Immunomodulators in the treatment of peritonitis in burned and malnourished animals
Waymack, J.P.; Miskell, P.; Gonce, S.J.; Alexander, J.W.
Surgery 96(2): 308-314
1984
ISSN/ISBN: 0039-6060 PMID: 6379960 Document Number: 235379
Deficiencies in the immune system which result in increased morbidity and mortality from infectious complications are well documented in patients with trauma, malnutrition, sepsis and thermal injuries. The potential benefit of immune stimulation for preventing infection in such conditions was studied in an animal model by evaluating 3 drugs: Corynebacterium parvum, thymopentin (TP-5) and CP-46,665. Of 180 female guineapigs rendered immunodeficient by first inflicting a 30% total body surface burn and then placed on diets with energy inadequate to maintain bodyweight, half were given one of the three immunomodulators on the first, third and fifth days after burn injury, to try to reverse immunodeficiency; the others received saline solution injections. Animal responses were evaluated by inserting a clot containing Escherichia coli and Bacillus fragilis into their peritoneal cavity 6 days after burn injury. The guineapigs were followed for 21 days after burn injury. Post mortem, those which died showed peritonitis or pneumonia, or both; post mortem, those which survived showed no pneumonia and there was consistent resolution of peritonitis. TP-5 and CP-46,665, but not C. parvum, significantly improved survival rates and mean survival time in guineapigs receiving 100 kcal/kg daily. TP-5 and CP-46,665 may be of benefit to the severely stressed, malnourished surgical patient who is at risk of bacterial infection.