CD40LG and Shock: Cui et al. (2019) in a meta-analysis published in 2019, including 19 studies (1,530 patients), estimated that mortality rates were significantly lower in patients who received intravenous IgM-enriched immunoglobulins than in their respective control groups [relative risk (RR) 0.60; 95% confidence interval (CI) 0.52–0.69]. An ongoing trial (Biagioni et al., 2021) aims to discriminate if a personalized dose based on patients serum IgM versus standard dose is more efficacious in the treatment of septic shock (IgM-fat trial registered on ClinicalTrials.gov (NCT04182737) on December 2, 2019).