IVIG adverse reactions: potential role of cytokines and vasoactive substances.
OBJECTIVE
A clinical study was conducted to determine the effect of IVIG infusion rates on adverse experiences (AE) and on serum levels of cytokines and vasoactive substances.


METHODS
Forty-two healthy volunteers were randomized into 3 groups with maximum IVIG infusion rates of 0.04, 0.06, and 0.08 ml/kg/min, and a final dose of 0.5 g IgG/kg body weight.


RESULTS
Adverse reactions were noted only at the highest infusion rate of 0.08 ml/kg/min, except in 1 subject infused at 0.06 ml/kg/min. There were significant increases in IL-6 (p = 0.011) and thromboxane B2 (p = 0.007) in AE subjects as compared to non-AE subjects.


CONCLUSIONS
IVIG-induced adverse reactions occur more often with rapid infusion rates and may be mediated by elevated levels of inflammatory cytokines and vasoactive substances.
Bagdasarian
A
A
Alpha Therapeutic Corporation, R&D Department, Los Angeles, CA 90032, USA.
Tonetta
S
S
Harel
W
W
Mamidi
R
R
Uemura
Y
Y
D000328:Adult; D053818:Chymases; D016207:Cytokines / Q000502:physiology; D004244:Dizziness / Q000139:chemically induced; D006261:Headache / Q000139:chemically induced; D006632:Histamine / Q000097:blood; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D018836:Inflammation Mediators / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D019679:Kininogen, High-Molecular-Weight / Q000097:blood; D007958:Leukocyte Count / Q000187:drug effects; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D009504:Neutrophils / Q000166:cytology; D012697:Serine Endopeptidases / Q000097:blood; D013929:Thromboxane B2 / Q000097:blood; D013997:Time Factors; D053802:Tryptases; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014666:Vasomotor System / Q000187:drug effects
D016207:Cytokines; D016756:Immunoglobulins, Intravenous; D018836:Inflammation Mediators; D007375:Interleukin-1; D015850:Interleukin-6; D019679:Kininogen, High-Molecular-Weight; D014409:Tumor Necrosis Factor-alpha; D013929:Thromboxane B2; D006632:Histamine; D012697:Serine Endopeptidases; C083294:chymase 2; D053818:Chymases; D053802:Tryptases