[Immunomodulatory effects of intravenous immunoglobulins in autoimmune diseases]

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.

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, particularly through modulation of Fas-induced apoptosis; interaction of IVIg with numerous other molecules onto the surface of T and B cells.

Better understanding of these mechanisms should allow a better definition of the spectrum of diseases likely to benefit from IVIg treatment.