Although the effect can be ascribed to multiple factors, including the timing of administration and the correctness of the other therapeutic actions, it is hypothesizable that IgM supplementation per se can play some role in the improved survival, as it has been demonstrated that plasma values of IgM are reduced in severe sepsis and septic shock and this reduction appears to be more marked and persisting in nonsurvivors [19,20]. Here, CD40LG is linked to Shock.