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Mechanisms of IVIG action in immune thrombocytopenic purpura
Ryan J Hansen1, Joseph P Balthasar
1Department of Pharmaceutical Sciences, University at Buffalo, The State University of New York, Buffalo, New York 14260, USA.
Intravenous immunoglobulin (IVIG) has been an important therapy of immune thrombocytopenic purpura (ITP) for more than 20 years; however, questions still remain regarding the mechanisms of IVIG action in ITP. Recent reviews have focused on the hypotheses that IVIG effects are mediated via inhibition of Fc-receptor mediated platelet phagocytosis, suppression of anti-platelet antibody production, and anti-idiotypic inhibition of anti-platelet antibodies; however, new research suggests that a significant portion of IVIG benefit may be due to IVIG-mediated acceleration of the elimination of anti-platelet antibodies. It is anticipated that promising new therapies of ITP, and other autoimmune conditions, will be developed based on a better understanding of IVIG mechanism of action.
Intravenous immunoglobulin (IVIG) has been an important therapy of immune thrombocytopenic purpura (ITP) for more than 20 years; however, questions still remain regarding the mechanisms of IVIG action in ITP. Recent reviews have focused on the hypotheses that IVIG effects are mediated via inhibition of Fc-receptor mediated platelet phagocytosis, suppression of anti-platelet antibody production, and anti-idiotypic inhibition of anti-platelet antibodies; however, new research suggests that a significant portion of IVIG benefit may be due to IVIG-mediated acceleration of the elimination of anti-platelet antibodies. It is anticipated that promising new therapies of ITP, and other autoimmune conditions, will be developed based on a better understanding of IVIG mechanism of action.
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