Bemelman F J, Parlevliet K J, Schellekens P T, Surachno S, van Royen E A, ten Berge R J
Academic Medical Centre, University of Amsterdam, The Netherlands.
Transpl Immunol. 1994;2(1):47-51. doi: 10.1016/0966-3274(94)90077-9.
In the present study the consequences of administration of low-dose (0.5 mg) OKT3 for respiratory side-effects and pulmonary sequestration of labelled granulocytes are compared with the known effects of 5 mg OKT3. Ten renal transplant patients were studied, of whom five were treated with 0.5 mg OKT3 and five with 5 mg OKT3. None of the patients in the 0.5 mg group and two of the patients in the 5 mg group experienced dyspnoea. Sequestration of labelled granulocytes in the lungs was significantly lower in the patients receiving 0.5 mg OKT3 compared with the patients receiving 5 mg OKT3. The simultaneously occurring peripheral blood granulocytopenia was significantly more severe in the 5 mg group than in the 0.5 mg group. We suppose that this sequestration of circulating granulocytes in the lungs is at least partly mediated by complement activation products. In vitro it is demonstrated that fixation of complement activation products on peripheral blood lymphocytes depends on the concentration of OKT3 present in the culture medium. We conclude that respiratory side-effects shortly following infusion of OKT3 are related to complement-induced pulmonary leucostasis, the degree of which is dependent on the administered dose of OKT3.
在本研究中，将低剂量（0.5毫克）OKT3给药对呼吸副作用及标记粒细胞在肺部隔离的影响，与已知的5毫克OKT3的作用进行了比较。对10名肾移植患者进行了研究，其中5名接受0.5毫克OKT3治疗，5名接受5毫克OKT3治疗。0.5毫克组的患者均未出现呼吸困难，而5毫克组有2名患者出现呼吸困难。与接受5毫克OKT3的患者相比，接受0.5毫克OKT3的患者肺部标记粒细胞的隔离显著降低。5毫克组同时出现的外周血粒细胞减少明显比0.5毫克组严重。我们推测，循环粒细胞在肺部的这种隔离至少部分是由补体激活产物介导的。体外实验表明，补体激活产物在外周血淋巴细胞上的固定取决于培养基中OKT3的浓度。我们得出结论，OKT3输注后不久出现的呼吸副作用与补体诱导的肺部白细胞停滞有关，其程度取决于OKT3的给药剂量。
