Dalakas Marinos C
National Institutes of Health, Bethesda, MD 20892, USA.
Neurology. 2002 Dec 24;59(12 Suppl 6):S13-21. doi: 10.1212/wnl.59.12_suppl_6.s13.
Intravenous immunoglobulin (IVIg) is an immunomodulating agent that has multiple activities, including modulation of complement activation products, suppressing idiotypic antibody, saturating Fc receptors on macrophages, and suppressing various inflammatory mediators including cytokines, chemokines, and metalloproteinases. Because all these factors are implicated to various degrees in the pathogenesis of immune-mediated demyelination of the PNS, administration of IVIg could be beneficial in treating neuropathies by suppressing the immune-mediated processes that are directed against myelin or axonal antigenic targets. This article outlines the actions of IVIg in CIDP and other autoimmune neuropathies based on data derived from in vivo and in vitro studies. The predominant mechanisms by which IVIg exerts its action on these neuropathies appear to be a combined effect on complement inactivation, neutralization of idiotypic antibodies, cytokine inhibition, and saturation of Fc receptors on endoneurial macrophages.
静脉注射免疫球蛋白（IVIg）是一种具有多种活性的免疫调节剂，包括调节补体激活产物、抑制独特型抗体、使巨噬细胞上的Fc受体饱和，以及抑制包括细胞因子、趋化因子和金属蛋白酶在内的各种炎症介质。由于所有这些因素在周围神经系统免疫介导的脱髓鞘发病机制中都有不同程度的牵连，静脉注射免疫球蛋白的给药可能通过抑制针对髓鞘或轴突抗原靶点的免疫介导过程而有益于治疗神经病变。本文根据体内和体外研究数据概述了静脉注射免疫球蛋白在慢性炎性脱髓鞘性多发性神经病（CIDP）和其他自身免疫性神经病变中的作用。静脉注射免疫球蛋白对这些神经病变发挥作用的主要机制似乎是对补体失活、独特型抗体中和、细胞因子抑制以及神经内膜巨噬细胞上Fc受体饱和的综合作用。
