Ohizumi Y, Suzuki H, Numazaki Y, Imaizumi M, Koisumi Y, Suzuki H, Tada K, Minegishi M, Tsuchiya S, Konno T
Clinical Research Division, Sendai National Hospital.
Tohoku J Exp Med. 1994 Sep;174(1):11-7. doi: 10.1620/tjem.174.11.
Thirty-two children with bone marrow transplantation (BMT) received intravenous injections of gammaglobulin (IVIG) with a high titer of neutralizing (NT) antibody against human cytomegalovirus (HCMV) (200 mg/kg/week) from 1 week before to 4 months after transplantation. NT antibody titers before BMT and the highest levels in serial determinations conducted after BMT were compared for each patient. They were classified into three groups according to the antibody response: primary HCMV infection as group I, endogenous reactivation or external reinfection as group II, and indeterminable cases as group III. Two (6.3%) out of 32 patients examined had BMT-associated primary HCMV infections, but did not show any clinical symptoms. Significant changes in clinical parameters were also lacking in all the other 30 patients, independent of whether they shed viruses into the urine, or demonstrated on antibody boost. It was concluded from the group variation that the antibody response was indeed due to the engraftment of BMT, rather than to a direct effect of treatment with IVIG. Our results further indicate that passive immunization with HCMV antibody does not prevent infection, but confers some protection against symptomatic disease.
32名接受骨髓移植（BMT）的儿童在移植前1周直至移植后4个月，每周静脉注射一次高滴度人巨细胞病毒（HCMV）中和（NT）抗体的丙种球蛋白（IVIG）（200mg/kg）。比较了每位患者BMT前的NT抗体滴度以及BMT后系列检测中的最高水平。根据抗体反应将他们分为三组：I组为原发性HCMV感染，II组为内源性再激活或外源性再感染，III组为无法确定的病例。32名接受检查的患者中有2名（6.3%）发生了与BMT相关的原发性HCMV感染，但未表现出任何临床症状。其他30名患者的临床参数也没有显著变化，无论他们是否向尿液中排出病毒，或在抗体增强方面表现如何。从组间差异得出的结论是，抗体反应确实是由于BMT的植入，而不是IVIG治疗的直接作用。我们的结果进一步表明，用HCMV抗体进行被动免疫不能预防感染，但能对有症状的疾病提供一定的保护。
