Treatment of systemic vasculitis with pooled intravenous immunoglobulin

Jayne, David; Lockwood, C. M.; Davies, Michael J.; Fox, Charles; Black, Carol M.

doi:10.1016/0140-6736(91)92797-6

Cited by 280 publications

(66 citation statements)

References 18 publications

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“…This was corroborated recently by Jayne et al who reported successful treatment of patients with microscopic polyangiitis, WG, and rheumatoid vascuhtis [13][14][15]. This prompted us to examine IVIG treatment in patients with ANCA-associated vasculitis.…”

Section: Introductionsupporting

confidence: 57%

Treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis with high-dose intravenous immunoglobulin

Richter

Schnabel

Csernok

et al. 1995

Clinical and Experimental Immunology

130

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SUMMARYIn this uncontrolled study 15 patients with ANCA-associated systemic vasculitis, who were poor responders to conventional therapy, were treated with single or multiple courses of intravenous immunoglobulin (IVIG), 30g/day over 5 days. Chnical and serological evaluation was performed before and 4 weeks after IVIG. Six of the 15 patients experienced clinically significant benefit from IVIG. Improvement was confined to single organ manifestations (skin, ENT findings), no improvement was seen with conjunctivitis and scleritis, pericarditis or nephritis. No patient experienced complete remission after IVIG. Repeated courses of IVIG at 4-week intervals were no more effective than single courses. In six anti-proteinase 3 (PR3)-positive patients pretreatment sera were incubated with F(ab')2 fragments of the IVIG preparation in vitro to measure the inhibitory effect of IVIG on anti-PR3 activity. An inhibition of anti-PR3 activity by 25-70% was observed; this did not correlate with clinical effects. Approximately 40% of patients benefited from IVIG treatment, though complete remission of disease activity did not occur. Neither clinical characteristics nor the inhibitory effect of the IVIG preparation on serum anti-PR3 activity in vitro predicted clinical response to this treatment modality.

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Section: Introductionsupporting

confidence: 57%

Treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis with high-dose intravenous immunoglobulin

Richter

Schnabel

Csernok

et al. 1995

Clinical and Experimental Immunology

130

View full text Add to dashboard Cite

show abstract

“…Pooled human intravenous Ig is used therapeutically with rapid improvement in symptoms and well-being in some individuals and rapid reduction in acute phase reactants such as C-reactive protein [21]. Intravenous Ig at levels of 10 mg/ml caused complete inhibition of anti-PR3 stimulated IL-1 (Fig.…”

Section: The Effect Of Pooled Human Intravenous Igmentioning

confidence: 99%

IL-1β production by human polymorphonuclear leucocytes stimulated by anti-neutrophil cytoplasmic autoantibodies: relevance to systemic vasculitis

Brooks

King

Radford

et al. 1996

Clinical and Experimental Immunology

107

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SUMMARYNeutrophils accumulate in the acute blood vessel lesions of patients with autoimmune systemic vasculitis. They have been shown previously to produce the cytokine IL-1¯in response to stimulation with TNF. This study demonstrates that neutrophils can be stimulated by anti-neutrophil cytoplasmic antibodies (ANCA), which are present in patients with systemic vasculitis, to express mRNA and protein for IL-1¯. Both human ANCA and MoAbs to a variety of autoantigens recognized by ANCA, including proteinase 3, myeloperoxidase, bactericidal/permeability increasing protein and elastase, are effective. This response can be inhibited by actinomycin and cycloheximide, suggesting a requirement for de novo protein synthesis. IL-1¯production can be inhibited by pooled human intravenous immunoglobulins but not by FK506 or cyclosporin A. These data suggest that ANCA in patients with active vasculitis may stimulate neutrophils to produce cytokines. It is hypothesized that cytokine production from neutrophils that accumulate in significant numbers in vasculitic lesions contribute to and augment the local inflammatory response by the activation of vascular endothelial cells and infiltrating leucocytes.

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“…Their study showed that IVIG decreased the leukocyte count, C-reactive protein level, Birmingham Vasculitis Activity Score and improved the systemic symptoms (Ito-Iharaet al, 2006). Other studies suggested that IVIG induces remission in 40-82% of patients Jayne et al, 1991;Levy et al, 1999;. IVIG appears to have an important place in the management of ANCA-RPGN, but it's indications have not been determined.…”

Section: Intravenous Immunoglobulins(ivig)mentioning

confidence: 99%

RPGN - Clinical Features, Treatment and Prognosis

Naseri¹

2011

An Update on Glomerulopathies - Clinical and Treatment Aspects

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Treatment of systemic vasculitis with pooled intravenous immunoglobulin

Cited by 280 publications

References 18 publications

Treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis with high-dose intravenous immunoglobulin

Treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis with high-dose intravenous immunoglobulin

IL-1β production by human polymorphonuclear leucocytes stimulated by anti-neutrophil cytoplasmic autoantibodies: relevance to systemic vasculitis

RPGN - Clinical Features, Treatment and Prognosis

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