Intravenous immunoglobulin: pharmacological properties and use in polyneuropathies

Livia Dézsi, Zoltán Horváth, László Vécsei

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Introduction: Intravenous immunoglobulin (IVIg) is increasingly used for the treatment of autoimmune and systemic inflammatory diseases with both licensed and off-label indications. The mechanism of action is complex and not fully understood, involving the neutralization of pathological antibodies, Fc receptor blockade, complement inhibition, immunoregulation of dendritic cells, B cells and T cells and the modulation of apoptosis. Areas covered: First, this review describes the pharmacological properties of IVIg, including the composition, mechanism of action, and adverse events. The second part gives an overview of some of the immune-mediated polyneuropathies, with special focus on the pathomechanism and clinical trials assessing the efficacy of IVIg. A literature search on PubMed was performed using the terms IVIg, IVIg preparations, side effects, mechanism of action, clinical trials, GBS, CIDP. Expert opinion: Challenges associated with IVIg therapy and the treatment possibilities for immune-mediated polyneuropathies are discussed. The availability of IVIg is limited, the expenses are high, and, in several diseases, a chronic therapy is necessary to maintain the immunomodulatory effect. The better understanding of the mechanism of action of IVIg could open the possibility of the development of disease-specific, targeted immune therapies.

Original languageEnglish
Pages (from-to)1343-1358
Number of pages16
JournalExpert Opinion on Drug Metabolism and Toxicology
Volume12
Issue number11
DOIs
Publication statusPublished - Nov 1 2016

Keywords

  • CIDP
  • Fc receptors
  • GBS
  • IVIg
  • IgG molecule
  • anti-ganglioside antibodies
  • anti-idiotype antibodies
  • sialylation

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology

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