mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-2014-4-311-322mimmun-697Research ArticleОБЗОРЫREVIEWSВНУТРИВЕННЫЕ ИММУНОГЛОБУЛИНЫ: МЕХАНИЗМЫ ТЕРАПЕВТИЧЕСКИХ ЭФФЕКТОВINTRAVENOUS IMMUNOGLOBULINS: MECHANISMS OF THERAPEUTIC EFFECTSЛазановичВ. А.LazanovichV. A.

к.м.н., ассистент кафедры клинической лабораторной диагностики, общей и клиническойиммунологии ГБОУ ВПО «Тихоокеанский государственный медицинский университет» Минздрава России

PhD (Medicine), Assistant Professor, Department of Clinical Laboratory Diagnostics, General and Clinical Immunology, Pacific State Medical University, Russian Ministry of Health Care

immuno2003@mail.ruПросековаЕ. В.ProsekovaE. V.

д.м.н., профессор, заведующая кафедрой клинической лабораторной диагностики, общейи клинической иммунологии ГБОУ ВПО «Тихоокеанский государственный медицинский университет»Минздрава России

PhD, MD (Medicine), Professor, Head, Department of Clinical Laboratory Diagnostics, General and Clinical Immunology, Pacific State Medical University, Russian Ministry of Health Care

ГБОУ ВПО «Тихоокеанский государственный медицинский университет» Минздрава России, г. ВладивостокРоссияPacific State Medical University of Ministry of Health of Russia, VladivostokRussian Federation201401082014164311322Copyright © Лазанович В.А., Просекова Е.В., 20142014Лазанович В.А., Просекова Е.В.Lazanovich V.A., Prosekova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/697

Внутривенные иммуноглобулины (ВВИГ) представляют собой наиболее широко исполь-зуемые в настоящее время, иммунобиологические лекарства, получаемые из донорской крови. Они содержат антитела, в подавляющем большинстве класса IgG, полученные из пулов плазмы от 3 000 до 15000 доноров (не менее от 1000 доноров, согласно международным требованиям и руководствам) и уже более 40 лет используются при терапии различных заболеваний. Первое время их применение носило сугубо иммунозаместительный характер при первичных иммуннодефицитных состояниях, но в последние годы клинические и экспериментальные данные, показывают эффективность ВВИГ при системных и аутоиммунных заболеваниях, при иммунологическом бесплодии и невынашивании беременности, в транслантологии, гематологии и других областях медицины. Их эффективность связывают с иммуномодулирующими эффектами. Растет количество публикаций посвященной этой теме, понимание механизмов терапевтических эффектов ВВИГ, которые базируются на последних фундаментальных и клинических научных открытиях в этой области. В тоже время много остается не ясным, противоречивым, а некоторые данные носят и вовсе взаимоисключающий характер. Все это обуславливает интерес к данной группе лекарственных средств. Цель данной статьи – обобщить основные известные механизмы лечебных эффектов, результаты последних исследований в данной области, и возможные перспективные направления использования ВВИГ в будущем.

Intravenous immunoglobulins (IVIG) are currently the most widely used immunobiological drug derived from donor blood. The IVIG preparations contain antibodies, mostly, of IgG class, obtained from plasma pools of 3,000 to 15,000 donors (over 1000 donors per lot, according to international standards and guidelines), being used for treatment of various diseases over four last decades. Initially, IVIG application wasaimed for immune support only in primary immunodeficiency states. However, recent clinical and experimental data show effectiveness of the IVIG in systemic and autoimmune diseases, immune-associated infertility and miscarriage. As well as in translantology, hematology and other fields of medicine. Their efficiency is associated with immunomodulatory effects. There is a growing number of publications bearing on this subject and elucidating possible mechanisms of therapeutic effects of IVIG, which are based on the latest basic and clinical research findings in this area. At the same time, much issues remain unclear and contradictory, and some data are mutually exclusive, thus prompting further studies and trials of IVIG preparations. The aim of this article is to summarize the known basic mechanisms of therapeutic effects, main results of recent research in this area,and potential clinical applications of IVIG in future.

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