在自身免疫性和炎症性疾病中，对 IVIg 机制和替代物的新见解。
New insights into IVIg mechanisms and alternatives in autoimmune and inflammatory diseases.
机构信息
Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario.
Centre for Innovation, Canadian Blood Services, Ottawa, Ontario.
出版信息
Curr Opin Hematol. 2020 Nov;27(6):392-398. doi: 10.1097/MOH.0000000000000609.
PURPOSE OF REVIEW
Intravenous immunoglobulin (IVIg) is an effective treatment for an increasing number of autoimmune and inflammatory conditions. However, IVIg continues to be limited by problems of potential shortages and cost. A number of mechanisms have been described for IVIg, which have been captured in newly emergent IVIg mimetic and IVIg alternative therapies. This review discusses the recent developments in IVIg mimetics and alternatives.
RECENT FINDINGS
Newly emergent IVIg mimetics and alternatives capture major proposed mechanisms of IVIg, including FcγR blockade, FcRn inhibition, complement inhibition, immune complex mimetics and sialylated IgG. Many of these emergent therapies have promising preclinical and clinical trial results.
SUMMARY
Significant research has been undertaken into the mechanism of IVIg in the treatment of autoimmune and inflammatory disease. Understanding the major IVIg mechanisms has allowed for rational development of IVIg mimetics and alternatives for several IVIg-treatable diseases.
目的综述
静脉注射免疫球蛋白（IVIg）是治疗越来越多自身免疫性和炎症性疾病的有效方法。然而，IVIg 仍然受到潜在短缺和成本问题的限制。已经描述了 IVIg 的许多作用机制，并在新兴的 IVIg 模拟物和 IVIg 替代疗法中得到了体现。这篇综述讨论了 IVIg 模拟物和替代物的最新进展。
最近的发现
新兴的 IVIg 模拟物和替代物捕捉到了 IVIg 的主要作用机制，包括 FcγR 阻断、FcRn 抑制、补体抑制、免疫复合物模拟物和唾液酸化 IgG。这些新兴疗法中的许多都具有有前景的临床前和临床试验结果。
总结
在自身免疫性和炎症性疾病的治疗中，对 IVIg 作用机制的研究已经取得了很大进展。对 IVIg 主要机制的理解为几种可通过 IVIg 治疗的疾病的 IVIg 模拟物和替代物的合理开发提供了依据。
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