New insights into IVIg mechanisms and alternatives in autoimmune and inflammatory diseases

• Published in: Current opinion in hematology Vol. 27; no. 6; pp. 392 - 398
• Main Authors: Norris, Peter A.A., Kaur, Gurleen, Lazarus, Alan H.
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-11-2020; Copyright Wolters Kluwer Health, Inc. All rights reserved
• ISSN: 1065-6251; 1531-7048
• DOI: 10.1097/MOH.0000000000000609

PURPOSE OF REVIEWIntravenous immunoglobulin (IVIg) is an effective treatment for an increasing number of autoimmune and inflammatory conditions. However, IVIg continues to be limited by problems of potential shortages and cost. A number of mechanisms have been described for IVIg, which have been captured in newly emergent IVIg mimetic and IVIg alternative therapies. This review discusses the recent developments in IVIg mimetics and alternatives.
RECENT FINDINGSNewly emergent IVIg mimetics and alternatives capture major proposed mechanisms of IVIg, including FcγR blockade, FcRn inhibition, complement inhibition, immune complex mimetics and sialylated IgG. Many of these emergent therapies have promising preclinical and clinical trial results.
SUMMARYSignificant research has been undertaken into the mechanism of IVIg in the treatment of autoimmune and inflammatory disease. Understanding the major IVIg mechanisms has allowed for rational development of IVIg mimetics and alternatives for several IVIg-treatable diseases.