Immunotherapy for Infectious Diseases

From: Immunotherapy for Infectious Diseases
Edited by: J. M. Jacobson © Humana Press Inc., Totowa, NJ
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Immunotherapy of Bacterial Infections and Sepsis
INTRODUCTION
Sam T. Donta
The use of immunoglobulins for the prevention and treatment of bacterial infections
has been an important principle and component of antibacterial therapies over the past
70 years. From its origins in the preantibiotic era as treatment for pneumococcal infections
(using serotype-specific antisera) to its use as adjunctive therapy in sepsis, the
concept of immunotherapy of bacterial infections has been very attractive and popular.
A number of issues, however (often practical as well as controversial) have hindered
even greater progress in this field.
Conceptually, immunoglobulins directed against surface products of bacteria (such
as polysaccharides, lipopolysaccharides, and proteins) or against soluble products such
as toxins released by bacteria should provide one means of hindering, if not stopping,
the progression of the infectious process. Immunotherapy would not be expected to
impact on pathogenetic events that take place on an intracellular level.
The timing of any immunotherapy would appear to play a key role in its effectiveness.
Immunoprophylaxis should be the most effective means of preventing the establishment
of the infectious process. Also, the earlier immunoglobulins are administered
once infection has been initiated, the greater is the impact of immunotherapy.
IMMUNOTHERAPY OF SPECIFIC BACTERIAL INFECTIONS
Staphylococcus aureus
There have been a number of attempts to develop type-specific antibodies for use in
the treatment of staphyloccal infections (1–4). Most of them have focused on the development
of vaccines to induce immunity against staphylococci (1,2) or the use of nonvirulent
staphylococci to colonize individuals and prevent colonization by virulent
staphylococci (3,4). None of these strategies has been shown to be effective to date,
although it should be possible eventually to develop a vaccine against staphylococcal
antigens that could induce protective immunity against invasive disease. One such antigen
would be the toxic shock syndrome toxin (TSST).
Pooled immunoglobulins have been used in the treatment of staphylococcal-associated
toxic shock syndrome (5,6). This appears to be a successful strategy in some cases, but