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Opsonic alpha2 surface binding glycoprotein therapy during sepsis

W A Scovill, T M Saba, F A Blumenstock

    Annals of Surgery
    |October 1, 1978
    PubMed
    Summary
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    Critically ill patients with low opsonic alpha(2) surface binding glycoprotein levels showed improved immune function and clinical status after receiving cryoprecipitate. This suggests cryoprecipitate can reverse hypoopsonemia in trauma patients.

    Area of Science:

    • Immunology
    • Critical Care Medicine
    • Biochemistry

    Background:

    • Critically ill trauma patients often exhibit depletion of opsonic alpha(2) surface binding (SB) glycoprotein, crucial for hepatic reticuloendothelial phagocytosis.
    • This glycoprotein shares properties with cold insoluble globulin (CIg), which is concentrated in cryoprecipitate.

    Purpose of the Study:

    • To investigate if cryoprecipitate infusion can restore opsonic alpha(2)SB glycoprotein levels in septic, injured patients.
    • To assess the clinical impact of reversing hypoopsonemia.

    Main Methods:

    • Six septic patients (trauma, burn, abscess) received cryoprecipitate.
    • Opsonin levels were measured pre- and post-infusion using bioassay and electroimmunoassay.
    • Clinical parameters including fever, leukocyte count, and pulmonary function were monitored.

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    Main Results:

    • Cryoprecipitate infusion successfully reversed severe opsonin depletion in all patients.
    • Patients experienced rapid improvement in febrile state, normalized leukocyte counts, and enhanced pulmonary function.
    • One patient showed increased cardiac output, improved limb blood flow, and oxygen delivery/consumption, with a decreased pulmonary shunt fraction.

    Conclusions:

    • Opsonic alpha(2)SB glycoprotein deficiency in critically ill septic injured patients can be effectively reversed by cryoprecipitate infusion.
    • Replacement therapy with cryoprecipitate may be a valuable strategy to prevent multiple organ failure in trauma patients with documented hypoopsonemia.