Schwarz J A, Koch W, Bühler V, Kaumeier S
Int J Clin Pharmacol Ther Toxicol. 1981 Aug;19(8):358-67.
Dextran-induced side effects were attributed to preformed antibodies that cross-react with dextran. These antibodies can be blocked by monovalent haptens (dextrans 1) in animals. Dextran 1 is also well tolerated in humans. Plasma levels and renal excretion of monovalent dextran (dextran 1, molecular weight around 1,000) were measured in five volunteers after intravenous administration of 20 ml 15% dextran 1 (3 g), and in one volunteer after intravenous administration of 50 ml (7.5 g). Measurements could be satisfactorily described by a two-compartment open model with elimination from the central compartment only: mean half-life for the beta phase of 1.9 h, a mean cumulative asymptotic elimination of dextran in the urine of 75%, and a mean renal clearance of 137 ml/min with a mean total clearance of 187 ml/min were estimated. The terminal half-life of dextran 60 (Macrodex) was 24 h (median). In volunteers with dextran antibodies no anaphylactoid symptoms were observed after Dx 1. In conclusion, the intravenous preinjection of dextran 1, owing to its pharmacokinetic behavior, should prevent antibody-mediated side effects after infusions with clinical dextrans (e.g., Macrodex, Rheomacrodex).
右旋糖酐引起的副作用归因于与右旋糖酐发生交叉反应的预先形成的抗体。在动物中，这些抗体可被单价半抗原（右旋糖酐1）阻断。右旋糖酐1在人体中也具有良好的耐受性。在5名志愿者静脉注射20 ml 15%右旋糖酐1（3 g）后，以及1名志愿者静脉注射50 ml（7.5 g）后，测量了单价右旋糖酐（右旋糖酐1，分子量约为1000）的血浆水平和肾排泄情况。测量结果可以用仅从中枢室消除的二室开放模型令人满意地描述：β相的平均半衰期为1.9小时，尿液中右旋糖酐的平均累积渐近消除率为75%，估计平均肾清除率为137 ml/min，平均总清除率为187 ml/min。右旋糖酐60（中分子右旋糖酐）的终末半衰期为24小时（中位数）。在有右旋糖酐抗体的志愿者中，注射右旋糖酐1后未观察到类过敏症状。总之，由于其药代动力学行为，静脉预注射右旋糖酐1应能预防临床使用右旋糖酐（如中分子右旋糖酐、低分子右旋糖酐）输液后抗体介导的副作用。
