免疫グロブリン製剤の使い方

High Dose Intravenous Immunoglobulin Therapy for Autoimmune Diseases of the Central Nervous System

中枢神経の自己免疫疾患の治療にはステロイド，血漿浄化，免疫抑制薬が用いられることが多いが，免疫グロブリン大量静注（IVIg）が用いられることもある。IVIg療法は，免疫細胞の貪食能・補体系・自己抗体・炎症性サイトカインの抑制などの薬理作用を有し，中枢神経の自己免疫疾患に対して効果が期待できる可能性がある。今後，有効性を確立するには，臨床試験によるエビデンスの蓄積が必要である。

Abstract

High-dose intravenous immunoglobulin (IVIg) therapy has pharmacological suppressive actions against phagocytosis, complement system, pathogenic autoantibodies, and inflammatory cytokines, making it an effective treatment for autoimmune diseases. Unfortunately, there is no established evidence of the efficacy of IVIg therapy for autoimmune diseases of the central nervous system. Patients who are resistant to steroids and other immunosuppressive therapies or have complications that preclude the use of strong immunosuppressive therapies are considered eligible for IVIg therapy. The advantages of IVIg therapy include safety and ease of use. However, further evidence of the efficacy of IVIg treatment for autoimmune diseases of the central nervous system is warranted.