title: Intravenous immunoglobulin preparations induce mild activation of neutrophils in vivo via triggering of macrophages--studies in a rat model.
abstract: Despite widespread use in various immune disorders, the in vivo mechanisms of action of intravenous immunoglobulin (IVIG) preparations are not well known. We previously reported that human neutrophils degranulate after incubation with IVIG in vitro as a result of interaction with FcgammaRII. The purpose of this study was to determine whether IVIG might stimulate neutrophils in vivo. Anaesthetized rats received a bolus intravenous injection of IVIG preparations, containing either high (aged IVIG) or low (fresh IVIG) amounts or IgG dimers at a dose of 250 mg/kg. Administration of aged IVIG induced neutrophil activation in vivo, whereas no effect was observed after infusion of fresh IVIG. Histological examination of lung tissue demonstrated mild influx of neutrophils into the pulmonary tissue after aged IVIG administration, though gross damage did not occur. Macrophage-depleted rats no longer showed activation of neutrophils after infusion of aged IVIG, suggesting that neutrophils become activated via an indirect macrophage dependent way. We conclude that IVIG induces a mild activation of neutrophils in vivo via triggering of macrophages depending on the amount of IgG dimers. For this reason, IVIG preparations with a high content of dimers may not always be as harmless as generally believed and may be responsible for some of the side-effects observed during IVIG infusions.
authors: Central Laboratory of The Netherlands' Red Cross Blood Transfusion Service and Laboratory of Experimental and Clinical Immunology, Academic Medical Centre, University of Amsterdam, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands. J_Teeling@clb.nl
authors: J L
authors: JL
authors: Teeling
authors: W K
authors: WK
authors: Bleeker
authors: G M
authors: GM
authors: Rigter
authors: N
authors: N
authors: van Rooijen
authors: T W
authors: TW
authors: Kuijpers
authors: C E
authors: CE
authors: Hack
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D015415:Biomarkers / Q000032:analysis; D019281:Dimerization; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous / Q000494:pharmacology*; D019041:L-Selectin / Q000032:analysis; D008168:Lung / Q000276:immunology*; D008262:Macrophage Activation; D016177:Macrophage-1 Antigen / Q000032:analysis; D023421:Models, Animal; D018375:Neutrophil Activation; D009504:Neutrophils / Q000276:immunology; D010972:Platelet Activating Factor / Q000494:pharmacology; D051381:Rats; D017208:Rats, Wistar; D013997:Time Factors
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D016177:Macrophage-1 Antigen; D010972:Platelet Activating Factor; D019041:L-Selectin