Changes of Serum IgG Dimer Levels after Treatment with IVIg in Guillain-Barré Syndrome

Svačina, Martin K R; Röth, Philip; Bobylev, Ilja; Sprenger, Alina; Zhang, Gang; Sheikh, Kazim A.; Lehmann, Helmar C.

doi:10.1007/s11481-019-09871-0

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…IVIg has pleiotropic immunomodulatory effects, which include inhibiting Fc-mediated activation of macrophages, preventing the binding of antibodies to neural targets, and preventing complement activation which would otherwise trigger further nerve damage ( Verboon et al, 2017 ). Dimerization of antiganglioside IgG antibodies induced by IVIg alleviates their immunoreactivity in GBS patients’ sera ( Svacina et al, 2019 ). Meanwhile, high-dose IVIg [ranging from 1000 to 3000 mg/kg body weight (BW)] results in immunosuppressive and anti-inflammatory phenotypes, which is universally employed to treat autoimmune diseases like GBS ( Arumugham and Rayi, 2020 ).…”

Section: Canonical and Emerging Immunotherapies Of Guillain–barré Syndromementioning

confidence: 99%

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Shang

Feng

et al. 2021

Front. Pharmacol.

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Guillain–Barré syndrome (GBS) is an acute polyneuropathy mostly characterized by acute flaccid paralysis with or without sensory/autonomous nerve dysfunction. Current immuno therapies including intravenous immunoglobulin (IVIg), plasma exchange (PE), and newly developed biological drugs benefit patients by alleviating hyperreactive immune responses. Up to 30% of patients develop respiratory failure during hospitalization and require mechanical ventilation and intensive care. Immunotherapies, mechanical ventilation, supportive care, and complication management during the intensive care unit (ICU) stay are equally emphasized. The most important aspect of intensive care and treatment of severe GBS, that is, mechanical ventilation, has been extensively reviewed elsewhere. In contrast to immunotherapies, care and treatment of GBS in the ICU setting are largely empirical. In this review, we intend to stress the importance of intensive care and treatment, other than mechanical ventilation in patients with severe GBS. We summarize the up-to-date knowledge of pharmacological therapies and ICU management of patients with severe GBS. We aim to answer some key clinical questions related to the management of severe GBS patients including but not limited to: Is IVIg better than PE or vice versa? Whether combinations of immune therapies benefit more? How about the emerging therapies promising for GBS? When to perform tracheal intubation or tracheostomy? How to provide multidisciplinary supportive care for severe cases? How to avert life-threatening complications in severe cases?

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Section: Canonical and Emerging Immunotherapies Of Guillain–barré Syndromementioning

confidence: 99%

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Shang

Feng

et al. 2021

Front. Pharmacol.

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“…A second antibody (from a different species) is tested for its ability to bind to the first. The ability of the second antibody to bind to the first is then monitored using peroxidase-linked antibody against the species from which the second antibody is derived [ 135 , 136 , 137 , 138 ]. As in the ELISA protocol, the first antibody is made up at a concentration of about 12 μM (assuming IgG antibodies have a molecular weight of 150,000 daltons) and then serially diluted by factors of three.…”

Section: Methodsmentioning

confidence: 99%

Complementary Sets of Autoantibodies Induced by SARS-CoV-2, Adenovirus and Bacterial Antigens Cross-React with Human Blood Protein Antigens in COVID-19 Coagulopathies

Root‐Bernstein

Huber

Ziehl

2022

IJMS

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COVID-19 patients often develop coagulopathies including microclotting, thrombotic strokes or thrombocytopenia. Autoantibodies are present against blood-related proteins including cardiolipin (CL), serum albumin (SA), platelet factor 4 (PF4), beta 2 glycoprotein 1 (β2GPI), phosphodiesterases (PDE), and coagulation factors such as Factor II, IX, X and von Willebrand factor (vWF). Different combinations of autoantibodies associate with different coagulopathies. Previous research revealed similarities between proteins with blood clotting functions and SARS-CoV-2 proteins, adenovirus, and bacterial proteins associated with moderate-to-severe COVID-19 infections. This study investigated whether polyclonal antibodies (mainly goat and rabbit) against these viruses and bacteria recognize human blood-related proteins. Antibodies against SARS-CoV-2 and adenovirus recognized vWF, PDE and PF4 and SARS-CoV-2 antibodies also recognized additional antigens. Most bacterial antibodies tested (group A streptococci [GAS], staphylococci, Escherichia coli [E. coli], Klebsiella pneumoniae, Clostridia, and Mycobacterium tuberculosis) cross-reacted with CL and PF4. while GAS antibodies also bound to F2, Factor VIII, Factor IX, and vWF, and E. coli antibodies to PDE. All cross-reactive interactions involved antibody-antigen binding constants smaller than 100 nM. Since most COVID-19 coagulopathy patients display autoantibodies against vWF, PDE and PF4 along with CL, combinations of viral and bacterial infections appear to be necessary to initiate their autoimmune coagulopathies.

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“…Typischerweise werden IVIg in einer Dosierung von 0,4 g/kg Körpergewicht über 5 Tage angewendet, die Therapie mittels Plasmapherese (mindestens 4 Behandlungen) wird bezüglich der Wirksamkeit als gleichwertig angesehen [3]. Während IVIg pleiotrope immunmodulierende Effekte (anti-idiotype Antikörper, vermehrter Katabolismus von Autoantikörpern, B-/T-Zell-Modulation) entfalten, werden bei der Plasmapherese/Immunadsorption pathogene Autoantikörper aus dem Blutplasma entfernt [3,32]. Für die Immunadsorption existieren beim GBS keine größeren randomisiert-kontrollierten Studien, basierend auf Fallserien und der klinischen Erfahrung wird jedoch eine äquivalente Wirksamkeit zur Plasmapherese bei geringerer hämodynamischer Belastung angenommen [2].…”

Section: Therapieunclassified