Clinical applications of immunoglobulin

Novaretti, Márcia Cristina Zago; Dinardo, Carla Luana

doi:10.5581/1516-8484.20110058

Cited by 6 publications

(5 citation statements)

References 83 publications

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“…It consists of over 95% IgG with a subclass distribution corresponding to that in normal human serum [113]. Initially used over 60 years ago to treat antibody deficiencies, IVIg was later recognized for its immune-modulating function and has been increasingly used in treating autoimmune conditions [114]. The underlying mechanism of the anti-inflammatory effect of IVIg is controversial and has been attributed to many factors, including complement blockage, inhibition of Fas-induced apoptosis, and various interactions between the IgG Fc domain and FcRs.…”

Section: Strategies For Targeting Fcrs In Autoimmune Diseasesmentioning

confidence: 99%

Targeting the Fc receptor in autoimmune disease

Kimberly

2014

Expert Opinion on Therapeutic Targets

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Introduction The Fc receptors and their interaction with immunoglobulin and innate immune opsonins such as CRP are key players in humoral and cellular immune responses. As the effector mechanism for some therapeutic monoclonal antibodies and often a contributor to the pathogenesis and progression of autoimmunity, FcRs are promising targets for treating autoimmune diseases. Areas covered This review discusses the nature of different Fc receptors and the various mechanisms of their involvement in initiating and modulating immunocyte functions and their biological consequences. It describes a range of current strategies in targeting Fc receptors and manipulating their interaction with specific ligands while presenting the pros and cons of these approaches. This review also discusses potential new strategies including regulation of FcR expression and receptor cross-talk. Expert opinion Fc receptors are appealing targets in the treatment of inflammatory autoimmune diseases. However, there are still knowledge limitations and technical challenges, the most important being a better understanding of the individual roles of each of the Fc receptors and enhancement of the specificity in targeting particular cell types and specific Fc receptors.

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Section: Strategies For Targeting Fcrs In Autoimmune Diseasesmentioning

confidence: 99%

Targeting the Fc receptor in autoimmune disease

Kimberly

2014

Expert Opinion on Therapeutic Targets

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“…However, the successful use of immunoglobulin in its current intravenous form was only possible in 1981 [ 6 ]. IVIG is also used for various other conditions like idiopathic thrombocytopenic purpura, primary immune deficiency, myeloma, chronic lymphocytic leukemia, and Kawasaki disease among others [ 7 ]. Barring a contraindication of previous anaphylaxis, clinical experience with IVIG has generally been favorable for GBS.…”

Section: Discussionmentioning

confidence: 99%

Hemolysis induced cross-matching difficulty with intravenous immunoglobulin: a case report

Sharma

Aryal

2018

J Med Case Reports

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BackgroundIntravenous immunoglobulin is one of the most common modalities of treatment for Guillain–Barré syndrome. Although minor complications are easily preventable with pre-medications, rare complications like hemolysis occur at unexpected times and carry risks of repeated transfusions. A complication like difficulties in cross-matching blood is an uncommon event and is often not anticipated. We present one such rare case.Case presentationA 56-year-old man of Asian origin had presented to our hospital with rapidly progressive weakness of bilateral upper and lower limbs over 4 days. Guillain–Barré syndrome was diagnosed by nerve conduction velocity testing and lumbar puncture examination. On the third day of admission in hospital he was intubated because of respiratory failure. Intravenous immunoglobulin at 0.4 mg/kg per day for 5 days was planned and started. Our patient was scheduled for tracheostomy on a routine basis anticipating prolonged requirement of ventilator support. As the blood was being arranged, the blood bank facilities informed us about difficulties in cross-matching of the blood. Repeated samples and attempts at cross-matching were futile. After reviewing the available literature and diagnosing a case of hemolysis, relevant tests were performed and they were positive.ConclusionsAnti-A and anti-B antibody present in intravenous immunoglobulin preparations sensitize the red blood cells to hemolysis and this occurrence is often incriminated as a cause of cross-matching and sometimes blood grouping difficulty. Although a high dose of intravenous immunoglobulin or repeated courses are often cited as reasons for hemolysis, individual variability in responses is common and it is not surprising to see one like we had in our case.

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“…Initially, immunoglobulins were administered by intramuscular injection; then, intravenous immunoglobulins were also introduced. Three generations of immunoglobulin preparations for intravenous administration are known: preparations obtained with the participation of enzymes, preparations containing chemically modified immunoglobulins and preparations in which immunoglobulins are processed at low pH [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Immunoglobulins as Immunomodulators in Autoimmune Diseases and Reproductive Medicine

et al. 2023

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Intravenous administration of immunoglobulins has been routinely used for more than 60 years in clinical practice, developed initially as replacement therapy in immunodeficiency disorders. Today, the use of intravenous immunoglobulins (IVIGs) is embedded in the modern algorithms for the management of a few diseases, while in most cases, their application is off-label and thus different from their registered therapeutic indications according to the summary of product characteristics. In this review, we present the state-of-the-art use of IVIGs in various autoimmune conditions and immune-mediated disorders associated with reproductive failure, as approved therapy, based on indications or off-label. IVIGs are often an alternative to other treatments, and the administration of IVIGs continues to expand as data accumulate. Additionally, new insights into the pathophysiology of immune-mediated disorders have been gained. Therefore, the need for immunomodulation has increased, where IVIG therapy represents an option for stimulating, inhibiting and regulating various immune processes.

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Clinical applications of immunoglobulin

Cited by 6 publications

References 83 publications

Targeting the Fc receptor in autoimmune disease

Targeting the Fc receptor in autoimmune disease

Hemolysis induced cross-matching difficulty with intravenous immunoglobulin: a case report

Intravenous Immunoglobulins as Immunomodulators in Autoimmune Diseases and Reproductive Medicine

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