Prins Christa, Gelfand Erwin W, French Lars E
Department of Dermatology, Geneva University Medical School, Geneva, Switzerland.
Acta Derm Venereol. 2007;87(3):206-18. doi: 10.2340/00015555-0249.
Since they were first administered to patients with antibody deficiency disorders over 50 years ago, human intravenous immunoglobulin preparations have been used successfully to treat a rapidly increasing number of autoimmune and inflammatory disorders, among which are a series of cutaneous autoimmune and inflammatory diseases. These include dermatomyositis, Kawasaki's disease, a number of autoimmune bullous diseases, severe adverse drug reactions, and other autoimmune and/or allergic conditions, such as atopic dermatitis. Although only a minority of these indications (dermatomyositis, Kawasaki's disease) are officially registered or based on double-blind, placebo-controlled clinical studies, the observed efficacy and safety profile of currently available intravenous immunoglobulin sometimes makes this a treatment of choice for initiation of therapy or for replacement of more toxic alternatives, such as systemic immunosuppressive medications. The increasing use of intravenous immunoglobulin has been associated with further understanding of its mechanism(s) of action, clinical manipulation and associated side-effects, as well as the introduction of improved or new types of intravenous immunoglobulin. This paper reviews the current knowledge of the mode of action of intravenous immunoglobulin, its reported therapeutic effects in cutaneous disease, its mode of administration and safety profile, and compares the currently available intravenous immunoglobulin preparations.
自50多年前首次应用于抗体缺乏症患者以来，静脉注射用人免疫球蛋白制剂已成功用于治疗越来越多的自身免疫性和炎症性疾病，其中包括一系列皮肤自身免疫性和炎症性疾病。这些疾病包括皮肌炎、川崎病、多种自身免疫性大疱性疾病、严重药物不良反应以及其他自身免疫和/或过敏性疾病，如特应性皮炎。尽管这些适应症中只有少数（皮肌炎、川崎病）是正式注册的或基于双盲、安慰剂对照临床研究，但目前可用的静脉注射免疫球蛋白所观察到的疗效和安全性有时使其成为起始治疗或替代毒性更大的替代药物（如全身免疫抑制药物）的首选治疗方法。静脉注射免疫球蛋白的使用日益增加，这与对其作用机制、临床操作及相关副作用的进一步了解以及改进型或新型静脉注射免疫球蛋白的推出有关。本文综述了静脉注射免疫球蛋白作用方式的现有知识、其在皮肤病中的报道治疗效果、给药方式和安全性，并比较了目前可用的静脉注射免疫球蛋白制剂。
