Berger Melvin
Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.
Immunol Allergy Clin North Am. 2008 Nov;28(4):779-802, viii. doi: 10.1016/j.iac.2008.07.002.
The availability of IgG preparations that could be administered safely by the intravenous route was finally achieved in the early to mid-1980s. Intravenous immunoglobulin (IVIG) revolutionized the treatment of primary immune deficiency diseases (PIDD) and led to the discovery of the therapeutic value of high-dose IgG in autoimmune and inflammatory diseases not associated with PIDD. Improved therapy has improved outcomes and expectations, and most PIDD patients can lead fully active and productive lives. Administration of IgG by the subcutaneous route is effective and safe and overcomes obstacles to the use of IVIG in some patients. Many patients find administration of subcutaneous IgG at home more convenient than receiving IVIG at the Doctor's office or hospital. The coming years will see increased use of subcutaneous immunoglobulin in PIDD, which will be facilitated by advances leading to higher-concentration IgG products and easier delivery.
20世纪80年代初至中期,终于实现了可通过静脉途径安全给药的免疫球蛋白制剂的供应。静脉注射免疫球蛋白(IVIG)彻底改变了原发性免疫缺陷疾病(PIDD)的治疗方法,并促使人们发现了高剂量免疫球蛋白在与PIDD无关的自身免疫性和炎症性疾病中的治疗价值。改进后的治疗方法改善了治疗效果和预期,大多数PIDD患者能够过上完全积极且富有成效的生活。通过皮下途径给药免疫球蛋白是有效且安全的,并且克服了一些患者使用IVIG的障碍。许多患者发现在家中皮下注射免疫球蛋白比在医生办公室或医院接受IVIG更方便。在未来几年,皮下免疫球蛋白在PIDD中的使用将会增加,这将因高浓度免疫球蛋白产品和更便捷给药方式等进展而得到推动。