Gilbert E M, Dewitt C W, Eiswirth C C, Renlund D G, Menlove R L, Freedman L A, Herrick C M, Gay W A, Bristow M R
Am J Med. 1987 Feb;82(2):202-6. doi: 10.1016/0002-9343(87)90056-8.
OKT3 monoclonal antibody is a murine monoclonal antibody specific for the T lymphocyte T3 cell surface receptor that mediates antigen recognition. The use of OKT3 monoclonal antibody for the treatment of cardiac allograft rejection refractory to conventional therapy with high-dose steroids and antithymocyte globulin is described. Seven patients received 5 mg of OKT3 monoclonal antibody intravenously per day for 10 to 14 days. Diagnosis of moderate or severe rejection was made in all seven from right ventricular endomyocardial biopsy. Biopsy was repeated 48 to 72 hours and seven to 10 days after OKT3 monoclonal antibody was begun. With treatment, four patients had a complete response, with improvement on both early and late biopsy. Two patients had partial responses, with improvement on early biopsy followed by worsening rejection on late biopsy. One patient died of graft failure six hours after receiving OKT3 monoclonal antibody. Adverse events were common in the first two days of therapy but were well tolerated. It is concluded that OKT3 monoclonal antibody is useful in the treatment of refractory cardiac allograft rejection.
OKT3单克隆抗体是一种针对T淋巴细胞T3细胞表面受体的鼠单克隆抗体，该受体介导抗原识别。本文描述了使用OKT3单克隆抗体治疗经大剂量类固醇和抗胸腺细胞球蛋白常规治疗无效的心脏移植排斥反应。7例患者每天静脉注射5mg OKT3单克隆抗体，持续10至14天。所有7例均通过右心室心内膜活检诊断为中度或重度排斥反应。在开始使用OKT3单克隆抗体后48至72小时以及7至10天重复进行活检。治疗后，4例患者完全缓解，早期和晚期活检均有改善。2例患者部分缓解，早期活检有改善，但晚期活检排斥反应恶化。1例患者在接受OKT3单克隆抗体6小时后死于移植物衰竭。不良事件在治疗的前两天很常见，但耐受性良好。结论是OKT3单克隆抗体可用于治疗难治性心脏移植排斥反应。
