实验性变应性神经炎中的膜血浆置换：对抗体水平和临床病程的影响。

Membrane plasma exchange in experimental allergic neuritis: effect on antibody levels and clinical course.

作者信息

Harvey G K, Schindhelm K, Antony J H, Pollard J D

机构信息

Department of Medicine, University of Sydney, Australia.

出版信息

J Neurol Sci. 1988 Dec;88(1-3):207-18. doi: 10.1016/0022-510x(88)90218-3.

DOI:10.1016/0022-510x(88)90218-3

PMID:3225620

Abstract

The effect of membrane plasma exchange on the course of chronic experimental allergic neuritis in rabbits is described. Using miniature membrane plasma separators conscious animals were treated with 4 exchanges over 5 days removing one plasma volume per procedure and using a non-immunogenic gelatin plasma solution as replacement. Comparisons of clinical scores between control and treated groups indicated that treated animals received significant benefit from plasma exchange (day 1 post-treatment P less than 0.002; day 3 post-treatment P less than 0.01). However, relapse was observed in all plasma exchanged animals such that by day 8 post-treatment there was no significant difference in clinical scores between the two groups. Quantitation of anti-myelin IgG and IgM by ELISA assay showed that 55-60% of circulating antibody was removed per exchange. Rapid post-exchange antibody rebound was observed for both IgG and IgM so that pre-exchange levels were re-established within 24-48 h. However, no significant overshoot in circulating levels of anti-myelin IgG nor IgM could be observed. It is probable that long-term remission as a result of therapeutic plasma exchange is a function of effective circulating plasma removal and if present, the suppression of ongoing antigenic stimuli.

摘要

描述了膜血浆置换对兔慢性实验性变应性神经炎病程的影响。使用微型膜血浆分离器对清醒动物进行治疗，在5天内进行4次置换，每次置换去除一个血浆容量，并使用非免疫原性明胶血浆溶液作为置换液。对照组和治疗组临床评分的比较表明，接受血浆置换的动物从血浆置换中获得了显著益处（治疗后第1天P<0.002；治疗后第3天P<0.01）。然而，在所有接受血浆置换的动物中均观察到复发，以至于治疗后第8天两组的临床评分无显著差异。通过ELISA测定法对抗髓磷脂IgG和IgM进行定量分析表明，每次置换可去除55%-60%的循环抗体。观察到IgG和IgM在置换后均迅速出现抗体反弹，因此在24-48小时内恢复到置换前水平。然而，未观察到抗髓磷脂IgG和IgM循环水平的显著过度升高。治疗性血浆置换导致的长期缓解可能是有效去除循环血浆的结果，如果存在持续的抗原刺激，还可能是对其抑制的结果。