Butler W T, Rossen R D
J Clin Invest. 1973 Oct;52(10):2629-40. doi: 10.1172/JCI107455.
To study the effects of methylprednisolone on immune mechanisms in the absence of other immunosuppressive agents or immunologically mediated diseases, we gave 17 normal adult male volunteers 96 mg of methylprednisolone daily for 3-5 days and compared results with 12 untreated controls who were studied simultaneously, 86% of treated volunteers had significant decreases in the concentrations of serum IgG. 2-4 wk after methylprednisolone, the treated volunteers had a mean decrease in IgG of 22% compared with a decrease of only 1% in untreated controls. Likewise, significant decreases in IgA concentration occurred in 43% of treated volunteers, whereas significant decreases in IgM occurred in only 14%. The lowest immunoglobulin levels occurred during the 2nd wk after a 3 day course of methylprednisolone and during the 3rd wk after a 5 day course of drug. Slightly decreased plasma concentration of [(125)I]IgG was seen in six of seven volunteers who received a 5 day course but in only one of four who received a 3 day course of drug. However, an increase in the rate of plasma clearance of IgG occurred only during the treatment period itself. During the period when the serum concentration of IgG was falling, the specific activity of IgG in the serum was relatively higher in treated men than in controls indicating decreased entry of newly synthesized IgG into the circulation. These findings suggest that a short course of methylprednisolone treatment causes a pronounced and sustained decrease in serum IgG due to increased catabolism during drug administration and to decreased synthesis during and for a variable time after drug administration.
为了研究在不存在其他免疫抑制剂或免疫介导疾病的情况下甲泼尼龙对免疫机制的影响，我们给予17名正常成年男性志愿者每天96毫克甲泼尼龙，持续3 - 5天，并将结果与同时研究的12名未治疗的对照者进行比较。86%接受治疗的志愿者血清IgG浓度显著降低。在使用甲泼尼龙2 - 4周后，接受治疗的志愿者IgG平均降低22%，而未治疗的对照者仅降低1%。同样，43%接受治疗的志愿者IgA浓度显著降低，而只有14%的志愿者IgM显著降低。最低免疫球蛋白水平出现在3天疗程的甲泼尼龙治疗后的第2周以及5天疗程的药物治疗后的第3周。在接受5天疗程药物的7名志愿者中有6名血浆[(125)I]IgG浓度略有下降，但接受3天疗程药物的4名志愿者中只有1名出现这种情况。然而，IgG血浆清除率的增加仅发生在治疗期间本身。在血清IgG浓度下降期间，接受治疗的男性血清中IgG的比活性相对高于对照者，表明新合成的IgG进入循环的量减少。这些发现表明，短期甲泼尼龙治疗会导致血清IgG显著且持续下降，这是由于给药期间分解代谢增加以及给药期间和给药后一段可变时间内合成减少所致。
