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Investigational Therapy of Sepsis: Anti-TNF, IL-1ra, Anti-PAF and G-CSF

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Clinical Trials for the Treatment of Sepsis

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 19))

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Abstract

Severe sepsis and septic shock are widely recognized as serious clinical problems causing substantial morbidity and mortality [1], Despite modern antibiotics, state-of-the-art intensive care, and timely surgery, the sequelae of severe sepsis are seemingly dissociated in time from the underlying infection. Recent advances in the biology of inflammatory response to infection shed light on this apparent dissociation of tissue injury from the underlying infection [2]. Indeed, the host-derived factors of the inflammatory response that result in an effective defense against infection, may become exaggerated, causing severe sepsis and organ dysfunction syndrome [3–4]. These mediators of this response to infection could be ultimately responsible for the progression of the lethal sepsis.

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References

  1. Bone RC (1992) Toward an epidemiology and natural history of SIRS. JAMA 101: 1481–1483

    CAS  Google Scholar 

  2. Tracey KJ (1991) Tumor necrosis factor (cachectin) in the biology of septic shock syndrome. Circ Shock 35: 123–128

    PubMed  CAS  Google Scholar 

  3. Bone RC (1991) Physiopathology of sepsis. Ann Intern Med 115: 457–469

    PubMed  CAS  Google Scholar 

  4. Larrick JW (1989) Antibody inhibition of the immunoinflammatory cascade. J Crit Care 4: 211–224

    Article  Google Scholar 

  5. Dinarello CA, Gelfand JA, Wolff SM (1993) Anticytokine strategies in the treatment of the systemic inflammatory response syndrome. JAMA 269: 1829–1835

    Article  PubMed  CAS  Google Scholar 

  6. Dhainaut JF, Mira JP, Fierobe L (1994) Platelet-activating factor: Pathophysiological changes and therapeutic implications in sepsis. In: Reinhart K, Eyrich K, Sprung C (eds) Sepsis. Springer-Verlag, Berlin, pp 397–413

    Google Scholar 

  7. Braquet P, Paubert-Braquet M, Bourgain RH, Bussolino F, Hosford D (1989) PAF/ cytokines autoregulated feedback networks in microvascular injury: Consequences in shock, ischemia and graft rejection. J Lipid Med 1: 75–112

    CAS  Google Scholar 

  8. 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 

  9. Chang SW, Feddersen CO, Henson PM, Voelkel NF (1987) Platelet activating factor mediates hemodynamic changes and lung injury in endotoxin-treated rats. J Clin Invest 79: 1498–1509

    Article  PubMed  CAS  Google Scholar 

  10. Hesse DG, Tracey KJ, Fong Y, et al (1988) Cytokine appearance in human endotoxemia and primate bacteremia. Surg Gynecol Obstet 166: 147–153

    PubMed  CAS  Google Scholar 

  11. Girardin E, Grau GE, Dayer JM, et al and the J5 Study Group (1988) Tumor necrosis factor and interleukin-1 in the serum of children with severe infectious purpura. N Engl J Med 319: 397–400

    Article  PubMed  CAS  Google Scholar 

  12. Leaver HA, Qu JM, Smith G, Howie A, Ross WB, Yap PL (1990) Endotoxin releases platelet-activating factor from human monocytes in vitro. Immunopharmacology 20: 105–113

    Article  PubMed  CAS  Google Scholar 

  13. 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 

  14. Saunders RN, Handley DA (1987) PAF antagonists. Annu Rev Pharmacol Toxicol 27: 237–255

    Article  PubMed  CAS  Google Scholar 

  15. Fisher CJ, Opal SM, Dhainaut JF, et al (1993) Influence of an anti-tumor necrosis factor monoclonal antibody on cytokine levels in patients with sepsis. Crit Care Med 21: 318–327

    Article  PubMed  Google Scholar 

  16. Fast DJ, Schlievert PM, Nelson RD (1989) Toxic shock syndrome-associated staphylo-coccal and streptococcal pyogenic toxins are potent inducers of tumor necrosis factor production. Infect Immunol 57: 291–294

    CAS  Google Scholar 

  17. Cabellos C, Maclntyre DE, Forrest M, Burroughs M, Prasad S, Tuomanen E (1992) Differing roles for platelet-activating factor during inflammation of the lung and suba-rachnoid space. The special case of streptococcus pneumoniae. J Clin Invest 90: 612–618

