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[中枢神经系统感染性炎症性疾病中IgG类治疗性免疫球蛋白的脑脊液通路]

[Cerebrospinal fluid passage of therapeutic immunoglobulins of the IgG class in infectious inflammatory disease of the CNS].

作者信息

Neu I, Kreuter F, Prosiegel M, Pfaffenrath V, Autenrieth W, Bauer H

出版信息

Fortschr Med. 1981 Nov 5;99(41):1719-22.

PMID:7319441
Abstract

Immunoglobulins are often used as an optimizing therapy in cases of infectious diseases of the central nervous system. To clarify the question of whether or not an intravenously administered compound of the IgG class is able to penetrate the cerebrospinal fluid barrier despite its high molecular weight, 12 anti-HBs negative patients received 20 ml each of a beta-Propiolacton treated IgG compound with a high anti-HBs titre (1 : 115 000) used as a marker. Four patients having an inconspicuous fluid condition were consulted for control. Five patients were suffering from slight disturbances and three other patients had severe disorders of the blood-cerebrospinal fluid barrier function resulting from inflammatory diseases of the central nervous systems. Cerebrospinal fluid was produced by way of lumbar puncture resp. drainage for the determination of anti-HBs. Simultaneously, the concentration of antibodies in serum was determined. In all patients having barrier disturbances, anti-HBs was evident in the cerebrospinal fluid, the transfer of intravenously administered immunoglobulins to cerebrospinal fluid increasing in correlation with the degree of the barrier disorder. The therapeutical importance of immunoglobulin therapy in treating infections of the central nervous system is pointed out.

摘要

免疫球蛋白常用于中枢神经系统感染性疾病的优化治疗。为了阐明静脉注射的IgG类化合物尽管分子量高但是否能够穿透脑脊液屏障这一问题,12名抗-HBs阴性患者每人接受了20毫升经β-丙内酯处理的具有高抗-HBs滴度(1:115000)的IgG化合物作为标记物。咨询了4名液体状况不明显的患者作为对照。5名患者有轻微干扰,另外3名患者因中枢神经系统炎症性疾病导致血脑脊液屏障功能严重紊乱。通过腰椎穿刺或引流获取脑脊液以测定抗-HBs。同时,测定血清中的抗体浓度。在所有有屏障紊乱的患者中,脑脊液中均有抗-HBs,静脉注射的免疫球蛋白向脑脊液的转移与屏障紊乱程度相关增加。指出了免疫球蛋白治疗在治疗中枢神经系统感染中的治疗重要性。

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