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The Advantage of Specific Intravenous Immunoglobulin (sIVIG) on Regular IVIG: Experience of the Last Decade

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Abstract

During the last decade it has been shown that some components of intravenous immunoglobulin (IVIG) are responsible for their broadly therapeutic application. Currently, such specific subfractions are defined as specific IVIG (sIVIG) and are affinity-purified from commercial IVIGs that target specific antigens/antibodies related to a specific autoimmune disease. A remarkable example of the therapeutic potential of sIVIG is the proven enhanced anti-inflammatory potency of sialylated and recombinant sialylated IVIG obtained from total IVIG. In other experimental models, it has also been demonstrated that sIVIG work in many other contrivances, such as revealing anti-idiotypic networks blocking pathogenic antibodies ameliorating disease activity. sIVIG has also been shown to exert its action by modulating specific receptors expressed on immune cells in both inflammatory and autoimmune diseases. Indeed, sIVIG has emerged as a novel approach to treat different immune-mediated conditions in a more accurate antigen-specific manner. Herein we review experimental evidence supporting sIVIG-efficacy in treating autoimmune diseases and inflammation.

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References

  1. Kazatchkine MD, Kaveri SV. Immunomodulation of autoimmune and inflammatory diseases with intravenous immune globulin. N Engl J Med. 2001;345(10):747–55.

    Article  PubMed  CAS  Google Scholar 

  2. Durandy A, Wahn V, Petteway S, Gelfand EW. Immunoglobulin replacement therapy in primary antibody deficiency diseases–maximizing success. Int Arch Allergy Immunol. 2005;136(3):217–29.

    Article  PubMed  CAS  Google Scholar 

  3. Ephrem A, Misra N, Hassan G, Dasgupta S, Delignat S, Duong Van Huyen JP. Immunomodulation of autoimmune and inflammatory diseases with intravenous immunoglobulin. Clin Exp Med. 2005;5(4):135–40.

    Article  PubMed  CAS  Google Scholar 

  4. Krause I, Shoenfeld Y. Intravenous immunoglobulin treatment for fibrosis, atherosclerosis, and malignant conditions. Methods Mol Med. 2005;109:403–8.

    PubMed  CAS  Google Scholar 

  5. Toubi E, Etzioni A. Intravenous immunoglobulin in immunodeficiency states: State of the art. Clin Rev Allergy Immunol. 2005;29(3):167–72.

    Article  PubMed  CAS  Google Scholar 

  6. Danieli MG, Calcabrini L, Calabrese V, Marchetti A, Logullo F, Gabrielli A. Intravenous immunoglobulin as add on treatment with mycophenolate mofetil in severe myositis. Autoimmun Rev. 2009;9(2):124–7.

    Article  PubMed  CAS  Google Scholar 

  7. Galeotti C, Bayry J, Kone-Paut I, Kaveri SV. Kawasaki disease: Aetiopathogenesis and therapeutic utility of intravenous immunoglobulin. Autoimmun Rev. 2010;9(6):441–8.

    Article  PubMed  CAS  Google Scholar 

  8. Kivity S, Katz U, Daniel N, Nussinovitch U, Papageorgiou N, Shoenfeld Y. Evidence for the use of intravenous immunoglobulins–a review of the literature. Clin Rev Allergy Immunol. 2010;38(2–3):201–69.

    Article  PubMed  CAS  Google Scholar 

  9. Anthony RM, Nimmerjahn F, Ashline DJ, Reinhold VN, Paulson JC, Ravetch JV. Recapitulation of IVIG anti-inflammatory activity with a recombinant IgG Fc. Science. 2008;320(5874):373–6.

    Article  PubMed  CAS  Google Scholar 

  10. Bayry J, Thirion M, Misra N, Thorenoor N, Delignat S, Lacroix-Desmazes S, et al. Mechanisms of action of intravenous immunoglobulin in autoimmune and inflammatory diseases. Neurol Sci. 2003;24 Suppl 4:S217–21.

    Article  PubMed  Google Scholar 

  11. Huang HS, Sun DS, Lien TS, Chang HH. Dendritic cells modulate platelet activity in IVIg-mediated amelioration of ITP in mice. Blood. 2010;116(23):5002–9.

    Article  PubMed  CAS  Google Scholar 

  12. Le Pottier L, Bendaoud B, Dueymes M, Daridon C, Youinou P, Shoenfeld Y, et al. BAFF, a new target for intravenous immunoglobulin in autoimmunity and cancer. J Clin Immunol. 2007;27(3):257–65.

    Article  PubMed  Google Scholar 

  13. Nimmerjahn F, Ravetch JV. Anti-inflammatory actions of intravenous immunoglobulin. Annu Rev Immunol. 2008;26:513–33.

    Article  PubMed  CAS  Google Scholar 

  14. Rossi F, Dietrich G, Kazatchkine MD. Anti-idiotypes against autoantibodies in normal immunoglobulins: Evidence for network regulation of human autoimmune responses. Immunol Rev. 1989;110:135–49.

