tailieunhanh - Basics of Blood Management - part 8

Tự kháng thể có thể được quy định là tốt. Với kiến thức này, nó dường như thận trọng để sử dụng globulin miễn dịch khi tổng hợp globulin miễn dịch của bệnh nhân là không đủ (trẻ sơ sinh, thiếu hụt miễn dịch chính), hoặc khi bệnh nhân bị nhiễm trùng hoặc một bệnh tự miễ | Plasma Fractions 273 also inactivate parts of it affecting the activation and effector functions of T and B cells inhibit the release of proin-flammatory factors and scavenge cytokines. Autoantibodies can be regulated as well. With this knowledge it seemed prudent to use immunoglobulins when the patient s own immunoglobulin synthesis is insufficient neonates primary immune deficiency or when a patient suffers an infection or an autoimmune diseases. A vast variety of human plasma-derived immunoglobulin concentrates are on the market. They can be divided into two main groups normal immunoglobulins and hyperimmunoglobulins. Normal immunoglobulins are a concentrate of one or more classes of immunoglobulins collected from a pool of the general donor population. They are made from at least 1000 donor plasmas and contain the whole spectrum of antibodies developed in this population those against infectious agents and their toxins as well as those directed against self autoantibodies . Hyperimmunoglobulins are made from plasmas of selected donors who have been immunized against a certain antigen. However it is not mandatory that hyperimmunoglobulins actually have a higher than normal titer of the required antibody. A major problem of the preparation of plasma-derived immunoglobulin concentrates is that they have to remain in a form enabling them to react with their antigen. The purification process activates them and aggregates form. The aggregates are mainly irreversible leave the immunoglobulins without the ability to bind their antigen and can activate the complementary system. This may contribute to the side effects of immunoglobulin therapy. The standardization of immunoglobulins is difficult. It has been ruled that at least 95 of the protein in an immunoglobulin concentrate must be immunoglobulins unless albumin is added . There exist major differences between the products of the manufacturers and between batches. It is desirable that the manufacturers of .

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