antibioticsАнтибиотики и ХимиотерапияAntibiot Khimioter = Antibiotics and Chemotherapy0235-2990ООО «Издательство ОКИ»antibiotics-204Research ArticleВ ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУGUIDELINES FOR PRACTITIONERSИзучение безопасности и эффективности препарата очищенного человеческого С1-эстеразного ингибитора у больных с сепсисомSafety and Efficacy of Pure Human Cl-Esterase Inhibitor in the Treatment of Patients with SepsisЛазареваН. Б.LazarevaN. B.noemail@neicon.ruИгонинА. А.IgoninA. A.noemail@neicon.ruМосковская медицинская академия им. И.М. СеченоваРоссияI.M. Sechenov Moscow Medical AcademyRussian Federation200913052020541-24245Copyright © Лазарева Н.Б., Игонин А.А., 20202020Лазарева Н.Б., Игонин А.А.Lazareva N.B., Igonin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.antibiotics-chemotherapy.ru/jour/article/view/204

Одним из новых экспериментальных направлений в фармакотерапии сепсиса является воздействие на систему комплемента путем использования С1-эстеразного ингибитора (С1И), относящегося к группе иммунобиологических препаратов. В открытом проспективном исследовании по изучению безопасности и эффективности препарата С1-эстеразного ингибитора было выявлено его позитивное влияние на уровень летальности пациентов с сепсисом. Введение 12 000 МЕ С1И оказывало выраженное подавляющее действие на активность системы комплемента, а также противовоспалительный эффект за счёт блокады комплемент-зависимого звена системного воспаления. Зафиксированные нежелательные и серьезные нежелательные явления не были связаны с введением исследуемого препарата.

One of the new experimental trends in pharmacotherapy of sepsis is the use of C1-esterase inhibitor (C1I) from the group of immunobiological agents influencing the complement system. An open prospective study on the safety and efficacy of C1I revealed its positive effect on the death rate among the patients with sepsis. In a dose of 12000 IU, C1I had a significant inhibitory action on the complement system activity, as well as an antiinflammatory effect by blocking the complement-dependent link in the systemic inflammation. The adverse and significant adverse events were not associated with the use of C1I.

сепсисС1-эстеразный ингибиторбезопасностьэффективностьsepsisCl-esterase inhibitorsafetyefficacyReferencesAngus D.C., Linde-Zwirble W.T., Lidicker J. et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome and associated costs of care. Crit Care Med 2001, 29: 1303-1310.Angus D.C., Linde-Zwirble W.T., Lidicker J. et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome and associated costs of care. Crit Care Med 2001, 29: 1303-1310.Bone R.C., Balk R.A., Cerra F.B. et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992; 101: 1644-1655.Bone R.C., Balk R.A., Cerra F.B. et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992; 101: 1644-1655.Zeerleder S., Caliezi C, van Mierlo G. Administration of C1 inhibitor reduces neutrophil activation in patients with sepsis. Clin Diagn Lab Immunol 2003; 10: 529-535.Zeerleder S., Caliezi C, van Mierlo G. Administration of C1 inhibitor reduces neutrophil activation in patients with sepsis. Clin Diagn Lab Immunol 2003; 10: 529-535.Liu D., Cai S., Gu J. et al. C1 inhibitor prevents endotoxin shock via a direct interaction with lipopolysaccharide. The Journal of Immunology 2003, 171: 2594-2601.Liu D., Cai S., Gu J. et al. C1 inhibitor prevents endotoxin shock via a direct interaction with lipopolysaccharide. The Journal of Immunology 2003, 171: 2594-2601.Davis A.E., Cai S., Liu D. C1 inhibitor: biologic activities that are independent of protease inhibition. Immunobiology 2007; 212: 4-5: 313-323.Davis A.E., Cai S., Liu D. C1 inhibitor: biologic activities that are independent of protease inhibition. Immunobiology 2007; 212: 4-5: 313-323.Hack C.E., Nuijens R.J., Felt-Bersma F. et al. Elevated plasma levels of the anaphylatoxins C3a and C4a are associated with a fatal outcome in sepsis. Am J Med 1989; 86: 20Hack C.E., Nuijens R.J., Felt-Bersma F. et al. Elevated plasma levels of the anaphylatoxins C3a and C4a are associated with a fatal outcome in sepsis. Am J Med 1989; 86: 20Nuijens J., Eerenberg-Belmer A., Huijbregts C. et al. Proteolytic inactivation of plasma C1 inhibitor in sepsis. J Clin Invest 1989; 84: 443-450.Nuijens J., Eerenberg-Belmer A., Huijbregts C. et al. Proteolytic inactivation of plasma C1 inhibitor in sepsis. J Clin Invest 1989; 84: 443-450.Caliezi C., Zeerleder S., Redondo M. C1-inhibitor in patients with severe sepsis and septic shock: beneficial effect on renal dysfunction. Crit Care Med 2002; 30: 1722-1728.Caliezi C., Zeerleder S., Redondo M. C1-inhibitor in patients with severe sepsis and septic shock: beneficial effect on renal dysfunction. Crit Care Med 2002; 30: 1722-1728.Hack C.E., Ogilvie A.C., Eisele B. C1 inhibitor substitution therapy in septic shock and in vascular leak syndrome induced by high doses of interleukin-2. Intensive Care Med 1993; 19: 19-28.Hack C.E., Ogilvie A.C., Eisele B. C1 inhibitor substitution therapy in septic shock and in vascular leak syndrome induced by high doses of interleukin-2. Intensive Care Med 1993; 19: 19-28.

The authors declare that there are no conflicts of interest present.