Charlton B, Antony G, Cooper S G, Schindhelm K
Centre for Biomedical Engineering, University of New South Wales, Kensington, Australia.
Clin Exp Immunol. 1988 May;72(2):326-9.
Plasma exchange (PE) and ex vivo immunoadsorption (IA) may be applicable to the removal of anti-insulin antibodies (AI-Ab) from diabetic patients. However, the removal of antibodies may prompt an increase in their rate of synthesis and an overshoot of antibody levels which may be deleterious to the patient. The effects of both PE and IA on AI-Ab synthesis were studied in a rabbit model. Rabbits were immunized with insulin and the resulting AI-Abs removed by both plasma exchange and specific immunoadsorption. Following AI-Ab removal by PE no increase in AI-Ab synthesis or antibody overshoot occurred. However a large increase in AI-Ab synthesis and overshoot occurred following specific AI-Ab removal by immunoadsorption. Despite similar reductions in AI-Ab levels by PE and IA, no increase in antibody synthesis occurred due solely to antibody removal. It is likely that antigen released from the immunoadsorbent stimulated the increase in antibody synthesis following immunoadsorption. These findings are relevant to the clinical application of both PE and IA.
血浆置换（PE）和体外免疫吸附（IA）可能适用于清除糖尿病患者体内的抗胰岛素抗体（AI-Ab）。然而，抗体的清除可能会促使其合成速率增加以及抗体水平出现过高现象，这可能对患者有害。在兔模型中研究了PE和IA对AI-Ab合成的影响。用胰岛素免疫兔子，然后通过血浆置换和特异性免疫吸附去除产生的AI-Ab。通过PE去除AI-Ab后，未出现AI-Ab合成增加或抗体过高现象。然而，通过免疫吸附特异性去除AI-Ab后，AI-Ab合成大幅增加且出现过高现象。尽管PE和IA使AI-Ab水平有相似程度的降低，但仅抗体清除并不会导致抗体合成增加。很可能是免疫吸附剂释放的抗原刺激了免疫吸附后抗体合成的增加。这些发现与PE和IA的临床应用相关。
