Interaction of Immunoglobulin with Cytomegalovirus-Infected Cells

Abstract

Intravenous immunoglobulin (IVIG) is used to treat or prevent severe viral infection, especially cytomegalovirus (CMV) infections. IVIG was characterized to understand its interaction with CMV-infected cells. IVIG retarded CMV spread and reduced virus yields depending on the neutralizing (NT) antibody titer. Immediate early protein synthesis was reduced by IVIG in 3 to 15 h, and IVIG specifically reduced the ratio of 66/68k protein synthesis among immediate early proteins in an NT antibody-dependent manner between 4 and 8 h after infection, indicating that antigenic modulation of CMV-infected cells by IVIG reduced viral protein synthesis and virus production. The half-life of antibody bound to CMV-infected cells was 3.8 h. NT antibody titers to varicella-zoster virus (VZV) and CMV in IVIG were dose dependently absorbed by cells infected with VZV and CMV, respectively, but the antibody titers to CMV and VZV, respectively, were not affected. NT antibody in 0.3 mL of IVIG (15 mg) was specifically absorbed by 10 CMV-infected cells and 10 VZV-infected cells, suggesting that the NT antibody in IVIG might be inactivated by one-tenth of a similar volume of CMV-infected or VZV-infected cells. Various antiviral activities of IVIG may contribute to control and alleviation of CMV infection.

Application of CMV‐IVIg as prophylaxis against cytomegalovirus reactivation in allogeneic hematopoietic stem cell transplantation patients

“…In Nobuyasu's study, they found that CMV-IVIg binds to CMV-infected cells, modifies protein synthesis, and suppresses the spread of CMV infection. Therefore, prophylactic CMV-IVIg after HSCT until the emergence of anti-CMV CD8+T cells may greatly reduce the risk of CMV reactivation 21. In our data, CMV-IVIg prophylaxis not only reduced the rate of CMV reactivation, but also shortened the time to CMV clearance.…”

Cytomegalovirus Pneumonia in a Patient with X-Linked Agammaglobulinemia: A Case Report

“…IRT may not significantly reduce viral respiratory infections among patients with primary antibody deficiency [ 16 ]; however, CMV was not included in the study. IVIG treatment reduces intracellular virus production and viral protein synthesis, eventually limiting the spread of CMV; thus, IVIG may contribute to the control and alleviation of CMV infection [ 17 ]. Moreover, IVIG showed similar CMV neutralization effects as CMV-specific hyperimmunoglobulins [ 18 ].…”

Anti-CMV therapy, what next? A systematic review

“…Two types of immunoglobulins are available in therapy: intravenous administered immunoglobulins (IVIG) and hyperimmune immunoglobulins (CMV-HIG). We will focus on HCMV-specific immunoglobulins which are able to neutralize viral infectivity ( Aiba et al, 2017 ). Immunoglobulins may be used in preventing congenital infections or in association with other antivirals to cure HCMV infection in transplantation ( El-Qushayri et al, 2021 ).…”