Article

Immunotherapy improves immune homeostasis and increases survival rate of septic patients.

Department of Surgical Intensive Care Unit, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Chinese Journal of Traumatology (English Edition) 12/2009; 12(6):344-9. pp.344-9
Source: PubMed

ABSTRACT To investigate the efficacy of immunotherapy on septic patients with Ulinastatin plus Thymosin-alpha(1).
Seventy postoperative septic patients were divided into two groups at random: the immunotherapy group (n equal to 36) and the conventional therapy group (n=34). Patients in the immunotherapy group received intravenous Ulinastatin of 200 000 U, 3 times per day for 3 days, Ulinastatin of 100 000 U, 3 times per day for 4 days, and subcutaneous injection of Thymosin-alpha(1) of 1.6 mg, twice per day for 3 days, then once per day for 4 days. While conventional therapies such as antibiotics and fluid resuscitation were undertaken in both groups. The expression levels of serum tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10), IgG, C3, T lymphocyte subsets, CD14+ monocyte human leukocyte antigen (locus) DR (HLA-DR) and patients'28-day survival rate of the two groups were observed and evaluated.
The survival rate was significantly higher in the immunotherapy group (63.9%; 23/36) compared with the conventional therapy group (41.2%; 14/34). The serum TNF-alpha levels [(1.38+/-0.50) ng/ml in the immunotherapy group vs (1.88+/-0.53) ng/ml in the conventional group, P less than 0.05] and the serum IL-10 levels [(217.52+/-15.71) ng/ml vs (101.53+/-16.57) ng/ml, P less than 0.05] were significantly different between the two groups. The serum IgG levels in the immunotherapy group [(17.65+/-6.81) g/L] were significantly higher than in the conventional group [(11.94+/-5.32) g/L]. There were also significant differences in the expression levels of CD4+ T lymphocyte (35%+/-13% in the immunotherapy group vs 21%+/-7% in the conventional group, P less than 0.05) and CD14+ monocyte HLA-DR (50%+/-5% in the former vs 35%+/-4% in the latter, P less than 0.05).
Immunotherapy with Ulinastatin plus Thymosin-alpha(1) can enhance the inflammatory response, improve the immune homeostasis, and increase the survival rate of septic patients.

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Keywords

3 days
 
3 times
 
4 days
 
antibiotics
 
CD14+ monocyte HLA-DR
 
CD14+ monocyte human leukocyte antigen
 
CD4+ T lymphocyte
 
conventional therapies
 
conventional therapy group
 
fluid resuscitation
 
immune homeostasis
 
Immunotherapy
 
immunotherapy group
 
intravenous Ulinastatin
 
patients'28-day survival rate
 
postoperative septic patients
 
serum tumor necrosis factor-alpha
 
subcutaneous injection
 
survival rate
 
T lymphocyte subsets
 

Shun-Wei Huang