title: Intravenous immunoglobulin in autoimmune disorders: an insight into the immunoregulatory mechanisms.
abstract: Intravenous immunoglobulin (IGIV) has increasingly been used for the treatment of autoimmune and systemic inflammatory diseases in addition to supportive therapy of immunodeficient patients. IGIV is beneficial in several diseases, including acute and chronic/relapsing diseases, autoimmune diseases and inflammatory disorders. Therapeutic efficacy of IGIV has also been established in a number of dermatologic diseases. Although a considerable progress has been made in understanding the mechanisms by which IGIV exerts immunomodulatory functions in autoimmune diseases, they remain not fully elucidated. The mode of action of IGIV is complex, involving modulation of expression and function of Fc receptors, interference with activation of complement and the cytokine network, modulation of idiotype network, regulation of cell growth, alteration of cellular adhesion process, and effects on the activation differentiation and effector functions of T and B cells and of antigen-presenting cells. The therapeutic effects of IGIV most likely reflect the functions of natural antibodies in maintaining immune homeostasis in healthy people. The ability of IGIV to interact through V regions with complementary V regions of antibodies and antigen receptors as well as with relevant soluble and surface molecules provides the basis for inducing the selection of immune repertoires. Since IGIV is frequently used to treat autoimmune and inflammatory diseases for which evidence of its efficacy is insufficiently documented, controlled trials, particularly of some neurologic and dermatologic diseases, are imperative.
authors.affiliation: INSERM, U681, Université Pierre et Marie Curie (UPMC-Paris 6), France.
authors.forename: Jagadeesh
authors.initials: J
authors.lastname: Bayry
authors.forename: Jagadeesh
authors.initials: J
authors.lastname: Bayary
authors.forename: Sooryasarathi
authors.initials: S
authors.lastname: Dasgupta
authors.forename: Namita
authors.initials: N
authors.lastname: Misra
authors.forename: Amal
authors.initials: A
authors.lastname: Ephrem
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Duong Van Huyen
authors.forename: Sandrine
authors.initials: S
authors.lastname: Delignat
authors.forename: Gazzala
authors.initials: G
authors.lastname: Hassan
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Caligiuri
authors.forename: Antonino
authors.initials: A
authors.lastname: Nicoletti
authors.forename: Sebastien
authors.initials: S
authors.lastname: Lacroix-Desmazes
authors.forename: Michel D
authors.initials: MD
authors.lastname: Kazatchkine
authors.forename: Srini
authors.initials: S
authors.lastname: Kaveri
mesh_terms: D000818:Animals; D001323:Autoantibodies / Q000502:physiology; D001327:Autoimmune Diseases / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007116:Immunization, Passive; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007249:Inflammation / Q000276:immunology / Q000473:pathology
chemical_list: D001323:Autoantibodies; D016756:Immunoglobulins, Intravenous