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Archives of General Internal Medicine | Volume 2
&
April 04-05, 2018 | Miami, USA
International Conference on
Internal Medicine & Practice and Primary Care
International Meeting on
Breast Pathology & Cancer Diagnosis
W
hen studying the pathogenesis of burn sepsis, it is
necessary to identify those changes in the parameters
of the immune system that contribute to the development
of a septic complication and are characteristic of it. We first
studied for sepsis in 85 patients with burns and 16 volunteers
(reference group) a large panel of phenotypic constitutive and
activation cell markers and established a quantitative formula
for its prognosis, determining a deep deficit of lymphocytes
(<9.3%), natural killers (<5%), HLA-DR+monocytes (<50%),
IgG (<6g/L) and a sharp increase in rod-nuclear neutrophils
(> 21%), endogenous intoxication index (>4 units) and
CD64+granulocytes (90-100%), which allowed predicting
sepsis in 33.3% of patients for 1-2 days, in 41.7% for 3-4 days,
for 16.7% for 5-7 days and for 8.3% for 2 weeks before the
clinical diagnosis was made. The coincidence of the clinical
and immune diagnosis in patients with sepsis and without it
was 100%. We examined 61 patients with burn disease in the
stage of burn toxemia and burn septicotoxemia (burn area
>30% body surface). Patients with sepsis received 10 days
of gabriglobin (Russian IgG) for 2.5g/day, in order to prevent
generalization of infection, a 5-days course of the drug. In
the control groups with burns, patients with gabriglobin
did not receive. The drug reduced the hyperactivation of
the immune system (O2-metabolism of phagocytes, CD70+
lymphocytes , neutrophils, monocytes, CD64+ granulocytes,
HLA-DR+T-Lph, endogenous intoxication), eliminated the
deficit of immune markers (lymphocytes, B cells, T-Lph,
natural killers, cytotoxic T-Lph, IgG). Those immunoglobulin
G normalized not only IgG deficiency but had a powerful
immunomodulatory effect. It was also clinically effective
(reducing the severity of the clinical condition, temperature,
respiration rate and pulse, leukocytosis, proteinuria,
procalcitonin and increasing blood pressure, proteinemia,
and thrombocytopenia) with sepsis at 78.75% (traditional
therapy without IgG had efficacy in 32% of patients), in
the prevention of generalization of infection in 72.34%
(traditional therapy without IgG had efficacy in 37%).
Speaker Biography
Zemskov V M has completed his PhD from Academy of Medical Sciences and MD
Postdoctoral studies from Second Moscow Medical Institute. He is the Chief of Clinical
Immunology group of Vishnevsky Institute of Surgery. He has published more than
200 papers in reputed journals, 42 monographs and textbooks for medical students
and has been serving as an Editorial Board Member of three Russian and six foreign
journals. He is an Academician of Russian Academy of Natural Sciences, Russian
Academy of Medical and Technical Sciences, honored Scientist of Russia, winner of the
Russia Government Prize. He is a Professor of Immunology and Allergology.
e:
vzemskov@facecontrol.bizImmune forecast of sepsis: Immunological treatment and prevention
Zemskov V M
Professor, Vishnevsky Surgery Institute, Russia