title: Immunotherapy improves immune homeostasis and increases survival rate of septic patients.
abstract: OBJECTIVE
  To investigate the efficacy of immunotherapy on septic patients with Ulinastatin plus Thymosin-alpha(1).
  
  
  METHODS
  Seventy postoperative septic patients were divided into two groups at random: the immunotherapy group (n equal to 36) and the conventional therapy group (n=34). Patients in the immunotherapy group received intravenous Ulinastatin of 200 000 U, 3 times per day for 3 days, Ulinastatin of 100 000 U, 3 times per day for 4 days, and subcutaneous injection of Thymosin-alpha(1) of 1.6 mg, twice per day for 3 days, then once per day for 4 days. While conventional therapies such as antibiotics and fluid resuscitation were undertaken in both groups. The expression levels of serum tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10), IgG, C3, T lymphocyte subsets, CD14+ monocyte human leukocyte antigen (locus) DR (HLA-DR) and patients'28-day survival rate of the two groups were observed and evaluated.
  
  
  RESULTS
  The survival rate was significantly higher in the immunotherapy group (63.9%; 23/36) compared with the conventional therapy group (41.2%; 14/34). The serum TNF-alpha levels [(1.38+/-0.50) ng/ml in the immunotherapy group vs (1.88+/-0.53) ng/ml in the conventional group, P less than 0.05] and the serum IL-10 levels [(217.52+/-15.71) ng/ml vs (101.53+/-16.57) ng/ml, P less than 0.05] were significantly different between the two groups. The serum IgG levels in the immunotherapy group [(17.65+/-6.81) g/L] were significantly higher than in the conventional group [(11.94+/-5.32) g/L]. There were also significant differences in the expression levels of CD4+ T lymphocyte (35%+/-13% in the immunotherapy group vs 21%+/-7% in the conventional group, P less than 0.05) and CD14+ monocyte HLA-DR (50%+/-5% in the former vs 35%+/-4% in the latter, P less than 0.05).
  
  
  CONCLUSIONS
  Immunotherapy with Ulinastatin plus Thymosin-alpha(1) can enhance the inflammatory response, improve the immune homeostasis, and increase the survival rate of septic patients.
authors.affiliation: Department of Surgical Intensive Care Unit, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Shun-wei
authors.initials: SW
authors.lastname: Huang
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Bin
authors.initials: B
authors.lastname: Ouyang
authors.forename: Chun-hua
authors.initials: CH
authors.lastname: Yang
authors.forename: Min-ying
authors.initials: MY
authors.lastname: Chen
authors.forename: Xiang-dong
authors.initials: XD
authors.lastname: Guan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006023:Glycoproteins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D015996:Survival Rate; D000077596:Thymalfasin; D013947:Thymosin / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D006023:Glycoproteins; D013947:Thymosin; C028665:urinastatin; D000077596:Thymalfasin