Effect of high-dose intravenous immunoglobulin on serum chemistry, hematology, and lymphocyte subpopulations: Assessments based on controlled treatment trials in patients with neurological diseases

Koffman, Boyd M.; Dalakas, Marinos C.

doi:10.1002/(sici)1097-4598(199709)20:9<1102::aid-mus2>3.0.co;2-c

Cited by 68 publications

(40 citation statements)

References 27 publications

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“…Hemolytic anemia has been reported in patients receiving high-dose IVIG therapy for autoimmune diseases (23). On the other hand, the difference noted in this study could have been the result of hemodilution, as has been noted by others (11). Assessment of the frequencies of anemia in premature infants is complex because these patients are constantly receiving red blood cell transfusions to compensate for the sampling for laboratory tests performed in the course of routine medical care.…”

Section: Discussionsupporting

confidence: 45%

Multicenter Study To Determine Antibody Concentrations and Assess the Safety of Administration of INH-A21, a Donor-Selected Human Staphylococcal Immune Globulin, in Low-Birth-Weight Infants

Capparelli¹,

Bloom

Kueser

et al. 2005

Antimicrob Agents Chemother

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Nosocomial or late-onset sepsis is a common complication among premature infants, with a frequency inversely correlated with birth weight. Increased susceptibility to infection is due in part to an immature humoral (antibody-mediated) immune response. This study investigated the pharmacokinetics (PKs) and safety of a donor-selected specific intravenous immune globulin (IVIG) preparation, INH-A21 (Veronate), for prevention of sepsis in premature infants. Thirty-six infants weighing between 500 and 1,250 g during the first postnatal week were eligible to begin a series of up to four intravenous infusions of 500 or 750 mg/kg of body weight INH-A21. Blood samples were analyzed for antibodies against the Ser-Asp dipeptide repeat G (SdrG) and clumping factor A (ClfA) surface proteins of staphylococci. Sparse sampling and population PK analyses were performed to derive PK parameters. Following administration of the 500-and 750-mg/kg doses, the estimated average steady-state levels of anti-ClfA were 6.1 U/ml and 9.2 U/ml, respectively, and those of anti-SdrG were 5.2 U/ml and 7.7 U/ml, respectively. The elimination half-lives for anti-ClfA and anti-SdrG were 719 h and 701 h, respectively, and the clearances were 0.18 ml/h and 0.21 ml/h, respectively. In the final model, the values of the PK parameters were independent of gestational age. Both doses of INH-A21 were well tolerated, and the safety profile was similar to those of other IVIG preparations. These results suggest that a shorter dosing interval should be utilized between the first and second doses to achieve and maintain higher titers of anti-ClfA and anti-SdrG antibodies. Further studies examining INH-A21 for the prevention of late-onset sepsis in infants within the weight range studied are warranted.

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Section: Discussionsupporting

confidence: 45%

Multicenter Study To Determine Antibody Concentrations and Assess the Safety of Administration of INH-A21, a Donor-Selected Human Staphylococcal Immune Globulin, in Low-Birth-Weight Infants

Capparelli¹,

Bloom

Kueser

et al. 2005

Antimicrob Agents Chemother

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“…Additionally, RALB increased both the serum ALB and GLB levels, and then some of the above changes may be caused by GLB. Intravenously injected Ig has been reported to transiently decrease LYM, MON, and/or PLT counts in patients 39,40 and to induce apoptosis in LYM and MON of humans 41 . The same mechanism may be involved in the decreased LYM, and MON counts in the present animals.…”

Section: Discussionmentioning

confidence: 99%

Aggravation of Galactosamine Hepatotoxicity by Albumin in Rats

et al. 2008

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Abstract:The effect of rat albumin (RALB) on D-galactosamine (GalN) hepatotoxicity was investigated in male Crl:CD(SD) rats aged 6 weeks. The animals were divided into control, RALB, GalN, and RALB + GalN groups. GalN (800 mg/kg) was intraperitoneally administered immediately after an intravenous injection of RALB (100 mg/kg). The animals were euthanized 6 or 24 h later and subjected to laboratory investigations and histological examinations of the liver. Furthermore, in order to determine the contributing factors of the effect on the hepatotoxicity, intra-and intergroup comparisons were made between liver-injured and normal animals for parameters showing marked fluctuations at 6 h post-dosing. As a result, RALB induced fluctuations in many parameters, but no histological changes were observed in the liver at both 6 and 24 h. GalN induced mild or moderate hepatocyte necrosis (necrosis and/or apoptosis of hepatocytes) at 6 and 24 h, respectively, accompanied by increases in the serum ALT and AST levels. Concurrent administration of RALB with GalN markedly aggravated the GalN-induced hepatotoxicity, as shown by severe hepatocyte necrosis accompanied by further increases in the serum ALT, AST, and T-BIL levels in the surviving animals at 6 and 24 h, and by very severe hepatocyte necrosis with congestion in the dead animals. Moreover, serum tumor necrosis factor-α (TNF-α) level was also increased at 6 h in the RALB + GalN group, but not in the RALB or GalN alone groups. In conclusion, RALB was shown to aggravate GalN hepatotoxicity in rats, and the increased serum TNF-α level is considered to be a contributing factor of the aggravation. (J Toxicol Pathol 2008; 21: 175-183)

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“…The mechanism by which IVIG acts in the treatment of PNS and other autoimmune disorders is not completely understood but may include the following: (1) interacting with Fc receptors on host effector cells (eg, neutrophils, natural killer cells), thereby "distracting" these cells from neural targets opsonized by PNS antibodies; (2) neutralizing the PNS autoantibody; (3) increasing the number and effect of the regulatory T cells that maintain immunologic self-tolerance; and (4) accelerating the fractional rate of catabolism of PNS antibodies by increasing the total immunoglobulin plasma concentration. [86][87][88][89][90][91][92][93] Adverse effects of IVIG are commonly mild, related to the infusion rate, and include headache, chills, dizziness, and fluid retention. Up to 7% of patients develop IVIG-associated nephrotoxicity, and most of these cases occur with sucrose-containing preparations.…”

Section: Paraneoplastic Neurologic Syndromesmentioning

confidence: 99%