Mechanisms of action and historical facts on the use of intravenous immunoglobulins in systemic lupus erythematosus

Autoimmun Rev. 2019 Mar;18(3):279-286. doi: 10.1016/j.autrev.2018.10.002. Epub 2019 Jan 11.

Abstract

The current existing therapies for severe cases of systemic lupus erythematosus (SLE) patients are still limited. Intravenous immunoglobulin (IVIGs), which are purified from the plasma of thousands of healthy human donors, have been profiled as efficacious and life-saving options for SLE patients refractory to conventional therapy. The specific mechanism of action by which IVIGs generate immunomodulation in SLE is not currently understood. In this manuscript, we reviewed some of the hypothesis that have been postulated to explain the IVIG effects, including those on T and B cell intracellular signalling and activation, as well as the interferon signalling pathways involved in the detection of nucleic acids and the defective removal of immune complexes and debris.

Keywords: Immune complexes; Interferon signalling; Intravenous immunoglobulin; Sialylated immunoglobulins; Systemic lupus erythematosus.

Publication types

  • Review

MeSH terms

  • Animals
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / immunology
  • Humans
  • Immunoglobulins, Intravenous / pharmacology
  • Immunoglobulins, Intravenous / therapeutic use*
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use*
  • Interferons / immunology
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Erythematosus, Systemic / immunology
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Interferons