Glotz D, Haymann J P, Sansonetti N, Francois A, Menoyo-Calonge V, Bariety J, Druet P
Service de Nephrologie, Hôpital Broussais, Paris, France.
Transplantation. 1993 Aug;56(2):335-7. doi: 10.1097/00007890-199308000-00015.
Renal transplantation in patients presenting end-stage renal failure can be hampered by the presence of alloantibodies against HLA antigens. In 4 out of 5 patients with HLA-specific alloantibodies waiting for a renal allograft, treatment with high-dose i.v. Ig resulted in a prolonged suppression (over 3 months) of most of the panel-reactive anti-HLA antibodies (PRA). Intravenous polyclonal human Ig (IVIg) and F(ab')2 fragments from IVIg inhibited the binding of patients' plasma and IgG fractions to peripheral blood lymphocytes from normal donors as well as their cytotoxicity, suggesting that the in vivo effect of IVIg was mediated by the presence, in the IVIg preparation, of anti-idiotypes directed against idiotypes borne on the anti-HLA antibodies. Thus, treatment with IVIg can be a valuable tool toward the transplantation of immunized patients.
终末期肾衰竭患者的肾移植可能会因存在针对HLA抗原的同种抗体而受到阻碍。在5名等待肾移植的具有HLA特异性同种抗体的患者中，有4名患者接受高剂量静脉注射免疫球蛋白治疗后，大多数群体反应性抗HLA抗体（PRA）受到了超过3个月的持续抑制。静脉注射多克隆人免疫球蛋白（IVIg）及其F(ab')2片段可抑制患者血浆和IgG组分与正常供体外周血淋巴细胞的结合及其细胞毒性，这表明IVIg的体内作用是由IVIg制剂中存在针对抗HLA抗体上独特型的抗独特型所介导的。因此，IVIg治疗可能是免疫患者移植的一种有价值的手段。
