摘要:

ABSTRACTThe major function of immunoglobulins is recognition of the antigen that has caused their formation with subsequent antigen binding and removal through antigen nonspecific recognition systems of the body. Such clearance for detrimental antigens depends on a complex system of now clearly characterized single features of the immunoglobulin molecule, such as antigen‐binding capacity, viral neutralization, complement activation, fixation to receptors on the reticuloendothelial system, and maintenance of an optimal half‐life in circulation before antigen removal.When gamma‐globulins are used therapeutically, the producer must choose a purification procedure that aims at fully maintaining these features. In fact, isolation of any protein from its natural plasma protein environment may induce subtle losses of function that do not appear when such variables as molecular weight or subunit size are applied as the only quality cri

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb01137.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThis study was undertaken to compare intravenous gamma‐globulin (IVGG) for 1 year in patients with primary immune defects who had previously been treated with intramuscular gamma‐globulin (IMGG). Forty‐three patients were available for analysis. After administration of 300 mg/kg of IVGG every 3 weeks, blood immunoglobulin levels increased to within 1 SD of normal for the patient's ages. In 5 patients, this dosage regimen did not raise the immunoglobulin levels satisfactorily, although they were still better than those achieved with IMGG. In 18 patients, treatment benefits became apparent after 5–6 months of treatment. Substantial improvement was observed in 70% of these patients. Sixteen reactions occurred with 638 infusions, an incidence rate of 2.5%. If 2 patients with an IgM macroglobulin and 1 patient with an anti‐IgA antibody were excluded, the reaction incidence would probably hav

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb01138.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract.In an effort to evaluate the capacity of polyspecific IgG preparations to sensitize homologous erythrocytes, immunoglobulin G for intramuscular use and an IgG preparation for intravenous use were tested for their tendency to associate with and to opsonize homologous erythrocytes. It was found that the amount of IgG associated with erythrocytes by far exceeded the opsonic moiety. Erythrocytes incubated in IgG in amounts higher than that achieved in vivo after 5 infusions of 0.4 g/kg body weight each, were sometimes lightly opsonized when tested on rosette formation with and phagocytosis by adherent monocytes. IgG for intravenous use was lower than IgG for intramuscular use in its opsonic activity and did often not reach the level of significance. Comparison with rosette formation and phagocytosis of erythrocytes with known amounts of antibodies allowed the prediction that following high‐dose infusion of IgG, less than 25 opsonic molecules per red blood cell are achieved in recipients of blood groups A, B, and AB (and probably even less in those of blood group (O). Erythrocytes preincubated in polyspecific IgG failed to inhibit phagocytosis of optimally sensitized erythrocytes by cultured macrophage

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb00762.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThe availability of safe and effective IgG preparations for replacement therapy for patients with primary disorders of humoral immunity allows almost unlimited doses of IgG to be used. Thus, knowledge of the optimal dose and serum concentration of IgG to be achieved is of practical importance. In a multicenter study of a reduced and alkylated IgG preparation (MISG), it was shown that the MISG was well tolerated and as effective as the intramuscular immune serum globulin (ISG) used for more than 30 years. During the course of this study, we observed that the standard dose of 100 mg/kg/month resulted in a wide range of IgG levels. We began a study using another intravenous IgG preparation to determine whether the variable IgG levels were due to variability in the half‐life of IgG in these patients and whether an individualized dose of IgG could be calculated based on the half‐life for each patient. The half‐life was greatly prolonged, ranging from 26 to 86 days compared with 21 days in normal individuals. However, there was no correlation between the half‐life and the serum IgG concentration over the range of concentrations measured. When patients were treated with higher doses of IgG, based on the amount calculated to raise the serum IgG concentration to 200 mg/dl, only 1 patient actually achieved that level and only 3 had a significant increase in the serum concentration despite the higher dose. Failure to achieve the predicted levels could not be explained by a shortened half‐life and seemed to be related to increased losses in the early, redistribution, phase. The half‐life was not reduced in patients who did achieve higher serum IgG concentrations, suggesting that the half‐life is characteristic for each patient and not directly dependent on the serum IgG concentration. However, only modest increases were observed and additional studies using much higher doses of IgG will be necessary before this issue can be settled. Similarly, we did not see an additional benefit in those patients receiving higher doses of IgG, and further studies will be necessary before it can be determined whether higher levels of IgG can reduce the incidence of chronic infections and justify the increased time and expense. The results of the completed study have been published

