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Anti-cytokine strategies
1Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.
European Cytokine Network
|January 1, 1992
Summary
Despite advances, bacterial infections remain deadly. Anti-cytokine therapies, targeting tumor necrosis factor (TNF) and interleukin-1 receptor antagonist (IL-1ra), show promise in reducing mortality from all infectious causes.
Area of Science:
- Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- Bacterial infections continue to have high mortality rates (40-50%) despite antibiotics and supportive care.
- Anti-lipopolysaccharide (LPS) passive immunotherapy is effective but limited to Gram-negative bacteremia.
- Existing treatments highlight the need for broader anti-infective strategies.
Purpose of the Study:
- To review the efficacy of anti-cytokine therapies in reducing mortality from infectious causes.
- To discuss the development and potential of novel anti-cytokine strategies.
- To evaluate the effectiveness of targeting inflammatory mediators in sepsis.
Main Methods:
- Review of current literature on anti-cytokine therapies.
- Analysis of clinical trial data for anti-TNF and IL-1ra treatments.
- Evaluation of preclinical data for soluble receptor-based anti-cytokine strategies.
Main Results:
- Anti-cytokine therapies, including monoclonal antibodies to TNF and IL-1ra, have demonstrated reduced mortality across various infectious causes.
- IL-1ra and monoclonal anti-TNF are in Phase III trials, indicating significant clinical interest.
- Soluble TNF and IL-1 receptor strategies are entering Phase I trials, with promising animal data.
Conclusions:
- Anti-cytokine therapies represent a promising approach to combatting mortality from a wide range of infections.
- Targeting key inflammatory cytokines like TNF and IL-1 is crucial for improving outcomes in sepsis.
- Further clinical investigation of both antibody-based and soluble receptor-based anti-cytokine therapies is warranted.