Immunomodulatory effects of intravenous immunoglobulins (IVIg) in autoimmune diseases abstract.

Purpose. - Intravenous immunoglobulins (IVIG) therapy has been reported to be beneficial in a large number of autoantibody-mediated or self-reactive T cells-associated autoimmune diseases. Thus, the beneficial effect of IVIg is probably due to multiple distinct mechanisms. Main points. - The immunoregulatory effect of IVIg in autoimmune diseases is dependent on: interaction of the Fc portion of IVIg with Fc receptors on leucocyte surfaces; interaction of infused IgG with complement components: modulation of synthesis and release of cytokines produced by lymphocytes and monocytes; V region-dependent neutralization of circulating autoantibodies by infused IgG; selection of immune repertoires; modulation of cell proliferation, particularily through modulation of Fas-induced apoptosis; interaction of IVIg with numerous other molecules onto the surface of T and B cells. Perspectives. - Better understanding of these mechanisms should allow a better definition of the spectrum of diseases likely to benefit from IVIg treatment. (C) 1999 Elsevier, Paris.