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首页> 外文期刊>Journal of neuroinflammation >Intravenous immunoglobulin and Alzheimer’s disease: what now?
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Intravenous immunoglobulin and Alzheimer’s disease: what now?

机译：静脉免疫球蛋白和阿尔茨海默氏病：现在怎么办？

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Intravenous immunoglobulin (IVIG) products are prepared from purified plasma immunoglobulins from large numbers of healthy donors. Pilot studies with the IVIG preparations Octagam and Gammagard in individuals with mild-to-moderate Alzheimer’s disease (AD) suggested stabilization of cognitive functioning in these patients, and a phase II trial with Gammagard reported similar findings. However, subsequent reports from Octagam’s phase II trial and Gammagard’s phase III trial found no evidence for slowing of AD progression. Although these recent disappointing results have reduced enthusiasm for IVIG as a possible treatment for AD, it is premature to draw final conclusions; a phase III AD trial with the IVIG product Flebogamma is still in progress. IVIG was the first attempt to use multiple antibodies to treat AD. This approach should be preferable to administration of single monoclonal antibodies in view of the multiple processes that are thought to contribute to AD neuropathology. Development of “AD-specific” preparations with higher concentrations of selected human antibodies and perhaps modified in other ways (such as increasing their anti-inflammatory effects and/or ability to cross the blood–brain barrier) should be considered. Such preparations, if generated with recombinant technology, could overcome the problems of high cost and limited supplies, which have been major concerns relating to the possible widespread use of IVIG in AD patients. This review summarizes the recent AD IVIG trials and discusses the major issues relating to possible use of IVIG for treating AD, as well as the critical questions which remain.
机译：静脉免疫球蛋白（IVIG）产品由大量健康供体的纯化血浆免疫球蛋白制备而成。对患有轻度至中度阿尔茨海默氏病（AD）的个体进行的IVIG制剂Octagam和Gammagard的初步研究表明，这些患者的认知功能稳定了，一项针对Gammagard的II期试验也报告了类似的发现。但是，随后来自Octagam的II期试验和Gammagard的III期试验的报道均未发现减慢AD进展的证据。尽管这些近期令人失望的结果降低了对IVIG作为AD可能治疗方法的热情，但现在得出结论尚为时过早; IVIG产品Flebogamma的III期AD试验仍在进行中。 IVIG是使用多种抗体治疗AD的首次尝试。鉴于考虑到有助于AD神经病理的多个过程，这种方法应比单一单克隆抗体的给药更可取。应该考虑开发具有更高浓度的选定人类抗体并可能以其他方式修饰（例如提高其抗炎作用和/或穿过血脑屏障的能力）的“ AD特异性”制剂。如果用重组技术制备这些制剂，则可以克服高成本和供应有限的问题，这是与IVIG在AD患者中可能广泛使用有关的主要问题。这篇综述总结了最近的AD IVIG试验，并讨论了与可能使用IVIG治疗AD相关的主要问题，以及仍然存在的关键问题。

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