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Immunomodulatory adjuvant therapy in severe community-acquired pneumonia

Morton, Ben ORCID: https://orcid.org/0000-0002-6164-2854, Pennington, Shaun ORCID: https://orcid.org/0000-0002-7160-6275 and Gordon, Stephen ORCID: https://orcid.org/0000-0001-6576-1116 (2014) 'Immunomodulatory adjuvant therapy in severe community-acquired pneumonia'. Expert Review of Respiratory Medicine, Vol 8, Issue 5, pp. 587-596.

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Abstract

Severe pneumonia has a high mortality (38.2%) despite evidence-based therapy. Rising rates of antimicrobial resistance increase the urgency to develop new treatment strategies. Multiple adjuvant therapies for pneumonia have been investigated but none are currently licensed. Profound immune dysregulation occurs in patients with severe infection. An initial hyper-inflammatory response is followed by a secondary hypo-inflammatory response with ‘immune-paralysis’. There is focus on the development of immunostimulatory agents to improve host ability to combat primary infection and reduce secondary infections. Successful treatments must be targeted to immune response; promising biomarkers exist but have not yet reached common bedside practice. We explore evidence for adjuvant therapies in community-acquired pneumonia. We highlight novel potential treatment strategies using a broad-based search strategy to include publications in pneumonia and severe sepsis. We explore reasons for the failure to develop effective adjuvant therapies and highlight the need for targeted therapy specific to immune activity.

Item Type: Article
Subjects: QW Microbiology and Immunology > QW 45 Microbial drug resistance. General or not elsewhere classified.
QW Microbiology and Immunology > Reference Works. General Immunology > QW 520 Research (General)
QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 800 Biological products producing immunity
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1586/17476348.2014.927736
Depositing User: Lynn Roberts-Maloney
Date Deposited: 29 Jan 2015 09:56
Last Modified: 06 Feb 2018 13:08
URI: http://archive.lstmed.ac.uk/id/eprint/4811

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