国产重组人生长激素的免疫原性及作用:血清gh抗体的测定与评价。

Shuangqing Li, Yerong Yu, Zhenmei An, Zhongyun Xiong, Honglin Yu
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摘要

目的:研究一种国产重组人生长激素(rhGH)制剂的免疫原性,并评价其促生长作用。方法:我们建立了一种特异性和敏感性的放射免疫沉淀法,用于检测gh缺乏(GHD)儿童接受rhGH制剂治疗后血清中抗GH-Ab的含量。该研究包括61名GHD儿童(49名男孩和12名女孩),他们每天在睡前皮下注射rhGH (0.1 IU/Kg) 6个月。测量治疗前后患者身高、生长速度及身高标准差评分。采用放射免疫沉淀法测定血清与125I-hGH的结合率和gh -抗体滴度;采用竞争RIA法和Scatchard图法分析其结合能力和亲和度。结果:在rhGH治疗3个月后,29例患者(48%)检测到血清GH-Abs,且GH-Abs持续呈阳性,直至试验结束。另外32例(52%)患者在治疗期间血清GH-Ab未检出。将GH-Abs阳性样本按125I-hGH结合率(B/T%)分为弱阳性(B/T < 10%, n = 20)和强阳性(B/T > 15%, n = 9)组;它们的结合力、亲和力(Ka)和滴度分别为(0.1 ~ 4.8)pmol/L、(1.7 × 10(7) ~ 6.5 × 10(8))L/mol和1:4 ~ 1:8。它们很弱,不能对rhGH活性产生负面影响。GH-Ab阳性患者的身高、生长速度及身高标准差评分在治疗过程中均无下降,与阴性患者无显著差异。结论:国产rhGH制剂对儿童GHD有一定的促生长作用。近48%的患者血清GH-Ab阳性,但由于GH-Ab的滴度和结合能力较低,对GHD儿童的身高速度没有负面影响。
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[The immunogenicity and effect of domestic recombinant human growth hormone: serum GH-antibody determination and evaluation].

Objective: To investigate the immunogenicity of a domestic recombinant human growth hormone (rhGH) preparation and assess its influence on the growth-promoting effect.

Methods: We developed a specific and sensitive radioimmuno-precipitation assay to determine the anti-hGH-antibody (GH-Ab) in serum of GH-deficient (GHD) children treated with rhGH preparation. The study included 61 GHD children (49 boys and 12 girls) who were treated with daily subcutaneous injections of rhGH (0.1 IU/Kg) before sleep for six months. The patients' height, growth velocity and height standard deviation score were measured prior to and after treatment. The binding ratio with 125I-hGH and titer of GH-Abs were measured by radioimmuno-precipitation assay; the binding capacity and affinity (Ka) were analyzed by competitive RIA and Scatchard plot method.

Results: Three months after rhGH therapy, serum GH-Abs were detected in 29 patients (48%), and their GH-Abs were persistently positive till the end of the trial. Serum GH-Ab was not detectable in the other 32 patients (52%) during treatment. The GH-Abs positive samples, according to the 125I-hGH binding ratio (B/T%), were divided into the weakly positive (B/T < 10%, n = 20) and strong positive (B/T > 15%, n = 9) groups; their binding capacity, affinity (Ka) and titer were (0.1-4.8) pmol/L, (1.7 x 10(7)-6.5 x 10(8))L/mol and 1:4-1:8, respectively. They were weak and not available to give negative effect to rhGH activity. The height and growth velocity as well as height standard deviation score of the GH-Ab positive patients presented no decrease during treatment and were not significantly different from that of negative patients.

Conclusion: The domestic rhGH preparation certainly had growth-promoting effect on the children with GHD. Nearly forty-eight percent patients showed GH-Ab positive in serum, but due to the lower titer and binding capacity, the GH-Ab had no negative effect on the height velocity of GHD children.

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