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Intravitreally injected human immunoglobulin attenuates the effects of Staphylococcus aureus culture supernatant in a rabbit model of toxin-mediated endophthalmitis. Arch Ophthalmol 2004 Oct;122(10):1499-506

Date

10/13/2004

Pubmed ID

15477462

DOI

10.1001/archopht.122.10.1499

Scopus ID

2-s2.0-5044224206 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

OBJECTIVE: To determine whether human immunoglobulin attenuates the toxic effects of Staphylococcus aureus culture supernatant in a rabbit model of endophthalmitis.

METHODS: Immunoglobulin binding to products of S aureus strain RN4220 was tested by Western blot analysis using known toxins (beta-hemolysin and toxic shock syndrome toxin-1) and a concentrated culture supernatant containing S aureus exotoxins (pooled toxin). To induce endophthalmitis, pooled toxin was injected into the rabbit vitreous. For immunoglobulin treatment, immunoglobulin and pooled toxin were either mixed and injected simultaneously or immunoglobulin was injected immediately after or 6 hours after pooled toxin injection. Severity of endophthalmitis was graded according to a 9-day course with clinical examination (slitlamp biomicroscopy or indirect ophthalmoscopy) and evaluation of histologic sections.

RESULTS: The toxic effects of pooled toxin were markedly reduced when immunoglobulin was mixed with pooled toxin and injected simultaneously. Delayed injection of immunoglobulin diminished its ability to reduce toxicity. Clinical and histologic signs of toxicity were partially attenuated when immunoglobulin was injected immediately after pooled toxin, but only minimal clinically detectable reductions in toxicity were observed when immunoglobulin injection was delayed for 6 hours.

CONCLUSION: Pooled human immunoglobulin can attenuate the toxic intravitreal effects of a concentrated culture supernatant containing S aureus exotoxins. Clinical Relevance Immunoglobulin may represent a novel adjuvant in the treatment of bacterial endophthalmitis. To optimize the potential therapeutic benefit, maximizing the mixture of immunoglobulin with bacterial products and early intervention are likely to be important.

Author List

Perkins SL, Han DP, Burke JM, Schlievert PM, Wirostko WJ, Tarasewicz DG, Skumatz CM

Author

William Wirostko MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Animals
Bacterial Toxins
Culture Media
Disease Models, Animal
Endophthalmitis
Enterotoxins
Hemolysin Proteins
Humans
Immunoglobulins
Immunotherapy
Rabbits
Retina
Sphingomyelin Phosphodiesterase
Staphylococcus aureus
Superantigens
Vitreous Body