The role of intravenous immunoglobulin therapy in autoimmune and inflammatory disorders
The role of intravenous immunoglobulin therapy in autoimmune and inflammatory disorders
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DOI：
10.1007/s100720200010
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发表时间：
2002-04-01
影响因子：
3.3
通讯作者：
Chiarini, F
中科院分区：
文献类型：
--
作者：
Emmi, L;Chiarini, F
历史上第一次使用免疫球蛋白治疗是在1890年，当时Emil Von Behring开发了针对白喉毒素的有效抗血清，但直到20世纪70年代初，血浆分离技术的进步才导致生产出可以静脉注射的免疫球蛋白制剂。静脉注射Ig产品是治疗原发性免疫缺陷、严重感染、自身免疫和炎症性疾病等疾病的主要药物。在自身免疫性和系统性炎症疾病中，IVIg表现出许多免疫调节活动，如：Fc受体介导的作用，补体的调节，细胞因子产生的调节，超抗原中和，独特型网络的抗体中和，IgG的分解代谢增加，以及IVIg制剂中存在的其他分子的生物效应。最近对IVIg成分和作用机制的了解可以解释其在自身免疫性和炎症性疾病中的治疗作用。然而，重要的是要强调IVIg是一种异质产物，很难确定其在每种疾病中的活动的确切机制。IVIg在自身免疫性疾病治疗中使用的增加概述了耐受性问题。IVIg不良反应发生在不到5%的患者中。
The first use of immunoglobulin therapy, historically, was in 1890 when Emil Von Behring developed effective antiserum against diphtheria toxin, but only in the early 1970s technological advancements in the fractionation of plasma lead to the production of Ig preparations which could be administered intravenously. Intravenous Ig products are a mainstay for disorders such as: primary immunodeficiency, serious infections, autoimmune and inflammatory disorders. During autoimmune and systemic inflammatory disease IVIg exhibits a number of immune modulatory activities such as: Fc Receptor- mediated effects, modulation of complement, modulation of cytokine production, superantigens neutralization, antibodies neutralization by idiotype network, increased catabolism of IgG, but also biologic effects of other molecules present in IVIg preparations. Recent understanding about IVIg composition and mechanism of action can explain its therapeutic effect in autoimmune and inflammatory disorders. Nevertheless it is important to underline that IVIg is a heterogeneous product and it is difficult to determine the exact mechanism of its activities in every disease. The increased use of IVIg in the treatment of autoimmune disorders outlined the issue of tolerability. Undesiderable effects to IVIg occurs in less than 5% of patients.