Anti-cytokine strategies

Although antibiotics and support systems have reduced the mortality due to bacterial infections, 40-50% mortality is still an unacceptable statistic. Anti-LPS (anti-lipid A) passive immunotherapy has reduced this mortality but only in patients with documented Gram-negative bacteriemia. However, anti-cytokine therapy such as monoclonal antibodies to TNF and the IL-1ra have reduced mortality to all infectious causes. IL-1ra is presently in Phase III trials as is monoclonal anti-TNF. Two other strategies are soluble (extracellular domains) receptors to TNF and IL-1. These are now entering Phase I trials but animal data strongly support that similar to antibodies to TNF and IL-1ra, these anti-cytokine therapies will also be effective.