AI Article Synopsis
- - The study examines the impact of intravenous polyspecific immunoglobulin G (IVIG) as a treatment for necrotising soft-tissue infection (NSTI) and its effects on inflammatory cytokines within the first three days of administration.
- - In the analysis of data from the INSTINCT trial involving 100 ICU patients, it was found that IVIG did not significantly alter the overall inflammatory response, except for a higher level of TNF in the IVIG group compared to placebo.
- - Ultimately, the research concludes that IVIG did not effectively lower the concentrations of inflammatory cytokines in NSTI patients during the initial three days of treatment.
Article Abstract
Background: A marked inflammatory response in necrotising soft-tissue infection (NSTI) may contribute to the severe clinical course. Intravenous polyspecific immunoglobulin G (IVIG) is used by some as adjuvant treatment for NSTI, but in the randomised INSTINCT trial, no effect of IVIG in NSTI patients was seen on physical quality of life. In experimental studies, IVIG may induce immunosuppressive effects by reducing the pro-inflammatory response and neutralising circulating superantigens. However, data on the potential immunomodulatory effects are sparse and remain to be investigated in a clinical setting. In this post hoc analysis of the INSTINCT trial, we aimed to assess the effect of IVIG on various inflammatory cytokines up to day 3 after randomisation.
Methods: Tumour necrosis factor (TNF), interleukin-1β, interleukin-6, interleukin-10 and granulocyte colony-stimulating factor were measured at admission, days 1, 2 and 3.
Results: A total of 100 ICU patients with NSTI were included; 50 were allocated to IVIG (25 g/d for 3 days) and 50 to placebo. No difference in the overall inflammatory response was observed between groups except from TNF, which was higher in the IVIG group as compared to the placebo group (area under curve-admission to day 3, 93.6 vs 60.2, P = .02). Similarly, no differences were observed in percentage change from baseline to day 3 in any of the studied cytokines between patients allocated to IVIG group and those allocated to placebo group.
Conclusion: In ICU patients with NSTI, IVIG did not reduce the plasma concentration of cytokines in the first 3 days.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/aas.13942 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!