Baumgartner J D
Schweiz Med Wochenschr. 1987 Jan 17;117(3):84-90.
The most important indications for passive immunotherapy in the field of infectious diseases are reviewed. Intramuscular immunoglobulins are useful in prophylaxis and treatment of diseases due to bacterial exotoxins and in prophylaxis of some viral infections. However, their efficacy against bacterial infections has not been demonstrated. Intravenous immunoglobulins have theoretical advantages in these infections. The few clinical studies performed in neonates and in patients of surgical intensive care units have suggested modest benefits. However, these studies did not allow to decide whether intravenous immunoglobulins have a role in these situations. Another approach still under investigation is to administer polyclonal antibodies directed against the central part of the endotoxin, the structure of which is well preserved among gram-negative bacteria. These antibodies have improved the survival of patients with gram-negative bacteremia or septic shock. When given prophylactically, they have reduced the incidence of gram-negative shock and related mortality in patients from surgical intensive care units. Further studies are in progress to determine the class and the precise specificity of these protective antibodies.
本文综述了传染病领域被动免疫治疗的最重要指征。肌内注射免疫球蛋白可用于预防和治疗由细菌外毒素引起的疾病，以及预防某些病毒感染。然而，其对细菌感染的疗效尚未得到证实。静脉注射免疫球蛋白在这些感染中具有理论优势。在新生儿和外科重症监护病房患者中进行的少数临床研究显示出一定益处。然而，这些研究无法确定静脉注射免疫球蛋白在这些情况下是否起作用。另一种仍在研究中的方法是给予针对内毒素核心部分的多克隆抗体，内毒素的结构在革兰氏阴性菌中保存良好。这些抗体提高了革兰氏阴性菌血症或感染性休克患者的生存率。预防性使用时，它们降低了外科重症监护病房患者革兰氏阴性休克的发生率及相关死亡率。正在进行进一步研究以确定这些保护性抗体的类别和精确特异性。
