IVIG new trends

    • Anonymous
      November 2, 2007 at 9:49 pm

      Graham on the British forum posted this interesting article:

      Thought this might interest you guys – from Science daily.

      Science Daily — By pinpointing the mechanism through which an intravenous therapy combats chronic inflammatory diseases, researchers have discovered that they may be able to replace the time-consuming infusion therapy with an injection that could be given during a quick office visit. Investigators at Hospital for Special Surgery in New York City have discovered that intravenous immune globulin (IVIG) or antibody therapy works, in part, by attaching to a receptor known as Fc³RIII and blocking the function of interferon gamma, a major inflammatory factor. Only a small component of the IVIG solution, 0.5%, is responsible for blocking this receptor.

      “The study suggests that it’s not the whole preparation itself, but the immune complexes within the preparation that are causing the therapeutic effect,” said Lionel Ivashkiv, M,D,, director of Basic Research at Hospital for Special Surgery (HSS) who led the study. Instead of using IVIG, which is pooled from thousands of blood donors, clinicians may be able to use small amounts of so-called immune complexes, or even design synthetic drugs that will avoid problems, such as potential exposure to infectious agents, that are associated with using blood products.

      The study appears in the January 2007 issue of the journal Immunity.

      For years, doctors have used IVIG to treat patients with autoimmune and chronic inflammatory diseases, such as dermatomyositis, Kawasaki disease, multiple sclerosis, lupus, chronic lymphocytic leukemia, and idiopathic thrombocytopenic purpura, but just how the therapy works has remained a mystery. Some researchers have shown that IVIG works, in part, by activating a receptor known as Fc³RIIb, which then suppresses auto-antibody-mediated inflammation. HSS researchers wondered whether an immune system protein called interferon gamma (IFN-³) could be involved–many chronic inflammatory and autoimmune diseases are caused or exacerbated by an overexpression of this protein.

      To test their theory, the investigators turned to macrophages, immune cells that engulf bacteria and are stimulated to kill their prey by IFN-³. The researchers found that in test tube studies of macrophages, IVIG could inhibit the action of IFN-³ signaling.

      Next, they tested the effects of IVIG in mice infected with Listeria monocytogenes, a bacteria that is usually controlled by IFN-³. They found that mice treated with IVIG, because of the suppression of IFN-³, had much more severe infections than mice treated with saline. Experiments in a mouse model of immune thrombocytopenic purpura also revealed that immune globulin inhibited IFN-³. IVIG sparks this inhibition by docking on a receptor called Fc³RIII.

      In another experiment, researchers turned their focus to a different question–which component of IVIG is responsible for its therapeutic effects. IVIG is composed of 99.5% monomeric IgG and 0.5% so-called immune complexes. The researchers cultured macrophages with the different IVIG components and discovered that the immune complexes were responsible for the suppression of IFN-³.

      “This study suggests that we can move away from using these IVIG preparations and generate very defined (synthetic) immune complexes, which have the potential to work better, be easier to deliver, and have fewer problems in terms of the infusion part of the therapy,” Dr. Ivashkiv said.

      Usually, patients must receive IVIG infusions in the hospital setting, which can involve three to four hours per day, for three consecutive days. “IVIG is time intensive, it’s somewhat expensive, and there are sometimes shortages, because it’s a human product,” Dr. Ivashkiv explained. “A lot of the limitations of the therapy is just the volume and the quantity of the material that is used. Some people get volume overload or severe allergic reactions.”

      If clinicians can deliver only the active agent of IVIG and/or design immune complexes with recombinant materials, they may be able to avoid many of these problems, say researchers. “It could be done as an injection, as part of an office visit,” commented Dr. Ivashkiv.[/I]

      Hope that’s useful – an annual injection certainly sounds very attractive compared with monthly IVIg sessions!!

      Best wishes


    • Anonymous
      November 2, 2007 at 11:44 pm

      WOW, interesting reading, I just hope that this is something that can come about in a timely fashion for those on this board who get regular infusions of IVIG. How much cheaper & easier it would be for those with CIDP, especially for the children like Emily & Kevie here on this Forum. It all makes sense, now I hope it can be accomplished very quickly.

      A friend of my son’s has early stage MS & was getting some kind of infusion or treatment every week up here, now he has just started getting a shot once a month down at the U of MN. Maybe this is something similar in the progress of MS?

    • Anonymous
      November 3, 2007 at 12:28 am


      I read something similar to what you posted about the Fc. It went into
      identifying a sugar called sialic that is what actually binds itself to the
      antibodies. It went on to state that there are few of these in an auto-
      immune deficiency and depending on whether the classes were Ig, Ia, Id,
      Im or Ih and what the subclasses were Ig1 or Ig2 and so forth. The higher
      concentration would be in the Ig1, with less in 2 or 3 or 4.

      But then, one could have a few deficiences in a couple of subclasses.

      I, uhhhhh, noticed that you were reading about mice, again…tap…tap…tap,
      you miss your little friends…I think you need to put your “ears” back on, lol.
      🙂 😀 🙂

      Great information…

      Miami Girl

    • November 3, 2007 at 12:01 pm

      Oh, thank you for that info Norb, and for pating the whole article! I can’t always figure out how to paste when just the site is given. I will put this article in the SPECIAL section of my Kevin binder and show it to the doc!
      Dawn Kevies mom

    • Anonymous
      November 3, 2007 at 3:06 pm

      I don’t think you need ‘ears’ yet.

      At least we have our ‘own brand’ of mice?
      It’s probably taken generations of mouse breeding to breed out the immune fighting aspects of any creature. With our very own mice, research can go at a far faster pace. Thank you dear mice!

    • Anonymous
      November 3, 2007 at 10:14 pm

      Hi Norb: Long time no hear. I hope you are well and enjoying the incredible Rocky Mountain fall we are having this year. Thanks for the info. Jeff