High dose intravenous immunoglobulin therapy in burn patients: pharmacokinetics and effects on microbial opsonization and phagocytosis.
Depressed serum immunoglobulin levels following severe burns may lead to subsequent infectious complications following such injuries. In a randomized study we administered multiple doses of Sandoglobulin (500 mg/kg) or albumin intravenously to patients with severe burn injuries and closely monitored serum IgG levels. Patients who received IgG therapy had earlier return of normal serum IgG levels compared to control patients; however, control patients attained normal IgG levels during the second postburn week. Serum half-lives of IgG following infusions were remarkably short (means, 47 hours for infusions within 3 days of injury and 154 hours for infusions in the third postburn week); Sandoglobulin has been reported to have approximately a 21-day half-life in normal individuals. We also measured the opsonic capacity of postburn serum, using fluorescein-labeled microbes and flow cytometry; we identified postburn opsonic defects with certain of the organisms as late as 15 days postinjury, even though serum IgG levels had normalized. These defects were corrected by the in vitro addition of Sandoglobulin to the incubation mixture.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000276:immunology*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage* / Q000032:analysis / Q000493:pharmacokinetics; D007262:Infusions, Intravenous; D008875:Middle Aged; D009894:Opportunistic Infections / Q000209:etiology; D009895:Opsonin Proteins / Q000302:isolation & purification; D010587:Phagocytosis; D011897:Random Allocation; D013997:Time Factors
D007074:Immunoglobulin G; D009895:Opsonin Proteins