Horneff G, Schwab J, Holtz N, Kalden J R, Burmester G R
Kinderklinik, Heinrich-Heine-Universität, Düsseldorf, BRD.
Infusionsther Transfusionsmed. 1993 Apr;20 Suppl 1:110-5; discussion 116-7.
Eight patients suffering from severe rheumatoid arthritis were treated with high-dose human immunoglobulin. Doses of 500 mg/kg were administered intravenously in the morning on 4 consecutive days. Improvement of arthritic symptoms was indicated by a significant decrease of the Ritchie index, the number of swollen joints, and the duration of morning stiffness as well as an increase of grip strength. The improvement lasted up to 4 months. In 2 patients the disease activity increased again after 4 weeks. Investigations of laboratory parameters demonstrated a significant reduction of the acute-phase response. Parallel investigations of immunological parameters revealed a decrease of Il-6 levels in the sera. Therefore, we suggest a decreased activation status of the monocyte-macrophage system and T cells as a possible mode of action of high-dose immunoglobulin therapy in rheumatoid arthritis.
八名患有严重类风湿性关节炎的患者接受了高剂量人免疫球蛋白治疗。连续4天每天上午静脉注射500毫克/千克的剂量。关节炎症状的改善表现为里奇指数、肿胀关节数量和晨僵持续时间显著降低，以及握力增加。这种改善持续了长达4个月。2名患者在4周后疾病活动度再次增加。实验室参数检查显示急性期反应显著降低。免疫参数的平行检查显示血清中白细胞介素-6水平降低。因此，我们认为单核细胞-巨噬细胞系统和T细胞的激活状态降低可能是高剂量免疫球蛋白治疗类风湿性关节炎的一种作用方式。
