Anti-idiotypic antibodies: From regulation to therapy of factor VIII inhibitors

Evidence has recently accumulated showing that antiidiotypic antibodies spe cific to anti-FVIII antibodies are present in the plasma of healthy individ uals and of haemophilia A patients with or without inhibitors, where they c an neutralise the FVIII inhibitory activity, Additionally, patients success fully desensitised towards FVIII have an increased production of anti-idiot ypic antibodies with no significant reduction in anti-FVIII antibodies. We review here possible strategies for modulating the anti-FVIII immune respon se by idiotypic interactions.