<p>Effectiveness of Intravenous Immunoglobulin for Management of Neuropathic Pain: A Narrative Review</p>

Abstract

Administrations of intravenous immunoglobulin (IVIG), an immune-modulating blood-derived product, may be beneficial for managing neuropathic pain. Here, we review previous studies to investigate the effectiveness of IVIG in managing neuropathic pain due to various neurological disorders. The electronic databases PubMed, Scopus, Embase, and the Cochrane Library were searched for studies published up to February 2020. Two reviewers independently assessed the studies using strict inclusion criteria. Ten studies were included and qualitatively analyzed. The review included patients with pain due to complex regional pain syndrome (CRPS), diabetic polyneuropathy, and others, such as postherpetic neuralgia and trigeminal neuralgia. We found that IVIG may be one of the beneficial options for managing neuropathic pain from various neurological disorders. In the four articles reviewed, no major adverse effects were reported, and the trend was toward a positive pain-reducing effect in eight articles. However, to confirm the benefits of IVIG on reducing neuropathic pain, more high-quality studies are required.

Neuropathic Pain Creates Systemic Ultrastructural Changes in the Nervous System Corrected by Electroacupuncture but Not by Pregabalin

“…Chronic pain is associated with neuroinflammation. 28 Several lines of evidence suggest that the mechanical allodynia induced by SNI is secondary to a neuroinflammatory response in the CNS, that is characterized by aberrant microglial activation in the spinal cord. 29 , 30 Gordh et al also reported that patients with severe peripheral neuropathic pain demonstrated upregulation of several chemokines in their cerebrospinal fluid.…”

Human Intravenous Immunoglobulin Alleviates Neuropathic Symptoms in a Rat Model of Paclitaxel-Induced Peripheral Neurotoxicity

“…Human intravenous immunoglobulin (IVIg) are therapeutic polyspecific IgGs derived from plasma pools of thousands of healthy donors, characterized by multiple immunomodulatory and anti-inflammatory properties. IVIg are used to manage neuropathic pain from various neurological disorders [ 32 ]. While their effectiveness has been demonstrated in several animal models of autoimmune and inflammatory neuropathies [ 33 , 34 ] mimicking Guillain-Barrè syndrome or chronic inflammatory demyelinating polyneuropathy [ 35 ] and also in experimental bortezomib-induced peripheral neuropathy [ 36 ], their use in PIPN has not yet been investigated.…”

Neuronal C‐Reactive Protein/FcγRI Positive Feedback Proinflammatory Signaling Contributes to Nerve Injury Induced Neuropathic Pain

“…Previous research has revealed that IVIG may be beneficial for managing neuropathic pain. [ 29 ] Some research has reported that IVIG and plasma exchange therapy could effectively improve pain symptoms in some CRPS patients. [ 30 ] Fc γ RI, which is the high‐affinity Fc‐gamma receptor, can bind both IgG‐IC and monomeric IgG.…”