    Article  PubMed  CAS  Google Scholar 

  15. Séïté JF, Cornec D, Renaudineau Y, Youinou P, Mageed RA, Hillion S. IVIg modulates BCR signaling through CD22 and promotes apoptosis in mature human B lymphocytes. Blood. 2010;116(10):1698–704.

    Article  PubMed  Google Scholar 

  16. Séïté JF, Shoenfeld Y, Youinou P, Hillion S. What is the contents of the magic draft IVIg? Autoimmun Rev. 2008;7(6):435–9.

    Article  PubMed  Google Scholar 

  17. Viard I, Wehrli P, Bullani R, Schneider P, Holler N, Salomon D, et al. Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science. 1998;282(5388):490–3.

    Article  PubMed  CAS  Google Scholar 

  18. Blank M, Anafi L, Zandman-Goddard G, Krause I, Goldman S, Shalev E, et al. The efficacy of specific IVIG anti-idiotypic antibodies in antiphospholipid syndrome (APS): Trophoblast invasiveness and APS animal model. Int Immunol. 2007;19(7):857–65.

    Article  PubMed  CAS  Google Scholar 

  19. Blank M, Nur I, Toub O, Maor A, Shoenfeld Y. Toward molecular targeting with specific intravenous immunoglobulin preparation. Clin Rev Allergy Immunol. 2005;29(3):213–7.

    Article  PubMed  CAS  Google Scholar 

  20. Damianovich M, Blank M, Raiter A, Hardy B, Shoenfeld Y. Anti-vascular endothelial growth factor (VEGF) specific activity of intravenous immunoglobulin (IVIg). Int Immunol. 2009;21(9):1057–63.

    Article  PubMed  CAS  Google Scholar 

  21. Fuchs S, Feferman T, Meidler R, Margalit R, Sicsic C, Wang N, et al. A disease-specific fraction isolated from IVIG is essential for the immunosuppressive effect of IVIG in experimental autoimmune myasthenia gravis. J Neuroimmunol. 2008;194(1–2):89–96.

    Article  PubMed  CAS  Google Scholar 

  22. Mimouni D, Blank M, Payne AS, Anhalt GJ, Avivi C, Barshack I, et al. Efficacy of intravenous immunoglobulin (IVIG) affinity-purified anti-desmoglein anti-idiotypic antibodies in the treatment of an experimental model of pemphigus vulgaris. Clin Exp Immunol. 2010;162(3):543–9.

    Article  PubMed  CAS  Google Scholar 

  23. Prasad NK, Papoff G, Zeuner A, Bonnin E, Kazatchkine MD, Ruberti G, et al. Therapeutic preparations of normal polyspecific IgG (IVIg) induce apoptosis in human lymphocytes and monocytes: a novel mechanism of action of IVIg involving the Fas apoptotic pathway. J Immunol. 1998;161(7):3781–90.

    PubMed  CAS  Google Scholar 

  24. Shoenfeld Y, Rauova L, Gilburd B, Kvapil F, Goldberg I, Kopolovic J, et al. Efficacy of IVIG affinity-purified anti-double-stranded DNA anti-idiotypic antibodies in the treatment of an experimental murine model of systemic lupus erythematosus. Int Immunol. 2002;14(11):1303–11.

    Article  PubMed  CAS  Google Scholar 

  25. Vassilev TL, Kazatchkine MD, Duong Van Huyen JP, Mekrache M, Bonnin E, Mani JC, et al. Inhibition of cell adhesion by antibodies to Arg-Gly-Asp (RGD) in normal immunoglobulin for therapeutic use (intravenous immunoglobulin, IVIg). Blood. 1999;93(11):3624–31.

    PubMed  CAS  Google Scholar 

  26. Zandman-Goddard G, Blank M, Shoenfeld Y. Intravenous immunoglobulins in systemic lupus erythematosus: from the bench to the bedside. Lupus. 2009;18(10):884–8.

    Article  PubMed  CAS  Google Scholar 

  27. Asherson RA. The antiphospholipid syndrome II: autoimmune thrombosis. 1st ed. Amsterdam: Elsevier; 2002.

    Google Scholar 

  28. Clark DA, Coulam CB, Stricker RB. Is intravenous immunoglobulins (IVIG) efficacious in early pregnancy failure? A critical review and meta-analysis for patients who fail in vitro fertilization and embryo transfer (IVF). J Assist Reprod Genet. 2006;23(1):1–13.

    Article  PubMed  Google Scholar 

  29. Meroni PL, Tedesco F, Locati M, Vecchi A, Di Simone N, Acaia B, et al. Anti-phospholipid antibody mediated fetal loss: Still an open question from a pathogenic point of view. Lupus. 2010;19(4):453–6.

