Human normal immunoglobulin for intravenous administration: mechanisms of therapeutic effects

Potapnev M.P., Karpenko F.N.

Republican Center for Transfusiology & Medical BioTechnologies, Minsk, Belarus

Normal human immunoglobulin for intravenous administration (IVIG) is widely used in medical practice. Over the last 40 years new technologies were applied for IVIG manufacture, and new indications were introduced to spread medical application of IVIG. This review presents the list of IVIG preparations and requirements of their quality control. Mechanisms of IVIG therapeutic effets are precisely described as well as the drug's activity in vitro and in vivo. Antiidiotypic antibodies possess neutralizing activity against autoantibodies, cytokines and inflammatory cell receptors. Normal immunoglobulin G displays Fc-dependent immunomodulatory activity on proinflammatory macrophages, dendritic cells, B cells. The level of T-regulatory cells increases after IVIG administration. It was concluded that IVIG can now be considered both as a target therapeutic for IgG deficiency and as a drug with a network action with anti-inflammatory, immunomodulatory and antiallergic activities. The last one determines expanded application of IVIG in medical practice.