Anti-idiotypic antibodies: From regulation to therapy of factor VIII inhibitors

Evidence has recently accumulated showing that antiidiotypic antibodies specific to anti-FVIII antibodies are present in the plasma of healthy individuals and of haemophilia A patients with or without inhibitors, where they can neutralise the FVIII inhibitory activity, Additionally, patients successfully desensitised towards FVIII have an increased production of anti-idiotypic antibodies with no significant reduction in anti-FVIII antibodies. We review here possible strategies for modulating the anti-FVIII immune response by idiotypic interactions.