Prevention of Jarisch-Herxheimer reactions by treatment with antibodies against tumor necrosis factor alpha - PubMed (original) (raw)
Clinical Trial
. 1996 Aug 1;335(5):311-5.
doi: 10.1056/NEJM199608013350503.
Affiliations
- PMID: 8663853
- DOI: 10.1056/NEJM199608013350503
Free article
Clinical Trial
Prevention of Jarisch-Herxheimer reactions by treatment with antibodies against tumor necrosis factor alpha
D Fekade et al. N Engl J Med. 1996.
Free article
Abstract
Background: In patients with louse-borne relapsing fever (Borrelia recurrentis infection), antimicrobial treatment is often followed by sudden fever, rigors, and persistent hypotension (Jarisch-Herxheimer reactions) that are associated with increases in plasma concentrations of tumor necrosis factor alpha (TNF-alpha), interleukin-6, and interleukin-8. We attempted to determine whether sheep polyclonal Fab antibody fragments against TNF-alpha (anti-TNF-alpha Fab) could suppress the Jarisch-Herxheimer reaction.
Methods: We conducted a randomized, double-blind, placebo-controlled trial in 49 patients with proven louse-borne relapsing fever. Immediately before the intramuscular injection of penicillin, the patients received an intravenous infusion of either anti-TNF-alpha Fab or a control solution.
Results: Ten of the 20 patients given anti-TNF-alpha Fab had Jarisch-Herxheimer reactions with rigors, as compared with 26 of the 29 control patients (P = 0.006). The controls had significantly greater mean maximal increases in temperature (1.5 vs. 0.8 degrees C, P < 0.001), pulse rate (31 vs. 13 per minute, P < 0.001), and systolic blood pressure (25 vs. 15 mm Hg, P < 0.003), as well as higher mean peak plasma concentrations of interleukin-6 (50 vs. 17 micrograms per liter) and interleukin-8 (2000 vs 205 ng per liter) (P < 0.001 for both comparisons). Levels of TNF-alpha were undetectable after treatment with anti-TNF-alpha Fab.
Conclusions: Pretreatment with sheep anti-TNF-alpha Fab suppresses Jarisch-Herxheimer reactions that occur after penicillin treatment for louse-borne relapsing fever, reduces the associated increases in plasma concentrations of interleukin-6 and interleukin-8, and may be useful in other forms of sepsis.
Comment in
- Tumor necrosis factor and the Jarisch-Herxheimer reaction.
Beutler B, Munford RS. Beutler B, et al. N Engl J Med. 1996 Aug 1;335(5):347-8. doi: 10.1056/NEJM199608013350512. N Engl J Med. 1996. PMID: 8663859 No abstract available.
Similar articles
- Tumor necrosis factor and the Jarisch-Herxheimer reaction.
Beutler B, Munford RS. Beutler B, et al. N Engl J Med. 1996 Aug 1;335(5):347-8. doi: 10.1056/NEJM199608013350512. N Engl J Med. 1996. PMID: 8663859 No abstract available. - The effect of antibody against TNF alpha on cytokine response in Jarisch-Herxheimer reactions of louse-borne relapsing fever.
Coxon RE, Fekade D, Knox K, Hussein K, Melka A, Daniel A, Griffin GG, Warrell DA. Coxon RE, et al. QJM. 1997 Mar;90(3):213-21. doi: 10.1093/qjmed/90.3.213. QJM. 1997. PMID: 9093599 Clinical Trial. - Detection of plasma tumor necrosis factor, interleukins 6, and 8 during the Jarisch-Herxheimer Reaction of relapsing fever.
Negussie Y, Remick DG, DeForge LE, Kunkel SL, Eynon A, Griffin GE. Negussie Y, et al. J Exp Med. 1992 May 1;175(5):1207-12. doi: 10.1084/jem.175.5.1207. J Exp Med. 1992. PMID: 1569394 Free PMC article. - Louse-borne relapsing fever (Borrelia recurrentis infection).
Warrell DA. Warrell DA. Epidemiol Infect. 2019 Jan;147:e106. doi: 10.1017/S0950268819000116. Epidemiol Infect. 2019. PMID: 30869050 Free PMC article. Review. - [Relapsing fever: an almost forgotten disease in focus again].
Wieser A, Löscher T, Schunk M, Seilmaier M, Balzer L, Margos G, von Both U, Schulzki T, Kopf S, Hoch M, Sing A, Fingerle V. Wieser A, et al. Dtsch Med Wochenschr. 2016 Jul;141(14):1009-13. doi: 10.1055/s-0041-110629. Epub 2016 Jul 12. Dtsch Med Wochenschr. 2016. PMID: 27404930 Review. German.
Cited by
- Differential induction of pro- and anti-inflammatory cytokines in whole blood by bacteria: effects of antibiotic treatment.
Frieling JT, Mulder JA, Hendriks T, Curfs JH, van der Linden CJ, Sauerwein RW. Frieling JT, et al. Antimicrob Agents Chemother. 1997 Jul;41(7):1439-43. doi: 10.1128/AAC.41.7.1439. Antimicrob Agents Chemother. 1997. PMID: 9210662 Free PMC article. - The Jarisch-Herxheimer Reaction After Antibiotic Treatment of Spirochetal Infections: A Review of Recent Cases and Our Understanding of Pathogenesis.
Butler T. Butler T. Am J Trop Med Hyg. 2017 Jan 11;96(1):46-52. doi: 10.4269/ajtmh.16-0434. Epub 2016 Oct 24. Am J Trop Med Hyg. 2017. PMID: 28077740 Free PMC article. Review. - Jarisch-Herxheimer Reaction Among Patients with Leptospirosis: Incidence and Risk Factors.
Guerrier G, Lefèvre P, Chouvin C, D'Ortenzio E. Guerrier G, et al. Am J Trop Med Hyg. 2017 Apr;96(4):791-794. doi: 10.4269/ajtmh.16-0457. Epub 2017 Jan 23. Am J Trop Med Hyg. 2017. PMID: 28115662 Free PMC article. - Clinical pharmacokinetics of antibacterials in cerebrospinal fluid.
Di Paolo A, Gori G, Tascini C, Danesi R, Del Tacca M. Di Paolo A, et al. Clin Pharmacokinet. 2013 Jul;52(7):511-42. doi: 10.1007/s40262-013-0062-9. Clin Pharmacokinet. 2013. PMID: 23605634 Review. - Elevated troponin and jarisch-herxheimer reaction in tick-borne relapsing Fever: a case report.
Hoekstra KA, Kelly MT. Hoekstra KA, et al. Case Rep Infect Dis. 2011;2011:950314. doi: 10.1155/2011/950314. Epub 2011 Oct 9. Case Rep Infect Dis. 2011. PMID: 22567483 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources