What are the specific physiologic effects of intravenous immunoglobulin (IVIG)?

Updated: Jul 05, 2018
  • Author: Jessica Katz, MD, PhD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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IVIG also has effects on the clearance of opsonized cells. The results of in vitro C3 uptake studies evaluating the effect of IVIG on the clearance of pre-opsonized cells suggest that IVIG produces a kinetic depression of C3 uptake and modifies the process of complement fragment deposition on erythrocytes.

IVIG also contains Natural Antibodies. Normal serum contains IgG, IgM, and IgA antibodies, which are referred to as natural antibodies because they are induced without deliberate immunization and are independent of antigenic exposure. They are considered key to the immunoregulatory effects of immune globulin in immune-mediated disorders. [6] Natural autoantibodies appear to be more polyreactive than immune antibodies; natural antibodies can frequently bind to different antigens. [6] Natural autoantibodies can (1) bind to pathogens; (2) help remove senescent or altered molecules, cells, and tumors; (3) induce remyelination; and (4) inhibit the growth of autoreactive B-cell clones. In the multifocal motor neuropathy disease state, IVIG intercedes to stop complement deposition that is triggered by anti-GM1 antibodies. [7]  The effect of IVIG could also relate to the presence of natural antibodies IVIG also contains cytokines, and perhaps neutralizing antibodies; interestingly, antibodies against granulocyte macrophage colony-stimulating factor, interferon, interleukin 1, and interleukin 6 in immune globulin have biologic activity in vivo. [6] IVIG contains natural antibodies, accounting for some of its effects.


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