Pouteil-Noble C, Touraine J L, Gibert R, Aymard M
Rev Fr Transfus Immunohematol. 1984 Jun;27(3):365-74. doi: 10.1016/s0338-4535(84)80177-4.
The frequency and severity of CMV infections in kidney, bone marrow, heart transplant recipients, in polytransfused patients, in immunodeficiencies and in newborns with congenital or peri-natal infection prompted clinical trials of immunoglobulins (Ig) with anti-CMV activity. Among the various methods for titrating Ig of plasmatic or placental origin, polyvalent or hyperimmune, ELISA would be the most sensitive assay and the neutralizing reaction might be the better reflection of a protective effect. In kidney transplantation, two non-randomized clinical trials have suggested a curative effect in association to other treatments, especially when given early. In bone marrow transplantation, three randomized studies have shown a prophylactic effect on incidence of symptomatic infections, interstitial pneumonias due to CMV, but only in seronegative patients not treated with leucocyte transfusions. No effect was observed on the time of infection, the survival of patients, the incidence of surinfections or graft versus host disease. The prophylactic effect of anti-CMV Ig in kidney and heart transplantation as well as in newborns has still to be documented in randomized trials. The possible clinical benefit for the patients and the mode of preparation of effective anti-CMV antibodies need further investigations.
巨细胞病毒（CMV）感染在肾移植、骨髓移植、心脏移植受者、多次输血患者、免疫缺陷患者以及患有先天性或围产期感染的新生儿中的发生频率和严重程度，促使人们开展了针对具有抗CMV活性免疫球蛋白（Ig）的临床试验。在用于滴定血浆来源或胎盘来源、多价或高效价免疫球蛋白的各种方法中，酶联免疫吸附测定（ELISA）可能是最灵敏的检测方法，而中和反应可能是对保护作用的更好反映。在肾移植中，两项非随机临床试验表明，免疫球蛋白与其他治疗方法联合使用具有治疗效果，尤其是早期使用时。在骨髓移植中，三项随机研究表明，免疫球蛋白对症状性感染、由CMV引起的间质性肺炎的发生率具有预防作用，但仅在未接受白细胞输血治疗的血清阴性患者中有效。对于感染时间、患者生存率、继发感染发生率或移植物抗宿主病，未观察到有任何影响。抗CMV免疫球蛋白在肾移植、心脏移植以及新生儿中的预防作用仍有待随机试验加以证实。免疫球蛋白对患者可能的临床益处以及有效抗CMV抗体的制备方式需要进一步研究。
