholar 

  5. Bone RC, Fisher CJ Jr, Clemmer TP, Slotman GJ, Metz CA, Balk RA (1987) A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317:653–658

    Article  PubMed  CAS  Google Scholar 

  6. McConnell JS, Appelmelk BJ, Cohen J (1990) Dissociation between Limulus neutralisation and in vivo protection in monoclonal antibodies directed against endotoxin core structures. Microb Pathogen 9:55–59

    Article  CAS  Google Scholar 

  7. Pollack M, Chia JK, Koles NL, Miller M, Guelde G (1989) Specificity and cross-reactivity of monoclonal antibodies reactive with the core and lipid A regions of bacterial lipopolysaccha-ride. J Infect Dis 159:168–188

    Article  PubMed  CAS  Google Scholar 

  8. Heumann D; Baumgartner JD, Jacot-Guillarmod H, Glauser MP (1991) Antibodies to core li-popolysaccharide determinants: Absence of cross reactivity with heterologous lipopolysac-charides. J Infect Dis 163:762–768

    Article  PubMed  CAS  Google Scholar 

  9. Appelmelk BJ, Verweij-Van Vught AM, Maaskant JJ, Schouten WF, Thijs LG, MacLaren DM ( 1986) Use of mucin and hemoglobin in experimental murine gram-negative bacteremia enhances the immunoprotective action of antibodies reactive with the lipopolysaccharide core region. Antonie van Leeuwenhoek 52:537–542

    Article  PubMed  CAS  Google Scholar 

  10. Selye H, Tuchweber B, Bertok L (1966) Effect of lead acetate on the susceptibility of rats to bacterial endotoxins. J Bact 91:884–890

    PubMed  CAS  Google Scholar 

  11. Lehmann V, Freudenberg MA, Galanos C (1987) Lethal toxicity of lipopolysaccharide and tumor necrosis factor in normal and D-galactosamine-treated mice. J Exp Med 165:657–663

    Article  PubMed  CAS  Google Scholar 

  12. Overbeek BP, Veringa EM (1991) Role of antibodies and antibiotics in aerobic gram-negative septicemia: Possible synergism between antimicrobial treatment and immunotherapy. Rev Infect Dis 13:751–760

    Article  PubMed  CAS  Google Scholar 

  13. Silva AT, Bayston KF, Cohen J (1990) Prophylactic and therapeutic effects of a monoclonal antibody to tumor necrosis factor — alpha in experimental gram-negative shock. J Infect Dis 162:421–427

    Article  PubMed  CAS  Google Scholar 

  14. Opal SM, Cross AS, Kelly NM, et al. (1990) Efficacy of a monoclonal antibody directed against tumor necrosis factor in protecting neutropenic rats from lethal infection with Pseu-domonas aeruginosa. J Infect Dis 161:1148–1152

    Article  PubMed  CAS  Google Scholar 

  15. Young LS, Gascon R, Alam S, Bermudez LE (1989) Monoclonal antibodies for treatment of gram-negative infections. Rev Infect Dis 11(Supp 7): 1564–1571

    Article  Google Scholar 

  16. Shenep JL (1986) Antibiotic-induced bacterial cell lysis: A therapeutic dilemma. Eur J Clin Microbiol 5:11–12

    Article  PubMed  CAS  Google Scholar 

  17. Woods JP, Black JR, Barritt DS, Connell TD, Cannon JG (1987) Resistance to meningococ-cemia apparently conferred by anti-H.8 monoclonal antibody is due to contaminating endotoxin and not to specific immunoprotection. Infect Immun 55:1927–1928

    PubMed  CAS  Google Scholar 

  18. Gearing AJ, Leung H, Bird CR, Thorpe R (1989) Presence of the inflammatory cytokines IL-1, TNF, and IL-6 in preparations of monoclonal antibodies. Hybridoma 8:361–367

    Article  PubMed  CAS  Google Scholar 

  19. Beutler B, Milsark IW, Cerami A (1985) Passive immunization against cachectin/tumor necrosis factor protects mice from lethal effect of endotoxin. Science 229:869–871

    Article  PubMed  CAS  Google Scholar 

  20. Tracey KJ, Beutler B, Lowry SF, et al. (1986) Shock and tissue injury induced by recombinant human cachectin. Science 234:470–474

    Article  PubMed  CAS  Google Scholar 

  21. Rothstein JL, Schreiber H (1988) Synergy between tumor necrosis factor and bacterial products causes hemorrhagic necrosis and lethal shock in normal mice. Proc Natl Acad Sci USA 85:607–611

    Article  PubMed  CAS  Google Scholar 

  22. Kiener PA, Marek F, Rodgers G, Lin P-F, Warr G, Desiderio J (1988) Induction of tumor necrosis factor, IFN-gamma, and acute lethality in mice by toxic and non-toxic forms of Lipid A. J Immunol 141:870–874

