Mechanism of action of IVIG and anti-D in ITP.
Infusion of large amounts of intravenous immunoglobulin (IVIG) or polyclonal anti-D can reverse thrombocytopenia in patients with idiopathic thrombocytopenic purpura within hours of the administration of these products. It has been suggested that the effects of IVIG appear to far outlast several half-lives of the product. Several mechanisms have been proposed to explain both the acute and long term effects of IVIG. These will be discussed in this review.
Lazarus
Alan H
AH
The Canadian Blood Services, and The Toronto Platelet Immunobiology Group, Ont., Toronto, Canada M5B 1W8. lazarusa@smh.toronto.on.ca
Crow
Andrew R
AR
D015703:Antigens, CD / Q000502:physiology; D006801:Humans; D007107:Immune System / Q000187:drug effects; D016756:Immunoglobulins, Intravenous / Q000494:pharmacology / Q000627:therapeutic use*; D007518:Isoantibodies / Q000494:pharmacology / Q000627:therapeutic use*; D012157:Mononuclear Phagocyte System / Q000187:drug effects; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D017452:Receptors, IgG / Q000502:physiology; D018029:Rho(D) Immune Globulin
D015703:Antigens, CD; C080571:Fc gamma receptor IIB; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies; C061961:RHO(D) antibody; D017452:Receptors, IgG; D018029:Rho(D) Immune Globulin