title: Mechanisms of immune regulation by IVIG.
abstract: OBJECTIVE
  In the past few years there have been many advances in our understanding of the mechanisms by which intravenous immune globulin (IVIG) modulates immune function in autoimmune disorders.
  
  
  RESULTS
  Previous investigations have focused on the Fc domain of the IgG molecule, and the role of the FcγRIIB receptor and the sialylated Fc domain that have been show to mediate the anti-inflammatory effects in certain murine models of autoantibody-mediated diseases. More recent findings have implicated the F(ab')₂ domain in IVIG-induced immune modulation in T-cell-mediated autoimmune disease models in which upregulation of T-regulatory cells and downregulation of the Th17 pathways are important components of this mechanism. The prostaglandin E pathway may be playing a role in the IVIG-induced changes in the T-regulatory pathway.
  
  
  CONCLUSIONS
  Many of the mechanisms proposed for the immune-modulating effects of IVIG demonstrate the complexity of immune effector functions in disease processes. Although controversy exists on the role of the FcγRIIB receptor and the importance of the sialylated Fc domain in human autoimmune disorders, probably no one single mechanism is responsible for the effects of IVIG in autoimmune and inflammatory diseases. The potential role of the prostaglandin E pathway may offer alternative treatments.
authors.affiliation: Division of Allergy and Immunology, University of South Florida, Morsani College of Medicine, Children's Research Institute, All Children's Hospital, St Petersburg, Florida, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Ballow
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D004195:Disease Models, Animal; D006801:Humans; D007141:Immunoglobulin Fc Fragments / Q000276:immunology*; D016756:Immunoglobulins, Intravenous / Q000276:immunology / Q000627:therapeutic use; D007155:Immunologic Factors / Q000276:immunology / Q000627:therapeutic use; D056747:Immunomodulation / Q000187:drug effects*; D011458:Prostaglandins E / Q000378:metabolism; D050378:T-Lymphocytes, Regulatory / Q000276:immunology / Q000473:pathology; D058504:Th17 Cells / Q000276:immunology / Q000473:pathology
chemical_list: D007141:Immunoglobulin Fc Fragments; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D011458:Prostaglandins E