Sabouraud A, Scherrmann J M
INSERM U26, Hôpital F. Widal, Paris.
Therapie. 1994 Jan-Feb;49(1):41-8.
Immunotherapy of drug intoxications is based on intravenous administration of antibodies or antibody Fab fragments specific to a drug. Mechanism of action involves toxin complexation in the antibody distribution space resulting in a gradient efflux of the toxin from its binding site by dissociation of toxin-receptor to the vascular space. Reversal of toxic effects by specific Fab fragments has been demonstrated experimentally for digitalis, colchicine and tricyclic antidepressants. The intravenous administration of antibodies or Fab fragments alters toxin pharmacokinetics including tissular depletion, plasma redistribution and decrease of systemic clearance. Benefit of this therapy in clinical toxicology has been clearly shown for cardiac glycosides but has to be confirmed for colchicine and tricyclic antidepressants. Safety and efficacy of specific Fab fragments should permit an extension of this antidotal procedure towards other toxins.
药物中毒的免疫疗法基于静脉注射针对特定药物的抗体或抗体Fab片段。其作用机制包括在抗体分布空间内使毒素形成复合物，导致毒素从其结合位点通过毒素 - 受体解离而向血管空间梯度流出。针对洋地黄、秋水仙碱和三环类抗抑郁药，已通过实验证明特异性Fab片段可逆转毒性作用。静脉注射抗体或Fab片段会改变毒素的药代动力学，包括组织内药物清除、血浆再分布以及全身清除率降低。这种疗法在临床毒理学中对强心苷的益处已得到明确证实，但对秋水仙碱和三环类抗抑郁药的益处还有待确认。特异性Fab片段的安全性和有效性应能使这种解毒方法扩展至其他毒素。
