Early intervention of ARDS using anti-CD6 monoclonal antibody Itolizumab: Case series of clinical evidence

Abstract

The case series of three patients is an attempt to report the importance of early use of Itolizumab in the treatment of non-COVID 19 acute respiratory distress syndrome (ARDS) admitted to the intensive care unit. Monitoring total counts, oxygen requirements, respiratory capacity, and sepsis biomarkers along with strong clinical history and presentation helped in determining the stage of sepsis, allowing the treating physician to prescribe Itolizumab as the treatment of choice when septic shock and complications such as multiple (greater than or equal to 2) organ system failure MOSF has not set in. The efficacy of Itolizumab in this clinical setting was preventative as it blocked the CD6+ receptors, preventing activation of inflammatory reaction and release of large amounts of pro-inflammatory mediators including IL-1, IL-6, TNF-α, and INF-γ, and salvaged the clinical deterioration observed in early stages of ARDS. When the clinical, biomarker and haematological parameters indicate advanced sepsis with impending MOSF, other rescue measures should be instituted to save the patient from fatal outcome. The three patients received Itolizumab while two patients showed improvements due to early institution of therapy, the third patient, in advanced sepsis led to rapid deterioration of clinical condition and death.