Effectiveness Of Thymosin A1 Therapy In Patients With Sepsis And Its Effects On Immune Function

Objective:To evaluate the treatment efficiency and its effects on immune function of Thymosinα1 in patients with sepsis. Laboratory variables, such as T cell subsets, immunoglobulin IgG, IgA, IgM and complement C3, C4 as well as C-reactive protein (CRP), procalcitonin (PCT),interleukin-6 (IL-6), Interleukin-10 (IL-10) were recorded in patients with sepsis. Acute physiology and chronic health evaluation II (APACHEⅡ) score, Staying time in the Intensive Care Unit (ICU) and 28-day mortality were all investigated.Methods:The study was a randomized, controlled clinical one. A total 42 patients with sepsis administrated in the intensive care unit (ICU) were enrolled. The diagnosis criteria was based on recommendation of 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference.All the patients were randomly divided into Thymosinα1 treatment group and routin treatment group before beening given a standard treatment in accordance with the guidelines for the treatment of sepsis in 2008. Differently,1.6 mg of Thymosinα1 was injected subcutaneously once a day for 7 days in Thymosinα1 treatment group. T cell subsets, C-reactive protein, procalcitonin, immunoglobulin IgG, IgA, IgM, complement C3, C4, and liver and renal function were measured before treatment (Do) and at day 3 (D3) and at day 7 (D7), respectively. Simultaneously, serum IL-6, IL-10 level were measured with ELISA. Clinical APACHEⅡscore, Staying time in ICU and 28-day mortality were recorded.Results:At day 7 after treatment CD4+T cell count and CD4+/ CD8+ ratio were higher than those before treatment in the Thymosinα1 treatment group. At day 3 and day 7 after treatment, CD4+ T cell count and CD4+/CD8+ratio were higher while C-reactive protein and PCT were lower in the Thymosinα1 treatment group than those in the routin treatment control group, and the difference was statistically significant (P <0.05). Inflammatory factor IL-10, immunoglobulin IgG as well as complement C3 levels elevated with IL-6 levels decreasing during treatment period in Thymosinα1 treatment group, and there was significant difference between the two groups (P<0.05). There is no significant difference between Thymosinα1 treatment group and routin treatment group before Thymosinα1 treatment in clinical features and parameters. APACHE II score significantly decreased in Thymosinα1 treatment group compared to routin treatment group (P<0.05). Thymosinα1 treatment can shorten staying time in ICU. But whether or not the Thymosinα1 treatment can decrease 28-day mortality is unknown.Conclusion:Thymosinα1 in sepsis therapy regimen may improve inflammatory factors, enhance cellular and humoral immunity. Thymosinα1 treatment can shorten ICU staying time. Further investigation is required to clarify its role in predicting outcomes of patients with sepsis.