Mouthon L, Guillevin L
Service de Médecine Interne, Hôpital Avicenne, Bobigny.
Ann Med Interne (Paris). 2000 Mar;151(2):136-43.
Intravenous immunoglobulin (IVIg) are therapeutic preparations of intact IgG that are obtained from a pool of more than one thousand healthy blood donors and contain antibodies directed toward a large panel of microbial agents. IVIg contain high amounts of antibodies with opsonising activity and are indicated in substitutive treatment of patients with constitutive hypogammaglobulinemia. IVIg also contain antibodies able to neutralize certain bacterial toxins exerting superantigenic activity, and by this mechanism exert both anti-infectious and immunomodulating activity. During the last fifteen years, indications of IVIg in the prophylactic treatment of infections have been well defined: a) primary antibody deficiency; b) multiple myeloma and chronic lymphocytic leukemia with hypogammaglobulinemia and recurrent bacterial infections; c) bone marrow allograft; d) childhood AIDS; e) chicken pox seroprophylaxis in immunosuppressed patients and pregnant women. Therapeutic indications of IVIg in infectious diseases are limited to chronic parvovirus B19 infection associated or not with HIV infection. Other therapeutic indications are not well defined.
静脉注射免疫球蛋白(IVIg)是完整IgG的治疗制剂,由一千多名健康献血者的血浆制备而成,含有针对多种微生物制剂的抗体。IVIg含有大量具有调理活性的抗体,适用于原发性低丙种球蛋白血症患者的替代治疗。IVIg还含有能够中和某些具有超抗原活性的细菌毒素的抗体,并通过这种机制发挥抗感染和免疫调节活性。在过去十五年中,IVIg在感染预防性治疗中的适应证已得到明确界定:a)原发性抗体缺陷;b)伴有低丙种球蛋白血症和复发性细菌感染的多发性骨髓瘤和慢性淋巴细胞白血病;c)骨髓同种异体移植;d)儿童艾滋病;e)免疫抑制患者和孕妇的水痘血清预防。IVIg在传染病中的治疗适应证仅限于与HIV感染相关或不相关的慢性细小病毒B19感染。其他治疗适应证尚不明确。