Buysmann S, Hack C E, van Diepen F N, Surachno J, ten Berge I J
Renal Transplant Unit, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
Transplantation. 1997 Dec 15;64(11):1620-3. doi: 10.1097/00007890-199712150-00024.
Use of the murine CD3 monoclonal antibody OKT3 is limited by first-dose side effects, which are thought to be caused by the release of inflammatory mediators. Because these processes might be influenced by the speed of administration, we compared a 2-hr OKT3 infusion with the bolus infusion usually applied nowadays.
Eighteen renal allograft recipients were prophylactically treated with OKT3 and randomized to receive the first dose either as a 2-hr infusion or as an intravenous bolus infusion. Clinical side effects score and the occurrence of complement activation, cytokine release, and activation of neutrophils were determined.
Two-hour infusion of OKT3 completely prevented the occurrence of dyspnea, reduced the incidence of other side effects, and attenuated complement activation. Cytokine release and depletion of peripheral blood lymphocytes were similar in both groups.
Thus, complement activation seems to play an additional role in the development of side effects after the first OKT3 dose.
鼠源CD3单克隆抗体OKT3的使用受到首剂副作用的限制，这些副作用被认为是由炎症介质的释放引起的。由于这些过程可能受给药速度的影响，我们将2小时输注OKT3与目前常用的静脉推注进行了比较。
18例肾移植受者接受OKT3预防性治疗，并随机分为两组，分别接受2小时输注或静脉推注首剂OKT3。测定临床副作用评分以及补体激活、细胞因子释放和中性粒细胞活化的发生情况。
2小时输注OKT3完全预防了呼吸困难的发生，降低了其他副作用的发生率，并减轻了补体激活。两组细胞因子释放和外周血淋巴细胞耗竭情况相似。
因此，补体激活似乎在首剂OKT3后副作用的发生中起额外作用。
