Effect of IVIG administration on complement activation and HLA antibody levels
Effect of IVIG administration on complement activation and HLA antibody levels
复制标题
DOI：
10.1111/j.1432-2277.2010.01088.x
复制
发表时间：
2010-10-01
影响因子：
3.1
通讯作者：
Scornik, Juan
中科院分区：
文献类型：
--
作者：
Machimoto, Takafumi;Guerra, Giselle;Scornik, Juan
本研究的目的是观察静脉注射免疫球蛋白（IVIG）后患者补体（C）活化和HLA抗体（Abs）浓度是否发生变化。评价的患者给予IVIG作为Ab介导的排斥反应或脱敏治疗。在IVIG施用之前和之后获得的患者血清测试其对IgG（HLA Ab）和C3 b（C活化）两者的沉积的影响，如通过流式细胞术在T细胞上测量的。IVIG输注后不久测量时，IVIG始终抑制C激活，但在2-4周时恢复至初始水平，此时总血清IgG也恢复至输注前水平。IVIG剂量越高，C抑制越明显，抑制程度与HLA Ab浓度成反比。IVIG没有阻断HLA抗体的结合后立即管理，虽然水平略有下降，但持续几个月IVIG输注后。数据显示，IVIG对C的抑制是短暂的，IVIG仅诱导HLA抗体的轻度减少，这不是立即观察到的，而是在治疗数月后观察到的。这些结果可能解释了IVIG实现脱敏的不一致结果。
P>The objective of the present study was to determine if there are changes on complement (C) activation and concentration of HLA antibodies (Abs) in patients treated with intravenous immunoglobulin (IVIG). The patients evaluated were given IVIG as treatment of Ab-mediated rejection or desensitization. The patients' sera obtained before and after IVIG administration were tested for their effects on the deposition of both IgG (HLA Abs) and C3b (C activation) as measured by flow cytometry on T cells. IVIG consistently inhibited C activation when measured shortly after IVIG infusion but returned to the initial levels at 2-4 weeks, when total serum IgG also returned to pre-infusion levels. C inhibition was more pronounced with higher IVIG doses and the degree of inhibition was inversely proportional to the HLA Ab concentrations. IVIG did not block the binding of HLA Abs immediately after administration, although levels were slightly but consistently lower after several monthly IVIG infusions. The data show that C inhibition by IVIG is short-lived and that IVIG induces only a mild reduction of HLA Abs, seen not immediately but after months of treatment. These results may explain the inconsistent results of IVIG to achieve desensitization.