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Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis.

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العنوان: Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis.
المؤلفون: Crees ZD; Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO., Patel DA; Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO., Dram A; Department of Anesthesiology and Critical Care Medicine, Washington University School of Medicine, St Louis, MO., Kim M; Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO., Bern MD; Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO., Eberly AR; Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO., Augustin K; Department of Pharmacy, Barnes-Jewish Hospital, St Louis, MO., Hotchkiss RS; Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.; Department of Anesthesiology and Critical Care Medicine, Washington University School of Medicine, St Louis, MO.; Department of Surgery, Washington University School of Medicine, St. Louis, MO., DiPersio JF; Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.
المصدر: Critical care explorations [Crit Care Explor] 2023 Oct 19; Vol. 5 (10), pp. e0990. Date of Electronic Publication: 2023 Oct 19 (Print Publication: 2023).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101746347 Publication Model: eCollection Cited Medium: Internet ISSN: 2639-8028 (Electronic) Linking ISSN: 26398028 NLM ISO Abbreviation: Crit Care Explor Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Wolters Kluwer Health, [2019]-
مستخلص: Background: We report the case of a patient with aplastic anemia and pancytopenia on immune-suppressive therapy who developed invasive pulmonary infection with mucormycosis and was treated with immune adjuvant therapy.
Case Summary: Given the patient's profound lymphopenia and progressive invasive mucor despite dual antifungal drug therapy, interleukin (IL)-7, a cytokine that induces lymphocyte activation and proliferation, was instituted and resulted in normalization of absolute lymphocyte counts and was temporally associated with clearance of fungal pathogens and resolution of clinical symptoms.
Conclusion: Patients with life-threatening fungal infections are frequently immune suppressed and immune adjuvant therapies should be considered in patients who are not responding to antifungal drugs and source control. Well-designed, double-blind, placebo-controlled trials are needed to advance the field. Although a number of immune adjuvants may be beneficial in fungal sepsis, IL-7 is a particularly attractive immune adjuvant because of its broad immunologic effects on key immunologic pathways that mediate enhanced antifungal immune system activity.
Competing Interests: Dr. Hotchkiss has been an investigator on several trials of IL-7 in sepsis. The remaining authors have not disclosed any potential conflicts of interest.
(Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
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معلومات مُعتمدة: R35 GM126928 United States GM NIGMS NIH HHS
فهرسة مساهمة: Keywords: fungal; immunity; infection; lymphocyte; sepsis
تواريخ الأحداث: Date Created: 20231023 Latest Revision: 20240302
رمز التحديث: 20240302
مُعرف محوري في PubMed: PMC10589520
DOI: 10.1097/CCE.0000000000000990
PMID: 37868029
قاعدة البيانات: MEDLINE
الوصف
تدمد:2639-8028
DOI:10.1097/CCE.0000000000000990