Glucan-Based Macrophage Stimulators a Review of Their Anti-Infective Potential

Document Type

Article

Publication Date

1-1-1996

Description

Sepsis and sepsis syndrome are significant causes of morbidity and mortality in critically ill surgical patients. Despite technological and therapeutic advances in critical care, sepsis continues to be a pivotal factor in 20 to 50% of deaths in surgical intensive care units. It is clear that alternative approaches to the prevention and/or treatment of sepsis must be found. Preclinical data indicate that macrophage activation with ( I ->3)-D-gIucans will ameliorate sequelae associated with Gram-negative septicaemia. We and others have translated these preclinical observations to the clinical setting and have shown that macrophage activation with (l->3)-D-gIucans will significantly reduce septic morbidity and mortality in trauma and/or high-risk surgical patients. The precise mechanism(s) by which ( I->3)-D-glucans prevent or ameliorate infections have not been fully elucidated. However, recent data suggest the anti-infective efficacy of (l->3)-D-gIucans is attributable, in part, to macrophage activation induced by binding of (l->3)-D-gIucan to a specific receptor followed by modulation of macrophage pro-inflammatory cytokine expression. This article reviews the anti-infective potential of ( l-3)-D-glucans in the prevention of sepsis and septic sequelae.

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