Szenborn Leszek
Katedra i Klinika Pediatrii i Chorób Infekcyjnych AM we Wrocławiu.
Pol Merkur Lekarski. 2011 Jun;30(180):441-7.
The use of immunoglobulins in the treatment of infectious diseases has a long tradition. Initially immunoglobulins from hyperimmunised animals were used for their antitoxic and antimicrobial activity. The development of preparations of human intravenous immunoglobulin (IVIG) and the observations of their long-term use enabled to assess their usefulness in the treatment of the diseases of proven or probable infectious etiology. In the treatment of infectious diseases IVIG are currently used as immunomodulating drugs or immunosuppressive therapy, more frequently than the specific antibodies against the viruses, bacteria or their toxins. In practice of the infectious ward IVIG are used as a drug of choice in the treatment of Kawasaki disease, in toxic epidermolysis and Stevens-Johnson syndrome. As adjunctive therapy IVIG are used in the infection with parvovirus B19, in hemophagocytic syndrome, for treatment of infections presenting with a severe toxemia caused by Clostridium difficile, Streptococcus pyogenes and Staphylococcus aureus. The rationale for the use of IVIG may be also serious infections caused by enteroviruses, particularly neuroinfections. The use of IVIG in the treatment of sepsis is controversial, since their effectiveness is not proven.
免疫球蛋白用于治疗传染病已有很长的历史。最初，来自高度免疫动物的免疫球蛋白因其抗毒和抗菌活性而被使用。人静脉注射免疫球蛋白（IVIG）制剂的研发以及对其长期使用的观察，使得人们能够评估其在治疗已证实或可能由感染引起的疾病中的效用。在传染病治疗中，IVIG目前用作免疫调节药物或免疫抑制疗法，其使用频率高于针对病毒、细菌或其毒素的特异性抗体。在感染病房的实际应用中，IVIG被用作治疗川崎病、中毒性表皮坏死松解症和史蒂文斯-约翰逊综合征的首选药物。作为辅助治疗，IVIG用于治疗细小病毒B19感染、噬血细胞综合征，以及治疗由艰难梭菌、化脓性链球菌和金黄色葡萄球菌引起的严重毒血症感染。使用IVIG的理论依据还可能包括由肠道病毒引起的严重感染，尤其是神经感染。IVIG用于治疗脓毒症存在争议，因为其有效性尚未得到证实。
