De Ponti F, Lecchini S, Cosentino M, Castelletti C M, Malesci A, Frigo G M
Department of Internal Medicine and Therapeutics, University of Pavia, Italy.
Drug Saf. 1993 Mar;8(3):235-50. doi: 10.2165/00002018-199308030-00005.
Long term administration of anticonvulsants is sometimes associated with impairment of the humoral and/or cellular immune response. Furthermore, certain well known adverse reactions to antiepileptics may have an immunotoxicological origin e.g. lymphadenopathy, pseudolymphoma and systemic lupus erythematosus. However, two important questions remain unresolved. First, the possibility that epilepsy per se might be primarily associated with immune alterations makes it difficult to assess the pathogenetic role of a specific drug, especially in a patient population usually on multiple drug therapy. Secondly, the clinical relevance of some of the observed immunological abnormalities is still highly controversial. This review is intended to give an outline of the present state of knowledge on the effects of anticonvulsants on humoral, cellular and nonspecific immunity, with particular regard to some of the major clinical conditions that have been ascribed to drug-induced immune dysregulation, such as pseudolymphoma and systemic autoimmune diseases. The immunotoxic potential of anticonvulsants appears to be low, and immunological monitoring is not usually required except in patients with known immune defects.
长期服用抗惊厥药有时会伴有体液和/或细胞免疫反应受损。此外，某些众所周知的抗癫痫药不良反应可能源于免疫毒理学，例如淋巴结病、假性淋巴瘤和系统性红斑狼疮。然而，有两个重要问题仍未解决。其一，癫痫本身可能主要与免疫改变有关，这使得评估特定药物的致病作用变得困难，尤其是在通常接受多种药物治疗的患者群体中。其二，一些观察到的免疫异常的临床相关性仍存在高度争议。本综述旨在概述抗惊厥药对体液免疫、细胞免疫和非特异性免疫影响的现有知识状态，特别关注一些被归因于药物诱导的免疫失调的主要临床病症，如假性淋巴瘤和全身性自身免疫性疾病。抗惊厥药的免疫毒性潜力似乎较低，除已知有免疫缺陷的患者外，通常不需要进行免疫监测。