    Article  PubMed  CAS  Google Scholar 

  30. Shoenfeld Y, Blank M, Sherer Y. Induction and treatment of the antiphospholipid syndrome–lessons from animal models. Eur J Clin Invest. 2001;31(8):736–40.

    Article  PubMed  CAS  Google Scholar 

  31. Konova E, Atanasova M, Stoykov S, Velkova A, Shoenfeld Y. Idiotypic and anti-idiotypic elastin autoantibodies: Implications for IVIg and pregnancy loss. J Autoimmun. 2007;28(1):46–54.

    Article  PubMed  CAS  Google Scholar 

  32. Aricha R, Mizrachi K, Fuchs S, Souroujon MC. Blocking of IL-6 suppresses experimental autoimmune myasthenia gravis. J Autoimmun. 2010;36(2):135–41.

    Article  PubMed  Google Scholar 

  33. Gajdos P, Chevret S. Treatment of myasthenia gravis acute exacerbations with intravenous immunoglobulin. Ann N Y Acad Sci. 2008;1132:271–5.

    Article  PubMed  CAS  Google Scholar 

  34. Heupel WM, Zillikens D, Drenckhahn D, Waschke J. Pemphigus vulgaris IgG directly inhibit desmoglein 3-mediated transinteraction. J Immunol. 2008;181(3):1825–34.

    PubMed  CAS  Google Scholar 

  35. Sticherling M, Erfurt-Berge C. Autoimmune blistering diseases of the skin. Autoimmun Rev. 2012;11(3):226–30. Epub 2011 May 27.

    Article  PubMed  CAS  Google Scholar 

  36. Amagai M, Ikeda S, Shimizu H, Iizuka H, Hanada K, Aiba S, et al. A randomized double-blind trial of intravenous immunoglobulin for pemphigus. J Am Acad Dermatol. 2009;60(4):595–603.

    Article  PubMed  Google Scholar 

  37. Arnold DF, Burton J, Shine B, Wojnarowska F, Misbah SA. An 'n-of-1' placebo-controlled crossover trial of intravenous immunoglobulin as adjuvant therapy in refractory pemphigus vulgaris. Br J Dermatol. 2009;160(5):1098–102.

    Article  PubMed  CAS  Google Scholar 

  38. Guillevin L, Pagnoux C, Mouthon L. Churg-strauss syndrome. Semin Respir Crit Care Med. 2004;25(5):535–45.

    Article  PubMed  Google Scholar 

  39. Jennette JC, Falk RJ. Small-vessel vasculitis. N Engl J Med. 1997;337(21):1512–23.

    Article  PubMed  CAS  Google Scholar 

  40. Guilpain P, Servettaz A, Batteux F, Guillevin L, Mouthon L. Natural and disease associated anti-myeloperoxidase (MPO) autoantibodies. Autoimmun Rev. 2008;7(6):421–5.

    Article  PubMed  CAS  Google Scholar 

  41. Guilpain P, Servettaz A, Goulvestre C, Barrieu S, Borderie D, Chereau C, et al. Pathogenic effects of antimyeloperoxidase antibodies in patients with microscopic polyangiitis. Arthritis Rheum. 2007;56(7):2455–63.

    Article  PubMed  CAS  Google Scholar 

  42. Csernok E. Anti-neutrophil cytoplasmic antibodies and pathogenesis of small vessel vasculitides. Autoimmun Rev. 2003;2(3):158–64.

    Article  PubMed  CAS  Google Scholar 

  43. Bansal PJ, Tobin MC. Neonatal microscopic polyangiitis secondary to transfer of maternal myeloperoxidase-antineutrophil cytoplasmic antibody resulting in neonatal pulmonary hemorrhage and renal involvement. Ann Allergy Asthma Immunol. 2004;93(4):398–401.

    Article  PubMed  Google Scholar 

  44. Schlieben DJ, Korbet SM, Kimura RE, Schwartz MM, Lewis EJ. Pulmonary-renal syndrome in a newborn with placental transmission of ANCAs. Am J Kidney Dis. 2005;45(4):758–61.

    Article  PubMed  Google Scholar 

  45. Amital H, Levy Y, Shoenfeld Y. Use of intravenous immunoglobulin in livedo vasculitis. Clin Exp Rheumatol. 2000;18(3):404–6.

    PubMed  CAS  Google Scholar 

  46. Danieli MG, Cappelli M, Malcangi G, Logullo F, Salvi A, Danieli G. Long term effectiveness of intravenous immunoglobulin in Churg-Strauss syndrome. Ann Rheum Dis. 2004;63(12):1649–54.

