Immunomodulatory effects of intravenous immunoglobulins.

Intravenous immunoglobulin (IVIg) has been used for many years in the treat ment of primary and secondary antibody deficiencies. IVIg was first demonst rated to be effective in autoimmune desorders twenty years ago in the treat ment of idiopathic thrombocytopenic purpura. The beneficial effect of IVIg has since been established in the Guillain-Barre syndrome, chronic inflamma tory demenilating polyneuropathy, myasthenia gravis, dermatomyositis, Kawas aki syndrome and graft versus host disease. The beneficial effect of IVIg h as been suggested in a large number of other auto-immune and systemic infla mmatory conditions. The mode of action of IVIg is complex, involving Fc rec eptor blockade, interference with complement activation and the cytokine ne twork, provision of anti-idiotypic antibodies and modulation of T and B cel l activation and differentiation. Such a broad range of activities reflects the function of normal circulating immunoglobulins in maintaining toleranc e to self in healthy individuals.