100 YEARS OF THERAPY WITH IMMUNE GLOBULIN S - OLD, NEW AND OBSOLETE INDICATIONS

Fifty years ago, diphtheria, tetanus, botulism, gas-gangrene, and pneu mococci were treated using immune globulin from horses, sheeps and oth er animals. For the first time, Cohn's alcohol fractionation method ma de it possible to use human immune globulin. On the one hand, immune g lobulins against bacterial infections became obsolete by the antibioti cs synchronously developed. On the other hand, human immune globulins became new therapeutical indications of virus infections, especially o f hepatitis. Afterwards, the development of intravenous immune globuli n enabled the therapy of primary or secondary immunodeficiencies. In c ontrast, the intravenous immune globulin therapy has been reported to be beneficial during the past decade for numerous autoimmune diseases, i.e. asthma bronchiale, myasthenia gravis, red-cell aplasia, rheumato id arthritis, thrombocytopenic purpura, Kawasaki's syndrome, and much others. There is some evidence for immunomodulation by intravenous imm une globulin in the same manner as it is well known of the anti-RhD pr ophylaxis since several decades. Finally, the hepatitis prophylaxis us ing immune globulin intramuscularly administered is obsolete since an inactivated hepatitis A vaccine is available.