Use of human immunoglobulins as an anti-infective treatment: the experience so far and their possible re-emerging role

Expert Rev Anti Infect Ther. 2017 Jun;15(6):585-604. doi: 10.1080/14787210.2017.1328278. Epub 2017 May 15.

Abstract

Pooled human immunoglobulins (IGs) are prepared from plasma obtained from healthy donors as a concentrated antibody-containing solution. In addition, high-titer IGs (hyperimmune) against a specific pathogen can be obtained from vaccinated or convalescing donors. Currently, IGs can be used for the treatment of a variety of infections for which no specific therapy exists or that remain difficult to treat. Moreover, the recent pathogen outbreaks for which there is no approved treatment have renewed attention to the role of convalescent plasma and IGs. Areas covered: In this review, a historical perspective of the use of sera and IGs in humans as anti-infective agents (any viral, bacterial, parasitic infection), excluding immunodeficient patients, is presented from early development to the latest clinical studies. A Medline search was conducted to examine the peer-reviewed literature, with no date limits. Expert commentary: Human pooled plasma-derived IG products benefit from the polyclonal response of every individual donor and from the interindividual variability in such response. The trend to increased availability of vaccines for infectious diseases also opens new potential applications of hyperimmune IGs for emerging or re-emerging infectious diseases (e.g.: Ebola, Zika, Dengue), for the prevention and treatment in the general population, healthcare personnel and caregivers.

Keywords: Emerging disease; immunoglobulin; infection; outbreak; plasma; serum.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Communicable Diseases, Emerging / drug therapy*
  • Communicable Diseases, Emerging / immunology
  • Communicable Diseases, Emerging / prevention & control
  • Communicable Diseases, Emerging / virology
  • Convalescence
  • Dengue Virus / drug effects
  • Dengue Virus / immunology
  • Dengue Virus / pathogenicity
  • Ebolavirus / drug effects
  • Ebolavirus / immunology
  • Ebolavirus / pathogenicity
  • Hemorrhagic Fever, Ebola / drug therapy*
  • Hemorrhagic Fever, Ebola / immunology
  • Hemorrhagic Fever, Ebola / prevention & control
  • Hemorrhagic Fever, Ebola / virology
  • Humans
  • Immune Sera / administration & dosage*
  • Immunization, Passive / methods*
  • Immunoglobulins / therapeutic use*
  • Severe Dengue / drug therapy*
  • Severe Dengue / immunology
  • Severe Dengue / prevention & control
  • Severe Dengue / virology
  • Vaccination
  • Viral Vaccines / administration & dosage
  • Viral Vaccines / biosynthesis
  • Zika Virus / drug effects
  • Zika Virus / immunology
  • Zika Virus / pathogenicity
  • Zika Virus Infection / drug therapy*
  • Zika Virus Infection / immunology
  • Zika Virus Infection / prevention & control
  • Zika Virus Infection / virology

Substances

  • Immune Sera
  • Immunoglobulins
  • Viral Vaccines