Immunoglobulin in Chronic Inflammatory Diseases

Abstract

Several case studies are presented to illustrate the success of intravenous gammaglobulin (IVIG) therapy in ulcerative colitis, Crohn's disease, chronic anterior uveitis, herpes zoster, and relapsing genital herpes simplex. Hypothetical mechanisms explain the marked improvement of the chronic disorders, with particular emphasis on substitution of specific antibodies. The recently recognized heterogeneity of the major histocompatibility complex (MHC) is explored as one possible explanation for low and high responders to particular antigens. It is suggested that various chronic inflammatory disorders result from ineffective immune responses, and that the administration of IVIG may shift the delicate balance between the pathogen and the host to favor the latter.

Autoimmune enteropathy in Swedish children, 1985–2002: A call for strict diagnostic criteria

“…Moreover, in primary immunodeficiency, intravenous immunoglobulin (IVIG) is a well-established therapy in the treatment of idiopathic thrombocytopenia, dermatomyositis and Kawasaki's disease. There are several case reports describing its successful usage in other conditions, but there are few controlled studies [16]. The mechanism of action is not known but regulation of complementary activity or interaction with receptor antibodies has been considered [17,18].…”

Use of Intravenous Immunoglobulin for Patients with Inflammatory Bowel Disease with Contraindications or Who Are Unresponsive to Conventional Treatments

“…9 The balance between inhibitory and activating Fc receptors may be critical in the understanding of immune function and regulation. 8,10,11 The infusion of IVIg may also result in the suppression of pathogenic cytokines, regulate the modulation of B and T cells, neutralize pathogenic auto antibodies, and interfere with complement aggregation at target tissues. 9,10 Although the data are limited, over 20 years of case reports, abstracts, review articles, and conference papers have reported clinical benefit of IVIg in IBD likely related to its antiinflammatory and immunomodulatory effects.…”