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb01139.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract.A therapeutic trial of plasma exchange was conducted in an 82‐year‐old woman with severe cold agglutinin hemolytic anemia, who was unresponsive to conventional treatment. In spite of considerable improvement of pertinent parameters (total IgM, cold agglutinin titer and thermal amplitude) this treatment failed to induce a clinical remission. This failure may be the result of the ability of the cold agglutinin to fix complement to the red cell membrane at temperatures much higher than the thermal amplitude. A simple laboratory test to detect this dissociation between complement fixing ability and agglutination activity is descri

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb00763.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTSince a pilot study of intravenous immune globulin showed it to induce a rapid rise of thrombocytes in immune thrombocytopenia purpura (ITP) in childhood, a randomized study was started for acute, untreated ITP and a prospective study for acute and chronic, pretreated ITP in children. The results of the pilot study and preliminary data of the ongoing studies are presented. Although little is known of the effects of intravenous immune globulin, possible mechanisms of action are discussed.

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb01140.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract.From January 1980 to December 1983,989,907 blood donations were screened for HBsAg. A total of 1,345 was found HBsAg positive; 33 of whom were negative for anti‐HBc (2.45%); in 10 cases HBeAg was present at a low level along with HBsAg. 2 of the 33 subjects were lost to follow‐up. Late serum samples were available for 28 blood donors, and clinical and biological data only were known for the 3 others. An evolution of HBV markers was observed in each case; anti‐HBc antibody became positive in 24 subjects (the 4 remaining subjects had a very short follow‐up); HBeAg was positive at a high titer in 18 subjects and seroconversion to anti‐HBe was observed in 7 individuals; HBsAg concentration increased in 21 subjects from 2 to 4,000 times and decreased in the 7 others. Seroconversion to anti‐HBs was observed in 8 individuals. According to these serological, biological and clinical findings, different outcomes were observed: in 6 subjects too short a follow‐up was available to allow appropriate classification, but there was evidence to suggest all probably developed clinical hepatitis; in 6 subjects asymptomatic hepatitis with rapid loss of HBsAg occurred; in 2 subjects asymptomatic hepatitis with the persistence of HBsAg at a low level and seroconversion to anti‐HBe occurred; and in 17 subjects clinical hepatitis developed. These observations establish that most of the 33 blood donors were infectious at the time of their blood donation, and that anti‐HBc antibody screening must not replace HBsAg screening fo

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb00764.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTWe have used intravenous polyvalent intact gamma‐globulin concentrate (Sandoglobulin®‐immune globulin IV) in the management of 2 adults and 2 children with refractory immune thrombocytopenic purpura (ITP). Excellent responses were obtained in 2 children with chronic ITP as compared to no response in 2 adults with long‐standing, severe ITP. The 2 adults who failed intravenous Sandoglobulin therapy had prolonged reticuloen‐dothelial system (RES) clearance of autologous antibody‐coated red blood cells before initiation of therapy as compared to normal RES clearance rates in the 2 children who responded to therapy. Blockade of the RES is one mechanism by which intravenous Sandoglobulin therapy may reverse thrombocytopenia in ITP — our observations suggest that patients who have impaired RES function before starting intravenous Sandoglobulin therapy may fail to respond to treatment. Continued studies are required to confirm these

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb01141.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Abstract.In this study we evaluated whether the 4 °C storage‐induced coating of red blood cells (RBC) with molecules of the third component of human complement, C3, affects the viability of the preserved RBC. To this end, we determined whether the amount of C3 bound to preserved RBC correlated with the 24‐hour survival value. The % anti‐C3c‐induced agglutination of stored RBC provided an estimate of the amount of RBC‐bound C3. In some cases, the number of RBC‐bound C3c‐containing molecules was also quantitated. The 24‐hour survival of autologous RBC was measured in 114 cases. All units were initially stored at 4°C as RBC concentrates followed in 21 cases by frozen storage and in 75 cases by biochemical rejuvenation and frozen storage.The data showed a significant correlation between % anti‐C3c‐induced agglutination of the preserved RBC and the length of 4°C storage of the RBC concentrates. Neither freezing nor rejuvenation cleaved the C3c fragment from stored RBC. The 24‐hour survival was significantly and negatively correlated with both the storage length of RBC concentrates at 4°C and with the amount of RBC‐bound C3 but not with RBC ATP level. These data suggest that the RBC‐bound C3 either contributes to or is a marker for the extent of t

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb00765.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1985.tb00766.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY