Effect of IgM-enriched intravenous immunoglobulin (Pentaglobin) on endotoxaemia and anti-endotoxin antibodies in bone marrow transplantation.
Endotoxin was measured in over 1000 plasma samples from bone marrow transplant patients in a randomized trial of the IgM-enriched intravenous immunoglobulin (IVIG) Pentaglobin. Peak endotoxaemia was significantly reduced (P = 0.02) in patients receiving Pentaglobin and 70% of all pyrexias of unknown origin were associated with endotoxaemia. Gut mucosal damage, assessed by lactulose/mannitol ratios, was significantly associated (P = 0.02) with endotoxaemia. Specific IgM antibody to endotoxin core-glycolipid was significantly raised (P < 0.01) in patients receiving the IVIG, and the IgM fraction of Pentaglobin was found to contain most of the anti-endotoxin antibody activity of the IVIG. These results suggest a role for IgM-enriched IVIG as a prophylactic agent for the reduction of endotoxaemia and its consequences in bone marrow transplant patients.
Jackson
S K
SK
Department of Medical Microbiology, University of Wales College of Medicine, Cardiff, UK.
Parton
J
J
Barnes
R A
RA
Poynton
C H
CH
Fegan
C
C
D000293:Adolescent; D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D001424:Bacterial Infections / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D016026:Bone Marrow Transplantation; D004731:Endotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000627:therapeutic use*; D007075:Immunoglobulin M / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D000888:Antibodies, Anti-Idiotypic; D004731:Endotoxins; D007070:Immunoglobulin A; D007075:Immunoglobulin M; C060166:pentaglobulin