Horiuchi A, Abe Y, Miyake M, Osuka Y, Kimura S
Second Department of Surgery, Ehime University School of Medicine, Japan.
Surg Today. 1993;23(3):241-5. doi: 10.1007/BF00309234.
The overproduction of cytokines such as the tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 alpha (IL-1 alpha) may cause further deterioration in the already critical condition of patients with shock, sepsis, and acute inflammation. The effectiveness of infusion therapy of natural human IgG to such patients is suggested to depend partly upon the inhibition of the productivity of these cytokines. In this study, we investigated the modulation effects of IgG and its fragments on the production of TNF-alpha and IL-1 alpha, on human peripheral blood mononuclear cells (PBMC). The production of TNF-alpha and IL-1 alpha was found to be dose-dependently inhibited by IgG when stimulated by lipopolysaccharide (LPS), phytohemagglutinin (PHA), concanavalin A (Con A), and interleukin-2 (IL-2). However, no inhibition was seen when stimulated by phorbormyristate acetate (PMA). The F(ab')2 fragment showed enhancing effects on cytokine production by LPS, while the Fc fragment showed not as much inhibitory effect as whole intact IgG. IgG showed no direct cytotoxic effect on PBMC. These data suggest that natural human IgG inhibits TNF-alpha and IL-1 alpha production by PBMC through the Fc portion. The results of this study led us to conclude that whole intact IgG may be the best form of therapeutic delivery.
肿瘤坏死因子-α(TNF-α)和白细胞介素-1α(IL-1α)等细胞因子的过度产生,可能会使休克、脓毒症和急性炎症患者本已危急的病情进一步恶化。有人认为,给这类患者输注天然人IgG进行治疗的有效性,部分取决于对这些细胞因子产生能力的抑制。在本研究中,我们调查了IgG及其片段对人外周血单个核细胞(PBMC)产生TNF-α和IL-1α的调节作用。结果发现,当受到脂多糖(LPS)、植物血凝素(PHA)、刀豆蛋白A(Con A)和白细胞介素-2(IL-2)刺激时,IgG对TNF-α和IL-1α的产生具有剂量依赖性抑制作用。然而,当受到佛波酯(PMA)刺激时,则未见抑制作用。F(ab')2片段对LPS诱导的细胞因子产生有增强作用,而Fc片段的抑制作用不如完整的IgG。IgG对PBMC没有直接细胞毒性作用。这些数据表明,天然人IgG通过Fc部分抑制PBMC产生TNF-α和IL-1α。本研究结果使我们得出结论,完整的IgG可能是最佳的治疗给药形式。