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静脉注射免疫球蛋白在儿童系统性、自身免疫性和血管炎疾病中的应用

[Intravenously applied immunoglobulin in systemic, autoimmune and vasculitis diseases in children].

作者信息

Zeman Krzysztof, Cywińska-Bernas Agnieszka

机构信息

Uniwersytet Medyczny w Łodzi, Klinika Pediatrii Kardiologii Prewencyjnej i Immunologii Wieku Rozwojowego.

出版信息

Pol Merkur Lekarski. 2011 Jun;30(180):400-4.

Abstract

Intravenous immunoglobulin (IVIG) have been widely used in clinical practice for more than 35 years. Their specificity and diversity and their relative safety make them potent therapy in antibody deficiencies, certain infections and several autoimmune and inflammatory disorders. IVIG is a biological drug that is used routinely for idiopathic thrombocytopenic purpura, Kawasaki disease, and Guillain-Barré syndrome. Therapeutic approaches for autoimmune diseases are primarily based on suppressive measures that down regulate an over productive immune system. IVIG efficacy has been established in many clinical trials for various autoimmune diseases, vasculitis and neuroimmunological, dermatological and hematological disorders. Despite the evidence of efficacy, there are no generally accepted therapeutic guidelines, the dosage and timing of IVIG therapy, and questions of costs/benefits ratio still remain insufficiently documented and multicentric controlled clinical trials are necessary. Most available evidence for a benefit for IVIG in children comes from uncontrolled open series or case reports.

摘要

静脉注射免疫球蛋白(IVIG)已在临床实践中广泛应用超过35年。其特异性、多样性及相对安全性使其成为治疗抗体缺陷、某些感染以及多种自身免疫性和炎症性疾病的有效疗法。IVIG是一种生物药物,常用于特发性血小板减少性紫癜、川崎病和格林-巴利综合征。自身免疫性疾病的治疗方法主要基于抑制措施,以下调过度活跃的免疫系统。IVIG的疗效已在许多针对各种自身免疫性疾病、血管炎以及神经免疫性、皮肤病学和血液学疾病的临床试验中得到证实。尽管有疗效证据,但尚无普遍接受的治疗指南,IVIG治疗的剂量和时机以及成本效益比问题仍记录不足,因此需要多中心对照临床试验。关于IVIG对儿童有益的大多数现有证据来自非对照开放系列研究或病例报告。

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