Antibody therapy (IVIG): evaluation of the use of genomics and proteomics for the study of immunomodulation therapeutics.
OBJECTIVE
Intravenous immunoglobulin (IVIG) is used for an increasingly diverse number of therapeutic applications as an immunomodulation drug. Although it has demonstrated therapeutic effectiveness, the mechanism of action of IVIG in these disorders is poorly understood; this lack of understanding complicates rational clinical application and reimbursement for 'off-label' use.


METHODS
Selected literature on the clinical use of IVIG as an immunomodulation drug is reviewed. We present a brief description of DNA microarray and protein microarray technology and the application of such technologies to the study of immune system cells. The several studies on the application of DNA microarray technology to study gene expression in response to IVIG are presented.


RESULTS
There is increasing data on the use of DNA microarray and protein microarray technology to study gene expression in immune system cells including T cells, B cells, macrophages, and leucocytes. There is less information on the effect of IVIG on gene expression in immune system cells. However, there is sufficient information available to suggest that this is a practical approach with the caveat that such work will require careful experimental design and clear definition of the normal population.


CONCLUSIONS
DNA and protein microarray assays can be used to (i) provide rational indications for the clinical use of IVIG, (ii) provide for specific analysis of raw material and end product IVIG in screening for content related to immunomodulation, and (iii) accelerate the development of next generation products which would be more focused and/or targeted therapeutics.
Sapan
C V
CV
Department of Pathology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Reisner
H M
HM
Lundblad
R L
RL
D005786:Gene Expression Regulation / Q000276:immunology*; D023281:Genomics; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000494:pharmacology / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000494:pharmacology / Q000627:therapeutic use*; D020411:Oligonucleotide Array Sequence Analysis; D010818:Practice Patterns, Physicians'; D040901:Proteomics
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors