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静脉注射免疫球蛋白IgG的临床应用

[Clinical use of intravenous immunoglobulin IgG].

作者信息

Permin H, Herlin T, Koch H G, Pedersen F K

机构信息

Epidemiafdeling M, Rigshospitalet, København.

出版信息

Ugeskr Laeger. 1992 Nov 23;154(48):3411-6.

PMID:1334293
Abstract

Intravenous human immunoglobulins (IVIG) are valuable in the treatment of several immunodeficiency and autoimmune diseases. The classic, well-known indications are primary hypogammaglobulinaemic conditions, immune thrombocytopenia and Kawasaki's syndrome. IVIG's content of specific antibodies toward a series of known, pathogenic microorganisms has led to the treatment of a number of infectious conditions and IVIG has a documented effect on AIDS in children, prophylactically in cases with potentially life-threatening CMV infections in certain types of transplants and prophylactically in hypogammaglobulinaemic patients with the most common variety of leukaemia, chronic lymphocytic leukaemia. Immunotherapy with IVIG in diseases of autoimmune character such as acute and chronic demyelinating neuropathy has recently shown promising results and encouraging reports have been published in the treatment of severe, steroid-dependent asthma, juvenile chronic arthritis and systemic vasculitis and dermatomyositis where IVIG possibly has a favourable immunomodulating effect on the patient's immune response. Future treatment will probably consist of polyvalent immunoglobulins as well as monoclonal or recombinant monovalent antibodies.

摘要

静脉注射用人免疫球蛋白(IVIG)在多种免疫缺陷和自身免疫性疾病的治疗中具有重要价值。经典的、广为人知的适应证包括原发性低丙种球蛋白血症、免疫性血小板减少症和川崎综合征。IVIG中针对一系列已知致病微生物的特异性抗体成分,已使其用于多种感染性疾病的治疗,并且IVIG在儿童艾滋病治疗中、在某些类型移植中对潜在危及生命的巨细胞病毒感染进行预防性治疗以及在患有最常见白血病类型即慢性淋巴细胞白血病的低丙种球蛋白血症患者中进行预防性治疗方面均有文献记载的效果。最近,在自身免疫性疾病如急性和慢性脱髓鞘性神经病中使用IVIG进行免疫治疗已显示出有前景的结果,并且在重症、依赖类固醇的哮喘、青少年慢性关节炎、系统性血管炎和皮肌炎的治疗中也已发表了令人鼓舞的报告,在这些疾病中IVIG可能对患者的免疫反应具有有利的免疫调节作用。未来的治疗可能包括多价免疫球蛋白以及单克隆或重组单价抗体。

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