    Article  PubMed  CAS  Google Scholar 

  18. Feuerstein G, Leader P, Siren AL, Braquet P (1987) Protective effect of a PAF-acether antagonist, BN 52021, in trichothecene toxicosis. Toxicology Letters 38: 271–274

    Article  PubMed  CAS  Google Scholar 

  19. O’Reilly M, Silver GM, Greenhalgh DG, et al (1992) Treatment of intra-abdominal infection with G-CSF. J Trauma 33: 679–682

    Article  PubMed  Google Scholar 

  20. Tracey KJ, Lowry SF, Fahey TJ III, et al (1987) Cachectin/tumor necrosis factor induces lethal shock and stress hormone responses in the dog. Surg Gynecol Obstet 164: 415–422

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  22. Remick DG, Kunkel RG, Larrick JW, et al (1987) Acute in vivo effects of human recombinant tumor necrosis factor. Lab Invest 56: 583 - 590

    PubMed  CAS  Google Scholar 

  23. Pfeffer K, Matsuyama T, Kundig TM, et al (1993) Mice deficient for the 55-kd TNF receptor are resistant to endotoxin shock, yet succumb to L. monocytogenes infection. Cell 73: 457 - 167

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  25. Fong Y, Tracey KJ, Moldawer LL, et al (1989) Antibodies to cachectin/TNF reduce interleukin-1 ß and interleukin-6 appearance during lethal bacteremia. J Exp Med 170: 1627 - 1633

    Article  PubMed  CAS  Google Scholar 

  26. Ashkenazi A, Marsters SA, Capon DJ (1991) Protection against endotoxic shock by a tumor necrosis factor receptor immunoadhesin. Proc Natl Acad Sei USA 88:10535–10539

    Article  CAS  Google Scholar 

  27. Hinshaw L, Olson P, Kuo G (1989) Efficacy of post-treatment with anti-TNF monoclonal antibody in preventing the pathophysiology and lethality of sepsis in the baboon. Circ Shock 27: 362 - 369

    Google Scholar 

  28. Emerson TE, Lindsey DC, Jesmok GJ, et al (1992) Efficacy of monoclonal antibody against TNF-a in an endotoxemic baboon model. Circ Shock 38: 75 - 84

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  30. 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 Pseudomonas aeruginosa. J Infect Dis 161: 1148 - 1152

    Article  PubMed  CAS  Google Scholar 

  31. Kindler V, Sappino AP, Grau GE, et al (1989) The inducing role of TNF in the development of bactericidal granulomas during BCG infection. Cell 56: 731 - 740

    Article  PubMed  CAS  Google Scholar 

  32. Exley AR, Cohen J, Buurman W, et al (1990) Monoclonal antibody to TNF in severe septic shock. Lancet 335: 1275 - 1277

    Article  PubMed  CAS  Google Scholar 

  33. Spooner C, Saravolatz L, Markowitz W, et al (1991) Safety and pharmacokinetics og murine antibody to human TNF. 31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago No 541 (Abst)

    Google Scholar 

  34. Wherry J, Abraham E, Wunderink R, et al (1994) Efficacy and safety of murine monoclonal antibody to human TNF (Bay x 1351). Intensive Care Med 20 (Suppl 1 ): S151 (Abst)

    Google Scholar 

  35. Zimmerman JL, Dillon K, Campbell W, Reinhart K (1994) Phase I/II trial of cA2, a chimeric anti-TNF antibody in patients with sepsis. Intensive Care Med 20 (Suppl 1 ): S151 (Abst)

    Google Scholar 

  36. Dhainaut JF, Vincent JL, Richard C (1994) CDP571, a CDR-grafted anti-human TNF antibody in septic shock: Safety, pharmacokinetics, and influence on cytokine levels. Am Rev Respir Dis (in press)

    Google Scholar 

  37. Reinhart K, Wiegand C, Kaul M (1994) Anti-TNF strategies with monoclonal antibody. Preliminary results with the specific monoclonal antibody MAK 195F. Intensive Care Med 20 (Suppl 1 ): S151 (Abst)

