Mechanisms of high-dose intravenous immunoglobulins in demyelinating diseases

Administration of high-dose intravenous immunoglobulins has become one of t he most successful new treatment regimens for demyelinating diseases. In a decade of molecular medicine, it came as a surprise that a natural blood pr oduct would prove effective in several disorders, including Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, multifocal mot or neuropathy, and, probably, multiple sclerosis. Many experimental studies , both in vivo and in vitro, have shown that intravenous immunoglobulins ca n interfere with the immune system at several levels. In addition, intraven ous immunoglobulins may promote remyelination in demyelinating disease asso ciated with viral infections. At present, no single mode of action has been identified as the crucial mechanism, which leads us to suggest that multip le effects may act in concert.