Varying titers of neutralizing antibodies to streptococcal superantigens in different preparations of normal polyspecific immunoglobulin G: Implications for therapeutic efficacy
Varying titers of neutralizing antibodies to streptococcal superantigens in different preparations of normal polyspecific immunoglobulin G: Implications for therapeutic efficacy
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DOI：
10.1086/514588
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发表时间：
1998-03-01
影响因子：
11.8
通讯作者：
Koth, M
中科院分区：
文献类型：
--
作者：
Norrby-Teglund, A;Basma, H;Koth, M
由于正常静脉注射多特异性免疫球蛋白 G (IVIG) 可以中和多种超抗原的活性，因此它可能是治疗与产生超抗原的生物体相关的疾病（包括严重的 A 族链球菌疾病）的有效辅助疗法。测定了五种 IVIG 制剂对纯化的超抗原、链球菌热原性外毒素 (Spe) 以及临床 A 组链球菌分离株培养上清液中存在的超抗原混合物的中和活性，发现不同 MG 制剂 (P < .05) 和同一 IVIG 品牌的不同批次 (P < .044) 之间存在显着差异，SpeA 的中和活性显着低于其他制剂链球菌超抗原 (P < .05)；然而，不同 IVIG 中 SpeA 结合和 SpeA 中和活性之间没有相关性。 IVIG输注后从患者获得的血浆样品中，中和抗体滴度与从各自分离株制备的培养物上清液的滴度有所不同，这种变化与给予每个研究患者的IVIG批次的中和滴度的差异平行。该研究表明，可以通过优化治疗中使用的MG类型和/或剂量来实现完全中和活性。
Inasmuch as normal intravenous polyspecific immunoglobulin G (IVIG) neutralizes the activity of a wide spectrum of superantigens, it may be an efficient adjunctive therapy for diseases associated with superantigen-producing organisms, including severe group A streptococcal diseases. The neutralizing activity against purified superantigens, streptococcal pyrogenic exotoxins (Spe), and a mixture of superantigens present in culture supernatant of clinical group A streptococcal isolates was determined for five IVIG preparations, A significant variation among different MG preparations (P < .05) and different lots of the same IVIG brand (P < .044) was found, Neutralization of SpeA activity was significantly lower than that of other streptococcal superantigens (P < .05); however, there was no correlation between SpeA binding and SpeA neutralizing activity in different IVIGs. Plasma samples obtained from patients after IVIG infusion varied in their titers of neutralizing antibodies to culture supernatants prepared from their respective isolates, and this variation paralleled differences in the neutralizing titer of the IVIG lot administered to each patient studied, The study suggests that complete neutralizing activity may be achieved by optimizing the type and/or dose of MG used in treatment.