Intravenous immunoglobulins and haematopoietic growth factors in the prevention and treatment of neonatal sepsis: ground reality or glorified myths?
Neonatal sepsis is a significant cause of morbidity and mortality in the neonatal intensive care unit. The epidemiology of neonatal infections is complex; however, they are in large part secondary to developmentally immature host defence mechanisms. These immunodeficiencies, which are exaggerated in premature and sick neonates, include quantitative and qualitative deficits in phagocytes, complement components, cytokines and immunoglobulins. Therapies that modulate or augment host defences may attenuate the virulence of neonatal infections. In this paper, we have reviewed immunotherapies that modulate the immune system of the neonate, including intravenous immunoglobulins and myeloid haematopoietic growth factors. Future studies should focus on investigating other abnormalities of neonatal host defence and/or combined immunotherapy approaches in an attempt to circumvent the immaturity of host defence and potentially reduce both the incidence and severity of neonatal sepsis.
Shaw
C K
CK
Department of Paediatrics, Manipal College of Medical Sciences (MCOMS), Pokhara, Nepal. shaw_1974@rediffmail.com
Thapalial
A
A
Shaw
P
P
Malla
K
K
D003906:Developing Countries; D005240:Feasibility Studies; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D018805:Sepsis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*
D016298:Hematopoietic Cell Growth Factors; D016756:Immunoglobulins, Intravenous