Utilisation thérapeutique des immunoglobulines polyvalentes en hématologie

P. Rachieru (Praticien attaché) , A. Schmidt (Assistante hospitalo-universitaire) , I. Pellier (Praticien hospitalier) , A. Godon (Assistant hospitalo-universitaire) , V. Daniel (Pharmacien hospitalier) , X. Rialland (Praticien hospitalier) , M. Hunault-Berger (Professeur des Universités, Praticien hospitalier) , N. Ifrah (Professeur des Universités, praticien hospitalier, chef de service)
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引用次数: 0

Abstract

The efficacy and the safety of intravenous immunoglobulins (IVIG) have been attentively explored since 1970. Their mechanisms of action involve the Fc-receptor blockade, the neutralization of microbial toxins, and the modulation of cytokine production. Their indications depend both on their replacement and immuno-modulation abilities. They include primary antibody deficiencies, secondary hypogammaglobulinemic states with serious repetitive infections, and autoimmune disorders such as the immune thrombocytopenic purpura, whereas IVIG are no more systematically used in sibling hematopoietic stem cell transplantation. Despite major precautions in the manufacturing process, there is still a possible transmission of hitherto unrecognized or recognized infective agents for blood-derived preparations. This emphasizes the need of excellent indications for these expensive products.

多价免疫球蛋白在血液学中的治疗应用
自1970年以来,静脉注射免疫球蛋白(IVIG)的有效性和安全性一直受到关注。它们的作用机制包括fc受体阻断、微生物毒素的中和和细胞因子产生的调节。它们的适应症取决于它们的替代和免疫调节能力。它们包括一抗缺陷、继发性低γ -球蛋白血症伴严重重复感染和自身免疫性疾病,如免疫性血小板减少性紫癜,而IVIG已不再系统地用于同胞造血干细胞移植。尽管在生产过程中采取了重大预防措施,但仍有可能传播迄今未被识别或已被识别的血液来源制剂感染因子。这强调了这些昂贵的产品需要良好的适应症。
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