The effects of single‐dose alternate‐day prednisone therapy on the immunological status of patients with neuromuscular diseases
The effects of single‐dose alternate‐day prednisone therapy on the immunological status of patients with neuromuscular diseases
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单剂量隔日强的松治疗对神经肌肉疾病患者免疫状态的影响
DOI：
10.1002/ana.410030213
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发表时间：
1978
影响因子：
11.2
通讯作者：
D. Engel
中科院分区：
文献类型：
--
作者：
MD” J. D. Cook;MD J. L. Trotter;MD W. K. Engel;MS J. S. Sciabbarrasi;D. Engel
在接受高单剂量、隔天强的松治疗神经肌肉疾病的患者中，研究了几个免疫变量。剂量依赖性白细胞增多症、淋巴细胞减少症和单核细胞减少症在泼尼松给药后6小时达到最大，但在24小时后恢复到对照水平。淋巴细胞减少涉及T细胞、B细胞和空细胞，其中T细胞受影响最大。血浆皮质醇水平和淋巴细胞转化对有丝分裂原的反应也被短暂和可逆地抑制。血清IgG持续下降。将正常淋巴细胞与治疗后的患者血清孵育或将治疗后的患者淋巴细胞孵育在自体预处理血清中，淋巴细胞转化也受到抑制。淋巴细胞经广泛洗涤后抑制因子未被去除。通过测量的免疫反应，对高单剂量、隔天交替的泼尼松治疗方案有反应的患者与无反应的患者无法区分。
Several immunological variables were examined in patients receiving high‐single‐dose, alternate‐day prednisone therapy for neuromuscular diseases. Dose‐dependent leukocytosis, lymphopenia, and monocytopenia occurred which were maximal 6 hours after prednisone administration but returned to control levels by the 24‐hour point. The lymphopenia involved T‐cells, B‐cells, and null cells, with the T‐cells most affected. Plasma cortisol levels and lymphocyte transformation in response to mitogens were also transiently and reversibly suppressed. There was a persistent decrease in serum IgG. Lymphocyte transformation was also suppressed when normal lymphocytes were incubated with treated patient sera or when treated patient lymphocytes were incubated in autologous pretreatment sera. The suppression factor was not removed from the lymphocytes by extensive washing. Patients whose disease responded to the high‐single‐dose, alternate‐day prednisone regimen were indistinguishable from nonresponders by the immunological responses measured.