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Letters |1 May 2007

Blood Products for Spanish Influenza: A Future H5N1 Treatment?

Thomas C. Luke, MD, MTMH, MA; Stephen L. Hoffman, MD, DTMH

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Author, Article, and Disclosure Information
  • From the Bureau of Medicine and Surgery, U.S. Navy, Washington, DC 20372-3000.

    Potential Financial Conflicts of Interest: None disclosed.

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We agree with Drs. Logtenberg and Bilo that the possible benefit of convalescent blood products, including plasma, for treating Spanish influenza pneumonia may not have been entirely due to the presence of neutralizing antibodies.
Plasma is a complex mixture of immunoglobulins, coagulation factors, cytokines, and other immunologically and physiologically active molecules. It is sometimes used to treat patients with circulatory collapse—presumably because it expands volume while increasing oncotic pressure, as theorized by Drs. Logtenberg and Bilo. Furthermore, both adaptive and innate immune responses likely contribute to the control of influenza infections. Products of the innate immune system in plasma may have contributed to controlling the infection in the patient in Drs. Logtenberg and Bilo's study and in the patients reported in our paper.
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Luke TC, Hoffman SL. Blood Products for Spanish Influenza: A Future H5N1 Treatment?. Ann Intern Med. ;146:687. doi: 10.7326/0003-4819-146-9-200705010-00021

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Published: Ann Intern Med. 2007;146(9):687.

DOI: 10.7326/0003-4819-146-9-200705010-00021

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2007 American College of Physicians
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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