    Google Scholar 

  38. Kwiatkowski D, Molyneux ME, Stephens S, et al (1994) Response to monoclonal anti- TNF antibody in children with cerebral malaria. Q J Med (in press)

    Google Scholar 

  39. Beutler B, Milsark IW, Cerami A (1985) Cachectin/TNF: Production, distribution, and metabolic fate in vivo. J Immunol 135: 3972–3977

    PubMed  CAS  Google Scholar 

  40. Engelmann H, Novick D, Wallach D (1990) Two TNF-binding proteins purified from human urine: Evidence for immunological cross-reactivity with cell surface TNF receptors. J Biol Chem 265: 1531–1536

    PubMed  CAS  Google Scholar 

  41. van Zee KJ, Kohno T, Fischer E, et al (1992) TNF soluble receptors circulate during experimental and clinical inflammation and can protect against excessive TNF in vitro and in vivo. Proc Natl Acad Sei USA 89: 4845 - 4849

    Article  Google Scholar 

  42. Peppel K, Crawford D, Beutler B (1991) A TNF receptor-IgG heavy chain chimeric protein as a bivalent antagonist of TNF activity. J Exp Med 174: 1483 - 1489

    Article  PubMed  CAS  Google Scholar 

  43. Sadoff J (1994) Phase II clinical trial on soluble TNF receptors (preliminary results) (personal communication)

    Google Scholar 

  44. Beutler B, Grau G (1993) TNF in the pathogenesis of infectious diseases. Crit Care Med 21: S423 - S435

    Article  PubMed  CAS  Google Scholar 

  45. Eisenberg SP, Evans RJ, Arend WP, et al (1990) Primary structure and functional ex-pression from complementary DNA of a human interleukin-1 receptor antagonist. Nature 343: 341 - 346

    Article  PubMed  CAS  Google Scholar 

  46. Hannum CH, Wilcox CJ, Arend WP, et al (1990) Interleukin-1 receptor antagonist activity of a human interleukin-1 inhibitor. Nature 343: 336 - 340

    Article  PubMed  CAS  Google Scholar 

  47. Arend WP, Welgus HG, Thompson RC, et al (1990) Biological properties of recombinant human monocyte-derived interleukin-1 receptor antagonist. J Clin Invest 85: 1694 - 1697

    Article  PubMed  CAS  Google Scholar 

  48. Ohlsson K, Bjork P, Bergenfeld M, et al (1990) An interleukin-1 receptor antagonist reduces mortality from endotoxin shock. Nature 348: 550 - 552

    Article  PubMed  CAS  Google Scholar 

  49. Fischer E, Marano MA, Van Zee KJ, et al (1992) Interleukin-1 receptor blockade improves survival and hemodynamic performance in E. coli septic shock, but fails to alter host responses to sublethal endotoxemia. J Clin Invest 89: 1551 - 1557

    Article  PubMed  CAS  Google Scholar 

  50. Wakabayashi G, Gelfand JA, Burke JF, et al (1991) A specific receptor antagonist for interleukin-1 prevents Escherichia coli-induced shock in rabbits. FASEB J 5: 338 - 343

    PubMed  CAS  Google Scholar 

  51. Aiura K, Gelfand JA, Burke JF, et al (1993) Interleukin-1 receptor antagonist prevents Staphylococcus epidermis-induced hypotension and reduces circulating levels of tumor necrosis factor and IL-1 in rabbits. Infect Immunol 61: 3342 - 3350

    CAS  Google Scholar 

  52. Fischer E, VanZee KJ, Marano MA, et al (1992) Interleukin-1 receptor antagonist circulates in experimental inflammation and in human disease. Blood 79: 2196 - 2199

    PubMed  CAS  Google Scholar 

  53. Granowitz EV, Santos AA, Poutsiaica DD, et al (1991) Production of interleukin-1 receptor antagonist during experimental endotoxemia. Lancet 338: 1423 - 1424

    Article  PubMed  CAS  Google Scholar 

  54. Fischer E, Marano MA, Barber A, et al (1991) A comparison between the effects of IL-1 alpha administration and sublethal endotoxemia in primates. Am J Physiol 261: 442 - 452

    Google Scholar 

  55. Granowitz EV, Porat R, Mier JW, et al (1992) Pharmacokinetics safety, and immuno-modulatory effects of human recombinant interleukin-1 receptor antagonist in healthy humans. Cytokine 4: 353 - 360

