Müller T, Keuchel M, Schindler S, Steinmetz A, Feiber H, Lange H
Abteilung Nephrologie, Zentrum Innere Medizin, Philipps-Universität Marburg/Lahn.
Helv Chir Acta. 1991 Sep;58(3):271-5.
The use of OKT3 monoclonal antibodies has improved the immunosuppressive therapy. Due to the high efficiency of this treatment there is an increased risk of overimmunosuppression and occurrence of life-threatening viral infections. Therefore a cautious application of OKT3 is mandatory, a reliable differential diagnosis of the deteriorating graft function essential. In this study the high diagnostic value of urinary neopterin in the early and reliable diagnosis of CMV infection under OKT3 therapy in contrast to serum amyloid A as a marker of rejection could be shown. A differential therapy, supporting or reducing the immunosuppression, might be facilitated by daily monitoring of the neopterin and serum amyloid A.
OKT3单克隆抗体的使用改善了免疫抑制治疗。由于这种治疗的高效性,过度免疫抑制和发生危及生命的病毒感染的风险增加。因此,必须谨慎应用OKT3,对移植功能恶化进行可靠的鉴别诊断至关重要。在本研究中,与作为排斥反应标志物的血清淀粉样蛋白A相比,尿新蝶呤在OKT3治疗下对巨细胞病毒感染的早期和可靠诊断具有较高的诊断价值。通过每日监测新蝶呤和血清淀粉样蛋白A,可能有助于进行支持或降低免疫抑制的差异化治疗。