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Downloaded from http://journals.lww.com/co-allergy by BhDMf5ePHKbH4TTImqenVJ2toCr/9wZZjwPUWvYES9lBjFbu9i0DAnSw4JagSjiU on 10/30/2020 URRENT Advances in the treatment of primary and PINION secondary immune deficiences Srini Kaveri Intravenous immunoglobulins (IVIgs) are a thera- patients with autoimmune haemophilia. This effect peutic preparation of pooled normal polyspecific was attributed to the presence in IVIg of antiidiotypic human IgGs obtained from large numbers of antibodies against anti-Factor VIII autoantibodies [7]. healthy donors. The preparation contains anti- Subsequently, several other groups demonstrated bodies to nonself-antigens (microbial antigens), the existence of antiidiotypic antibodies against a antibodies to self-antigens (natural autoantibodies), wide range of pathogenic autoantibodies [6]. and antibodies that recognize other antibodies, also A proposed anti-inflammatory mechanism of known as antiidiotypic antibodies [1,2]. action for IVIg was an anticomplement scavenging In order to explain the therapeutic benefit effect. Indeed, binding of IVIg with complement conferred by IVIg in a large number of hetero- inhibits the generation of the C5b-9 membrane geneous disorders, several mutually nonexclusive attack complex and subsequent complement- mechanisms of action have been proposed, in the mediated tissue damage, such as that which occurs contexts of primary immune deficiency (PID), auto- in muscle microvasculature during dermatomyositis immunity, and inflammation. In PID, it is generally [8]. In the course
Current Opinion in Allergy & Clinical Immunology – Wolters Kluwer Health
Published: Jul 1, 2013
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