Anest. intenziv. Med. 2010;21(1):23-30

Immunotherapy of sepsisIntesive Care Medicine - Review Article

Průcha Miroslav^1,*, Černý Vladimír²

¹ Oddělení klinické biochemie, hematologie a imunologie, Nemocnice Na Homolce, Praha

² Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Fakultní nemocnice Hradec Králové

A disorder of the immune mechanisms of innate and adaptive immunity, inadequate inflammatory response and/or immunoparalysis are the drivers of the search for an effective immunomodulatory treatment in septic patients. During the last 30 years various approaches have been tried without substantial effect. Immunomodulatory therapy involves anti-inflammatory treatment - with intravenous immunoglobulins, corticosteroids, therapy targeting the inflammatory cascade - cytokine inhibitors or inhibitors of Toll-like receptor mechanisms of recognition. On the other hand there is immunostimulatory therapy whose repertoire is significantly smaller - growth factors or leukocyte dialyzate. The current knowledge of the immunopathogenesis of sepsis shows the dominance of immunosuppression in septic patients. The promising results of using immunomodulatory therapy in experimental studies have not been confirmed in clinical trials. Immunotherapy of sepsis could represent the "magic bullet" that has not yet been found. This article summarizes the current knowledge and results of clinical trials on the immunotherapy of sepsis.

Keywords: sepsis; immunity; immunosuppression; anti-inflammatory therapy; immunostimulation

Received: October 8, 2009; Accepted: November 1, 2009; Published: February 1, 2010  Show citation