Effectiveness of immune stimulatory therapy in patient with severe community-acquired pneumonia (CAP)

Abstract

Objectives: to determine the role of immune stimulatory therapy in patients with severe CAP.

Methods: 23 patients (age – 56,1±3,36 years, men – 13 (56,5%)) with verified severe CAP without HIV, divided into two groups: group 1 – 11 (47,8%) patients with severe CAP with using of immunomodulator glutamyl-glycine cysteinyl disodium from tiopoetyns; group 2 – 12 (52,2%) patients with severe CAP without immunomodulator. Control group included 10 clinically healthy individuals (age – 51,1±5,6 years, men – 6 (60%)). General analysis, biochemical analysis, serum procalcitonin (PCT), blood CD4, CD8 prior antibacterial treatment (ABT) (visit 1), on 3 – 5 day of ABT (visit 2), on 7–10 day of ABT (visit 3), statistic.

Results: On visit 1 groups were comparable on initial severity, inflammatory level, immunological status. On visit 2 normalization of body temperature, consciousness, bilirubin, creatinine, PCT were more often in patients in group 1.On visit 3 in patients of group 1 the level of CD4 has increased by almost 72%, while in the subgroup 2 – only by 50%

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Conclusions: 1) some patients with severe CAP has decrease of immune markers CD4, CD8 less than 500 mcl-1; 2) adding of immunomodulator during5–7 days prior adjuvant therapy of severe CAP increases the number of CD4 by almost 75% compared to the initial.