    Article  PubMed  CAS  Google Scholar 

  47. Levy Y, George J, Fabbrizzi F, Rotman P, Paz Y, Shoenfeld Y. Marked improvement of Churg-Strauss vasculitis with intravenous gammaglobulins. South Med J. 1999;92(4):412–4.

    Article  PubMed  CAS  Google Scholar 

  48. Martinez V, Cohen P, Pagnoux C, Vinzio S, Mahr A, Mouthon L, et al. Intravenous immunoglobulins for relapses of systemic vasculitides associated with antineutrophil cytoplasmic autoantibodies: results of a multicenter, prospective, open-label study of twenty-two patients. Arthritis Rheum. 2008;58(1):308–17.

    Article  PubMed  CAS  Google Scholar 

  49. Muso E, Ito-Ihara T, Ono T, Imai E, Yamagata K, Akamatsu A, et al. Intravenous immunoglobulin (IVIg) therapy in MPO-ANCA related polyangiitis with rapidly progressive glomerulonephritis in Japan. Jpn J Infect Dis. 2004;57(5):S17–8.

    PubMed  Google Scholar 

  50. Schwartz-Albiez R, Monteiro RC, Rodriguez M, Binder CJ, Shoenfeld Y. Natural antibodies, intravenous immunoglobulin and their role in autoimmunity, cancer and inflammation. Clin Exp Immunol. 2009;158 Suppl 1:43–50.

    Article  PubMed  CAS  Google Scholar 

  51. Shoenfeld Y. 5th International symposium on IVIG: IVIG in the third millenium, 25–27 September 2003, Interlaken, Switzerland. Autoimmun Rev. 2004;3(3):234–41.

    Article  PubMed  Google Scholar 

  52. Takigawa N, Kawata N, Shibayama T, Tada A, Kimura G, Munemasa M, et al. Successful treatment of a patient with severe Churg-Strauss syndrome by a combination of pulse corticosteroids, pulse cyclophosphamide, and high-dose intravenous immunoglobulin. J Asthma. 2005;42(8):639–41.

    Article  PubMed  Google Scholar 

  53. Taniguchi M, Tsurikisawa N, Higashi N, Saito H, Mita H, Mori A, et al. Treatment for Churg-Strauss syndrome: induction of remission and efficacy of intravenous immunoglobulin therapy. Allergol Int. 2007;56(2):97–103.

    Article  PubMed  CAS  Google Scholar 

  54. Tsurikisawa N, Taniguchi M, Saito H, Himeno H, Ishibashi A, Suzuki S, et al. Treatment of Churg-Strauss syndrome with high-dose intravenous immunoglobulin. Ann Allergy Asthma Immunol. 2004;92(1):80–7.

    Article  PubMed  CAS  Google Scholar 

  55. Anthony RM, Ravetch JV. A novel role for the IgG Fc glycan: the anti-inflammatory activity of sialylated IgG Fcs. J Clin Immunol. 2010;30 Suppl 1:S9–14.

    Article  PubMed  CAS  Google Scholar 

  56. Anthony RM, Wermeling F, Karlsson MC, Ravetch JV. Identification of a receptor required for the anti-inflammatory activity of IVIG. Proc Natl Acad Sci U S A. 2008;105(50):19571–8.

    Article  PubMed  CAS  Google Scholar 

  57. Kaneko Y, Nimmerjahn F, Ravetch JV. A + Science. 2006;313(5787):670–3.

    CAS  Google Scholar 

  58. Makhoul B, Braun E, Herskovitz M, Ramadan R, Hadad S, Norberto K. Hyperimmune gammaglobulin for the treatment of West Nile virus encephalitis. Isr Med Assoc J. 2009;11:151–3.

    PubMed  Google Scholar 

  59. Ben-Nathan D, Gershoni-Yahalom O, Samina I, Khinich Y, Nur I, Taub O, et al. Using high titer West Nile intravenous immunoglobulin from selected Israeli donors for treatment of West Nile virus infection. BMC Infect Dis. 2009;9:18.

    Article  PubMed  Google Scholar 

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Acknowledgments

The study was supported by E-rare grant no. 4790 given by the EU/Israeli Ministry of Health and Laboratoire Français des Biotechnologies, LFB Tegeline, France.

This work was performed in partial fulfillment of the requirements for the PhD thesis of Nina Svetlicky, Sackler Faculty of Medicine, Tel Aviv University, Israel.

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The authors declare that they have no conflict of interest.

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Correspondence to Yehuda Shoenfeld.

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Svetlicky, N., Ortega-Hernandez, OD., Mouthon, L. et al. The Advantage of Specific Intravenous Immunoglobulin (sIVIG) on Regular IVIG: Experience of the Last Decade. J Clin Immunol 33 (Suppl 1), 27–32 (2013). https://doi.org/10.1007/s10875-012-9842-5

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  • DOI: https://doi.org/10.1007/s10875-012-9842-5

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