Efficacy and potential clinical applications of Pentagloblin®, an IgM-enriched immunoglobulin concentrate suitable for intravenous infusion

Objective: Characterisation of the antibodies against important human pathogens in two immunoglobulin preparations: Intraglobin F and IgM-enriched Pentaglobin(R). Design: In vitro assay of antibody titre using bacterial outer-membrane proteins, lipopolysaccharides (LPS), and exotoxins of clinically relevant bacteria. Methods: Antibody reactivities measured by ELISA and immunoblot techniques against antigens from bacteria that cause sepsis, antibiotic-resistant nosocomial pathogens, and enteric pathogens. Results: IgG anti-LPS reactivity was present in both study drugs. Specific IgM antibodies against LPS of Gram-negative bacteria that cause sepsis were also detected in the IgM-enriched Pentaglobin(R) IgG-reactivity against Gram-positive multiresistant strains of Staphylococcus aureus (S. aureus) were detectable in both preparations. IgG and IgM antibodies present against Yersinia outer proteins and Campylobacter jejuni (C. jejuni) outer membrane proteins were detected in Pentaglobin(R) Both preparations reacted against alpha toxin of S. aureus and streptolysin of Streptococcus pyogenes. Pentaglobin(R) showed a strong IgM-reactivity against alpha-haemolysin. Conclusion. Our data suggest that infusion of well characterised immunoglobulin preparations might be beneficial for patients with severe infections. This is highly relevant in view of the high pathogenicity of bacteria that cause infections in patients in hospital and the continually increasing antibiotic resistance (particularly methicillin-resistant S. aureus).