Soluble molecules in intravenous immunoglobulin: benefits and limitations

Azimi, Maryam; Aghamohammadi, Asghar; Ochs, Hans D.; Rezaei, Nima

doi:10.1586/1744666x.2016.1111138

Cited by 3 publications

(4 citation statements)

References 27 publications

(28 reference statements)

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“…Recent evidence shows that immune reconstitution with IVIG has diverse effects on the immune system of CVID patients [89][90][91]. IVIG resulted in elevation of CD4 + T-cell percentages [92], correction of the inverted CD4/CD8 ratio, and improvement in T-cell function [93].…”

Section: Effects Of Ivig On T Cells In Cvid Patientsmentioning

confidence: 99%

T-Cell Abnormalities in Common Variable Immunodeficiency

Azizi

Rezaei

Kiaee

et al. 2016

J Investig Allergol Clin Immunol

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Common variable immunodeficiency (CVID) is the most common clinical primary immunodeficiency. It is characterized by a defect in B-cell differentiation to plasma and memory B cells. Moreover, numerous T-cell abnormalities have been reported and include decreased T-cell count and proliferative response, increased T-cell activation and apoptosis, and abnormalities in cytokine production. The aims of this review are to describe phenotypic and functional defects in T cells in CVID patients and to review the literature with respect to the effects of immunoglobulin replacement on the T-cell component in CVID patients. Key words: Common variable immunodeficiency. T cell. Helper T cells. Regulatory T cells. ResumenLa inmunodeficiencia común variable (CVID) es la inmunodeficiencia primaria más frecuente. Se caracteriza por un defecto en la diferenciación de linfocitos B hacia células plasmáticas y linfocitos B memoria. Se han descrito numerosas alteraciones en los linfocitos T de estos pacientes, tales como disminución en el número de linfocitos T y en sus respuestas proliferativas, aumento en la activación de células T y en la apoptosis, así como alteraciones en la producción de citokinas. El objetivo de esta revisión es describir las alteraciones funcionales y fenotípicas de los linfocitos T en los pacientes con CVID y revisar la bibliografía en relación a los efectos que la administración de inmunoglobulinas produce en los linfocitos T de los pacientes con CVID. Palabras clave: Inmunodeficiencia común variable. Células T. Células T helper. Células T reguladoras.

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Section: Effects Of Ivig On T Cells In Cvid Patientsmentioning

confidence: 99%

T-Cell Abnormalities in Common Variable Immunodeficiency

Azizi

Rezaei

Kiaee

et al. 2016

J Investig Allergol Clin Immunol

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“…They compete with major histocompatibility complex class IIrestricted autoreactive T lymphocytes in binding HLA-II, resulting in immune tolerance. 18 Thus, IVIG has been used as a steroid-tapering agent in various inflammatory diseases. 19,20 Based on these findings, IVIG treatment in patients with steroid hyporesponsive DRESS syndrome might be effective.…”

Section: Discussionmentioning

confidence: 99%

“…All patients had elevated liver enzymes, and half had hyperbilirubinemia. Patients showed increased inflammatory indicators, such as ESR (7), CRP (18), FDP (17), and D-dimer (17). All patients had elevated LDH, and all but one had elevated ferritin.…”

Section: Laboratory and Radiologic Findingsmentioning

confidence: 99%

Efficacy of add‐on therapy with intravenous immunoglobulin in steroid hyporesponsive DRESS syndrome

Sim

Koh

2021

Clinical Translational Sci

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Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, potentially life-threatening, delayed, drug-induced hypersensitivity reaction. Immediate withdrawal of the culprit drug and administration of systemic corticosteroids is the most widely accepted treatment. However, it is difficult to manage patients with DRESS syndrome who are not responsive to systemic steroids. We studied the efficacy of intravenous immunoglobulins (IVIGs) in patients with DRESS syndrome unresponsive to systemic steroids. We retrospectively reviewed patients with DRESS syndrome who received IVIG in addition to systemic steroids during 2012-2017 and compared the clinical features and course of DRESS syndrome, before and after IVIG treatment. Eighteen DRESS patients (9 men) were included. The most frequent offending drugs were dapsone in five patients, followed by vancomycin in three patients, and carbamazepine in three patients. Rash, fever, lymphadenopathy, atypical lymphocytes, and hepatic involvement were common clinical findings. IVIG treatment was added within a median time of 7 days from the commencement of systemic steroid therapy. After IVIG treatment (total dosage: 1-2 g/kg), the fever resolved within a median time of 1 day (range, 0-3) and liver enzymes improved substantially within a median time of 13 days (range, 0-27). No severe adverse reactions related to IVIG therapy were observed in this study; however, there was one case of mortality. The addition of IVIG in DRESS syndrome in cases refractory to systemic steroid treatment may be helpful in hastening recovery. However, comparative studies using a placebo group are needed. Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe delayed drug reaction. The main treatment is administration of systemic steroids. However, treatment of steroid hyporesponsive adults is unclear.

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“…Human Ig can be used in various modes; for instance, subcutaneous (SCIG), intravenous (IVIG), and intramuscular (IMIG) administration (84-87). However, all administrations mentioned above have their advantages and disadvantages (72,78,88,89). Although there are wide Ig therapeutic approaches for clinical use, applying them in clinical trials is not quite as simple as it might seem.…”

Section: Immunoglobulinsmentioning

confidence: 99%