    Article  PubMed  CAS  Google Scholar 

  56. Fisher CJ, Slotman GJ, Opal SM, et al (1994) Initial evaluation of human recombinant interleukin-1 receptor antagonist in the treatment of sepsis syndrome: A randomized, open-label, placebo-controlled multicenter trial. Crit Care Med 22: 12–21

    PubMed  Google Scholar 

  57. Fisher CJ, Dhainaut JF, Opal SM, et al (1994) Recombinant human interleukin-1 receptor antagonist reduces the mortality of patients with septic syndrome as a function of disease severity. JAMA (in press)

    Google Scholar 

  58. Knaus WA, Harreil F, Fisher CJ, et al (1993) The clinical evaluation of new drugs for sepsis: A prospective study design based on survival analysis. JAMA 270:1233–1241

    Article  PubMed  CAS  Google Scholar 

  59. Wallace JL, Whittle BJR (1986) Prevention of endotoxin-induced gastrointestinal damage by CV-3988, an antagonist of platelet-activating factor. Eur J Pharmacol 124:209–210

    Article  PubMed  CAS  Google Scholar 

  60. Terashita Z, Imura Y, Nishikawa K, Sumida S (1985) Is platelet activating factor (PAF) a mediator of endotoxin shock? Eur J Pharmacol 109: 257 - 263

    Article  PubMed  CAS  Google Scholar 

  61. Toyofuku T, Kubo K, Kobayashi T, Kusama S (1986) Effects of ONO-6240, a platelet activating factor antagonist, on endotoxin shock in unanesthetized sheep. Prostaglandins 31: 271 - 280

    Article  PubMed  CAS  Google Scholar 

  62. Adnot S, Lefort J, Lagente V, Braquet P, Vargaftig BB (1986) Interference of BN 52021, a PAF-acether antagonist, with endotoxin-induced hypotension in the guinea-pig. Pharmacol Res Commun 18: 197 - 200

    Article  PubMed  CAS  Google Scholar 

  63. Etienne A, Hecquet F, Soulard C, Spinnewyn B, Clostre F, Braquet P (1985) In vivo inhibition of plasma protein leakage and Salmonella enteridis-induced mortality in the rat by a specific PAF-acether antagonist: BN 52021. Agents Actions 17: 368 - 370

    Article  CAS  Google Scholar 

  64. Braquet P, Touqui L, Shen T, Vargaftig B (1987) Perspectives in platelet-activating factor. Pharmacol Rev 39: 97 - 145

    PubMed  CAS  Google Scholar 

  65. Rabinovici R, Yue TL, Farhat M, et al (1990) PAF and TNF interactions in endotox- emic shock: Studies with BN 50739, a novel PAF antagonist. J Pharmacol Exp Ther 255: 258 - 263

    Google Scholar 

  66. Graham RM, Stephens CJ, Silvester W, et al (1994) Plasma degradation of platelet- activating factor in severely ill patients with clinical sepsis. Crit Care Med 22: 204 - 212

    Article  PubMed  CAS  Google Scholar 

  67. Dhainaut JF, Tenaillon A, Le Tulzo Y, et al (1994) PAF receptor antagonist, BN 52021, in the treatment of severe sepsis. Crit Care Med (in press)

    Google Scholar 

  68. Clark SC, Kamen R (1987) The human hematopoietic CSF. Science 236: 1229 - 1237

    Article  PubMed  CAS  Google Scholar 

  69. Crawford J, Ozer H, Stoller R, et al (1991) Reduction by G-CSF of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. N Engl J Med 325: 164 - 170

    Article  PubMed  CAS  Google Scholar 

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© 1995 Springer-Verlag Berlin Heidelberg

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Dhainaut, JF., Mira, J.P., Brunet, F. (1995). Investigational Therapy of Sepsis: Anti-TNF, IL-1ra, Anti-PAF and G-CSF. In: Vincent, JL., Sibbald, W.J. (eds) Clinical Trials for the Treatment of Sepsis. Update in Intensive Care and Emergency Medicine, vol 19. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79224-3_17

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  • DOI: https://doi.org/10.1007/978-3-642-79224-3_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79226-7

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