Ring J
Fortschr Med. 1982 Nov 4;100(41):1917-21.
Dextrans are used in clinical medicine since more than 35 years. One of the main problems of dextran application are severe incompatibility reactions of the anaphylactoid type. Lethal cases have been reported. In the early fifties antibodies against high molecular weight dextrans have been described in patients with incompatibility reactions as well as in normals. By the introduction of new dextrans (produced by B. Leuconostoc mesenteroides B 512) with lower molecular weight and less branching newer solutions were developed without immunogenicity. When, in the early seventies, cases of severe incompatibility reactions to those dextrans were reported, nonimmunological mechanisms were discussed as e.g. direct mediator release--as in the model of rat dextran hypersensitivity--or direct complement activation via the alternative pathway.
右旋糖酐应用于临床医学已有35年以上历史。右旋糖酐应用的主要问题之一是类过敏型的严重不相容反应。已有致死病例的报道。在五十年代早期，在发生不相容反应的患者以及正常人中已发现针对高分子量右旋糖酐的抗体。通过引入新的（由肠系膜明串珠菌B 512产生的）分子量较低且分支较少的右旋糖酐，开发出了无免疫原性的新型制剂。在七十年代早期，当有报道称对这些右旋糖酐发生严重不相容反应的病例时，人们讨论了非免疫机制，例如直接介质释放——如在大鼠右旋糖酐超敏反应模型中——或通过替代途径直接激活补体。
