La Gamma E F, De Castro M H
Regional Neonatal Center, Westchester Medical Center, New York Medical College, Valhalla, New York 10595, USA.
Acta Paediatr Suppl. 2002;91(438):109-16. doi: 10.1111/j.1651-2227.2002.tb02914.x.
Neonatal sepsis remains an unsolved major contributor to morbidity and mortality. In the 1980s the promise of augmenting immune function using pooled intravenous gammaglobulin to supplement the exceedingly low levels of immunoglobulin G in premature infants failed to demonstrate a clear advantage. Similarly, cytokine augmentation of cellular function in the 1990s largely appeared to be suffering the same fate. However, both results may arise from a problem in experimental design where the combination of both treatments may be necessary along with specific antibody. For example, in vitro, independently of an array of other humoral and cellular immature immune system issues, opsonization of bacteria is improved in the presence of antibody. The question is whether the same result can be achieved in vivo. No experiments have been reported that directly test this hypothesis.
More investigation is needed in this challenging area of neonatal research.
新生儿败血症仍然是导致发病和死亡的一个尚未解决的主要因素。在20世纪80年代，使用静脉注射丙种球蛋白来增强免疫功能以补充早产儿极低水平的免疫球蛋白G的前景未能显示出明显优势。同样，20世纪90年代细胞因子增强细胞功能的方法似乎也遭遇了相同的命运。然而，这两个结果可能都源于实验设计中的一个问题，即可能需要将两种治疗方法与特异性抗体联合使用。例如，在体外，不考虑一系列其他体液和细胞免疫系统不成熟的问题，在有抗体存在的情况下细菌的调理作用会得到改善。问题是在体内是否能取得相同的结果。尚未有直接检验这一假设的实验报道。
在这个具有挑战性的新生儿研究领域需要更多的研究。
