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- MEDICINE, Page 70Blasting Bacteria
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- A man-made antibody battles massive infections
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- One of the gravest threats to anyone severely burned or
- injured -- or to soldiers wounded in battle -- is massive,
- system-wide bacterial infection. Such infection with toxic,
- "gram-negative" bacteria kills up to 100,000 Americans a year,
- many of them surgical patients and trauma victims. Last week
- researchers at the University of California at San Diego
- reported a major victory in the war against these microbes.
- Using injections of a biotech product called monoclonal
- antibodies in patients suffering from toxic infections and
- septic shock, they reduced the expected death rate 40%, in some
- cases rescuing patients from the brink of death. The advance
- comes just in time for soldiers who might be wounded in the
- gulf war.
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- Gram-negative bacteria -- so named because they do not
- retain a laboratory stain devised by the Danish bacteriologist
- Christian Gram -- are usually harmless. They reside on the skin
- and in the gut, where they aid in digestion. But any
- significant disruption to the body's immune response -- caused,
- for instance, by severe burns, chemotherapy or major abdominal
- surgery -- allows these rod-shaped bacteria to multiply out of
- control and invade other parts of the body, eventually entering
- the bloodstream. Once there, one part of the bacterial cell
- wall called endotoxin can trigger a cascade of lethal effects,
- culminating in multiple organ failure and death, sometimes
- within hours.
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- The new treatment, reported by Dr. Elizabeth Ziegler and
- colleagues in the New England Journal of Medicine, employs a
- man-made antibody called HA-1A designed to zero in on the
- endotoxin molecule and render it harmless. Although the Food
- and Drug Administration has yet to approve HA-1A for use in the
- U.S., the agency has given the Pentagon special permission to
- utilize the antibody in the gulf. Large quantities are on hand
- in MASH units and field hospitals.
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- The antibody does not provide a guaranteed cure. In the
- study, 30% of the patients receiving the treatment died (vs.
- 50% of those who did not receive it). Still, HA-1A appears to
- be one more high-tech weapon U.S. soldiers can count on.
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