The role of adjuvant immunomodulatory agents for treatment of severe influenza.

摘要: A severe inflammatory immune response with hypercytokinemia occurs in patients hospitalized influenza, such as avian influenza A(H5N1), A(H7N9), and seasonal A(H1N1)pdm09 virus infections. The role of immunomodulatory therapy is unclear there have been limited published data based on randomized controlled trials (RCTs). Passive immunotherapy convalescent plasma hyperimmune globulin some studies demonstrating benefit when administered an adjunctive for influenza. Triple combination oseltamivir, clarithromycin, naproxen has one study supporting its use, confirmatory would be great interest. Likewise, sirolimus without concomitant corticosteroid should explored a research priority. Other agents potential immunomodulating effects, including non-immune intravenous immunoglobulin, N-acetylcysteine, acute use statins, macrolides, pamidronate, nitazoxanide, chloroquine, antiC5a antibody, interferons, human mesenchymal stromal cells, mycophenolic acid, peroxisome proliferator-activated receptors agonists, non-steroidal anti-inflammatory agents, mesalazine, herbal medicine, the plasmapheresis hemoperfusion rescue supportive preclinical or observational clinical data, deserve more investigation preferably by RCTs. Systemic corticosteroids high dose may increase risk mortality morbidity not used, while utility low systemic requires further investigation.