Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea.
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea.
Int Immunopharmacol. 2017 Nov;52:1-6. doi: 10.1016/j.intimp.2017.08.020. Epub 2017 Aug 31.
Polyvalent human immunoglobulin G (IgG) preparations produced from the plasma pools of healthy blood donors have been used for the treatment of various autoimmune diseases and allergic diseases because of their anti-inflammatory and immunomodulatory effects. We hypothesized that intramuscular administration of autologous total IgG would induce immunomodulatory effects in patients with allergic diseases, based on the clinical efficacy of autologous blood therapy in patients with atopic dermatitis (AD).
Sixteen adult AD patients with IgE-mediated sensitization to the house dust mite (Dermatophagoides farinae) received intramuscular injections of 50 mg autologous total IgG twice a week for 4 weeks. The serum levels of IgE, IgG, and IgG4 antibodies to the recombinant group 2 major allergen of Dermatophagoides farinae (Der f 2) and serum levels of interleukin (IL)-10, IL-4, IL-12, and interferon gamma (IFN-γ) were measured by enzyme-linked immunosorbent assay at baseline and at weeks 4, 8, and 12.
The serum level of IgE antibodies to Der f 2 was significantly decreased at 12 weeks compared with baseline (p<0.005). The serum levels of IgG and IgG4 antibodies to Der f 2 were significantly increased at 4, 8, and 12 weeks compared with baseline (p<0.05). The serum levels of IL-10 and IFN-γ were significantly increased at 4, 8, and 12 weeks compared with baseline (p<0.05). There were no significant differences in the serum levels of IL-4 or IL-12 before and after intramuscular administrations of autologous total IgG (p>0.05).
Intramuscular administration of autologous total IgG induced anti-allergic immunomodulatory effects in AD patients. Further studies are required to evaluate the detailed immunological mechanism underlying these effects.
多价人免疫球蛋白 G(IgG)制剂是从健康献血者的血浆池制备的,由于其具有抗炎和免疫调节作用,已被用于治疗各种自身免疫性疾病和过敏性疾病。我们假设,基于变应性皮肤病(AD)患者自体血疗法的临床疗效,肌内注射自体总 IgG 会诱导过敏性疾病患者的免疫调节作用。
16 例 IgE 介导的尘螨(屋尘螨)过敏的成年 AD 患者每周两次肌内注射 50mg 自体总 IgG,共 4 周。在基线和第 4、8、12 周时,通过酶联免疫吸附试验测定血清 IgE、IgG 和 IgG4 抗体对重组尘螨组 2 主要过敏原(Der f 2)的水平,以及血清白细胞介素(IL)-10、IL-4、IL-12 和干扰素 γ(IFN-γ)的水平。
与基线相比,第 12 周时 Der f 2 的 IgE 抗体血清水平显著降低(p<0.005)。与基线相比,第 4、8 和 12 周时 Der f 2 的 IgG 和 IgG4 抗体血清水平显著升高(p<0.05)。第 4、8 和 12 周时,血清 IL-10 和 IFN-γ 水平与基线相比显著升高(p<0.05)。肌内注射自体总 IgG 前后血清 IL-4 或 IL-12 水平无显著差异(p>0.05)。
肌内注射自体总 IgG 诱导 AD 患者产生抗过敏性免疫调节作用。需要进一步研究以评估这些作用的详细免疫学机制。