大剂量静脉注射丙种球蛋白对针对凝血因子VIII（抗血友病因子）自身抗体的抗独特型抑制作用。

Anti-idiotypic suppression of autoantibodies to factor VIII (antihaemophilic factor) by high-dose intravenous gammaglobulin.

作者信息

Sultan Y, Kazatchkine M D, Maisonneuve P, Nydegger U E

出版信息

Lancet. 1984 Oct 6;2(8406):765-8. doi: 10.1016/s0140-6736(84)90701-3.

DOI:10.1016/s0140-6736(84)90701-3

Abstract

In two patients with high-titre autoantibodies to antihaemophilic factor (VIIIc), treatment with high-dose intravenous immunoglobulin (IVIg) resulted in rapid and prolonged, although not total, suppression of antibody. IVIg also inhibited anti-VIIIc activity in patients' plasma in vitro; IVIg and F(ab')2 fragments from IVIg inhibited anti-VIIIc activity of the IgG fraction and of the Fab'2 fragments of the IgG fraction from patients' plasma, indicating that the in-vivo effect of IVIg was due to the presence in the therapeutic immunoglobulins of anti-idiotypic antibodies against idiotypes expressed by anti-VIIIc autoantibodies. In contrast, IVIg had little or no effect on antibody titre in two haemophilic patients with anti-VIIIc alloantibodies. These observations suggest that IVIg contains anti-idiotypes against autoantibodies and may be effective in the treatment of some autoimmune diseases through idiotypic/anti-idiotypic interactions.

摘要

在两名针对抗血友病因子（VIIIc）具有高滴度自身抗体的患者中，大剂量静脉注射免疫球蛋白（IVIg）治疗导致抗体快速且持久（尽管并非完全）抑制。IVIg在体外也抑制患者血浆中的抗VIIIc活性；IVIg及IVIg的F(ab')2片段抑制患者血浆IgG组分及IgG组分的Fab'2片段的抗VIIIc活性，表明IVIg的体内效应归因于治疗性免疫球蛋白中存在针对抗VIIIc自身抗体所表达的独特型的抗独特型抗体。相比之下，IVIg对两名患有抗VIIIc同种抗体的血友病患者的抗体滴度几乎没有影响。这些观察结果表明，IVIg含有针对自身抗体的抗独特型抗体，并且可能通过独特型/抗独特型相互作用有效治疗某些自身免疫性疾病。