    PubMed  CAS  Google Scholar 

  23. Silva AT, Appelmelk BJ, Buurman WA, Bayston KF, Cohen J (1990) Monoclonal antibody to endotoxin core protects mice from Escherichia coli sepsis by a mechanism independent of tumor necrosis factor and interleukin-6. J Infect Dis 162:454–459

    Article  PubMed  CAS  Google Scholar 

  24. Bagby GJ, Plessala KJ, Wilson LA, Thompson JJ, Nelson S (1991) Divergent efficacy of antibody to tumor necrosis factor alpha in intravascular and peritonitis models of sepsis. J Infect Dis 163:83–88

    Article  PubMed  CAS  Google Scholar 

  25. Freudenberg MA, Galanos C (1991) Tumor necrosis factor alpha mediates lethal activity of killed gram-negative and gram-positive bacteria in D-galactosamine-treated mice. Infect Immun 59:2110–2115

    PubMed  CAS  Google Scholar 

  26. Hinshaw LB, Emerson TE Jr, Taylor FB Jr, et al. (1992) Lethal Staphyococcus aureus-indu-ced shock in primates: Prevention of death with anti-TNF antibody. J Trauma (in press)

    Google Scholar 

  27. Wayte J, Silva AT, Cohen J (1991) Role of tumour necrosis factor (TNF) in experimental gram-positive sepsis. Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago. (Abst) 789

    Google Scholar 

  28. Natanson C, Danner RL, Elin RJ, et al. (1989) Role of endotoxemia in cardiovascular dysfunction and mortality. Escherichia coli and Staphylococcus aureus challenges in a canine model of human septic shock. J Clin Invest 83:243–251

    Article  PubMed  CAS  Google Scholar 

  29. Rokke O, Revhaug A, Osterud B, Giercksky ICE (1988) Increased plasma levels of endotoxin and corresponding changes in circulatory performance in a porcine sepsis model: The effect of antibiotic administration. Prog Clin Biol Res 272:247–262

    PubMed  CAS  Google Scholar 

  30. Okusawa S, Gelfand JA, Ikejima T, Connolly RJ, Dinarello CA (1988) Interleukin-1 induces a shock-like state in rabbits. Synergism with tumor necrosis factor and the effect of cy-clooxygenase inhibition. J Clin Invest 81:1162–1172

    Article  PubMed  CAS  Google Scholar 

  31. Weinberg JR, Wright DJ, Guz A (1988) Interleukin-1 and tumor necrosis factor cause hypotension in the conscious rabbit. Clin Sci 75:251–255

    PubMed  CAS  Google Scholar 

  32. Wakabayashi G, Gelfand JA, Jung WK, Connolly RJ, Burke JF, Dinarello CA (1991) Staphylococcus epidermidis induces complement activation, tumor necrosis factor and interleukin-1, a shockk-like state and tissue injury in rabbits without endotoxemia. Comparison to Escherichia coli. J Clin Invest 87:1925–1935

    Article  PubMed  CAS  Google Scholar 

  33. Natanson C, Eichenholz PW, Danner RL, et al. (1989) Endotoxin and tumor necrosis factor challenges in dogs simulate the cardiovascular profile of human septic shock. J Exp Med 169:823–832

    Article  PubMed  CAS  Google Scholar 

  34. Tracey KJ, Fong Y, Hesse DG, et al. (1987) Anti-cachectin/TNF monoclonal antibodies prevent septic shock during lethal bacteraemia. Nature 330:662–664

    Article  PubMed  CAS  Google Scholar 

  35. Minami A, Fujimoto K, Aozaki Y, Nakamura S (1988) Augmentation of host resistance to microbial infections by recombinant human interleukin-1 alpha. Infect Immun 56:3116–3120

    PubMed  CAS  Google Scholar 

  36. Hinshaw LB, Tekamp-Olson P, Chang AC, et al. (1990) Survival of primates in LD 100 septic shock following therapy with antibody to tumor necrosis factor (TNF alpha). Circ Shock 30:279–292

    PubMed  CAS  Google Scholar 

  37. Exley AR, Buurman WA, Bodmer M, Cohen J (1989) Monoclonal antibody to recombinant human tumor necrosis factor in the prophylaxis and treatment of endotoxic shock in Cyno-molgus monkeys. Clin Sci 76:50p

    Google Scholar 

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© 1992 Springer-Verlag Berlin Heidelberg

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Cohen, J. (1992). Experimental Basis of New Therapeutic Approaches to Septic Shock. In: Lamy, M., Thijs, L.G. (eds) Mediators of Sepsis. Update in Intensive Care and Emergency Medicine, vol 16. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84827-8_21

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  • DOI: https://doi.org/10.1007/978-3-642-84827-8_21

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-84829-2

  • Online ISBN: 978-3-642-84827-8

  • eBook Packages: Springer Book Archive

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