Intravenous immunoglobulins in immunodeficiencies: more than mere replacement therapy

Authors

  • S. V. Kaveri,

    Corresponding author
    1. Institut National de la Santé et de la Recherche Médicale Unité 872, Paris, France
    2. Centre de Recherche des Cordeliers, Unité Mixte de Recherche-Santé 872, Equipe 16-Immunopathology and Therapeutic Immunointervention, Université Pierre et Marie Curie-Paris 6, Paris, France
    3. Unité Mixte de Recherche-Santé 872, Université Paris Descartes, Paris, France
      Srini V. Kaveri, INSERM U 872, Centre de Recherche des Cordeliers-UMRS 872, 15, rue de l'Ecole de Médecine, Paris, 75006, France
      E-mail: srini.kaveri@crc.jussieu.fr
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  • M. S. Maddur,

    1. Institut National de la Santé et de la Recherche Médicale Unité 872, Paris, France
    2. Centre de Recherche des Cordeliers, Unité Mixte de Recherche-Santé 872, Equipe 16-Immunopathology and Therapeutic Immunointervention, Université Pierre et Marie Curie-Paris 6, Paris, France
    3. Unité Mixte de Recherche-Santé 872, Université Paris Descartes, Paris, France
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  • P. Hegde,

    1. Institut National de la Santé et de la Recherche Médicale Unité 872, Paris, France
    2. Université de Technologie, Compiègne, France
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  • S. Lacroix-Desmazes,

    1. Institut National de la Santé et de la Recherche Médicale Unité 872, Paris, France
    2. Centre de Recherche des Cordeliers, Unité Mixte de Recherche-Santé 872, Equipe 16-Immunopathology and Therapeutic Immunointervention, Université Pierre et Marie Curie-Paris 6, Paris, France
    3. Unité Mixte de Recherche-Santé 872, Université Paris Descartes, Paris, France
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  • J. Bayry

    1. Institut National de la Santé et de la Recherche Médicale Unité 872, Paris, France
    2. Centre de Recherche des Cordeliers, Unité Mixte de Recherche-Santé 872, Equipe 16-Immunopathology and Therapeutic Immunointervention, Université Pierre et Marie Curie-Paris 6, Paris, France
    3. Unité Mixte de Recherche-Santé 872, Université Paris Descartes, Paris, France
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Srini V. Kaveri, INSERM U 872, Centre de Recherche des Cordeliers-UMRS 872, 15, rue de l'Ecole de Médecine, Paris, 75006, France
E-mail: srini.kaveri@crc.jussieu.fr

Summary

Intravenous immunoglobulin (IVIG) is a therapeutic compound prepared from pools of plasma obtained from several thousand healthy blood donors. For more than 20 years, IVIG has been used in the treatment of a wide range of primary and secondary immunodeficiencies. IVIG now represents a standard therapeutic option for most antibody deficiencies. Routinely, IVIG is used in patients with X-linked agammaglobulinaemia (XLA), common variable immunodeficiency (CVID), X-linked hyper-IgM, severe combined immunodeficiency, Wiskott-Aldrich syndrome, and selective IgG class deficiency. In addition, IVIG is used extensively in the treatment of a wide variety of autoimmune disorders. IVIG is administered at distinct doses in the two clinical settings: whereas immunodeficient patients are treated with replacement levels of IVIG, patients with autoimmune and inflammatory diseases are administered with very high doses of IVIG. Several lines of experimental evidence gathered in the recent years suggest that the therapeutic beneficial effect of IVIG in immunodeficiencies reflects an active role for IVIG, rather than a mere passive transfer of antibodies.

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