Intravenous immunoglobulin and immunodeficiency in children

A. G. Ugazio, M. Duse, L. D. Notarangelo

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Immunoglobulins, obtained from human plasma by ethanol extraction (Cohn fraction II), have been used for 40 years in substitution therapy for antibody deficiencies and as prophylaxis for and treatment of several infectious diseases [1]. Cohn fraction II contains over 90% IgG; 10% to 15% of IgG is present as aggregates which, upon entering the circulation, can activate the complement cascade and the effector cells of the immune system. As a consequence, anaphylactoid reactions may result from the release of anaphylatoxins in the circulation. Therefore, classic immunoglobulin preparations can be used by intramuscular administration only (IMIG). One of the limitations of this route of administration is that pain can be present at the site of injection due to viscosity of the solution (16.5% of IgG), which may cause sterile abscesses, damage to peripheral nerves, or tissue necrosis, although this is rare. Furthermore, only small volumes can be injected because of excessive pain and poor compliance, resulting in low dosages of IgG. It follows that satisfactory IgG serum levels or effective antibody titers or both are difficult and slow to achieve because absorption is unpredictable and local proteolysis with degradation of antibody molecules may occur. To solve these problems, efforts have been aimed at obtaining immunoglobulin preparations suitable for intravenous use (IVIG). These preparations have now been available for more than 10 years and have constituted an important achievement in the treatment of humoral immunodeficiencies, having also resulted, in some cases, in a dramatic improvement in prognosis.

Original languageEnglish
Pages (from-to)5-12
Number of pages8
JournalCurrent Opinion in Pediatrics
Volume1
Issue number1
Publication statusPublished - 1989

Fingerprint

Intravenous Immunoglobulins
Immunoglobulin G
Immunoglobulins
Antibodies
Anaphylatoxins
Pain
Nerve Tissue
Peripheral Nerves
Viscosity
Abscess
Proteolysis
Communicable Diseases
Immune System
Ethanol
Necrosis
Therapeutics
Injections
Serum
Cohn fraction II

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Ugazio, A. G., Duse, M., & Notarangelo, L. D. (1989). Intravenous immunoglobulin and immunodeficiency in children. Current Opinion in Pediatrics, 1(1), 5-12.

Intravenous immunoglobulin and immunodeficiency in children. / Ugazio, A. G.; Duse, M.; Notarangelo, L. D.

In: Current Opinion in Pediatrics, Vol. 1, No. 1, 1989, p. 5-12.

Research output: Contribution to journalArticle

Ugazio, AG, Duse, M & Notarangelo, LD 1989, 'Intravenous immunoglobulin and immunodeficiency in children', Current Opinion in Pediatrics, vol. 1, no. 1, pp. 5-12.
Ugazio, A. G. ; Duse, M. ; Notarangelo, L. D. / Intravenous immunoglobulin and immunodeficiency in children. In: Current Opinion in Pediatrics. 1989 ; Vol. 1, No. 1. pp. 5-12.
@article{222cc15af992423ba87c628c620bc3b9,
title = "Intravenous immunoglobulin and immunodeficiency in children",
abstract = "Immunoglobulins, obtained from human plasma by ethanol extraction (Cohn fraction II), have been used for 40 years in substitution therapy for antibody deficiencies and as prophylaxis for and treatment of several infectious diseases [1]. Cohn fraction II contains over 90{\%} IgG; 10{\%} to 15{\%} of IgG is present as aggregates which, upon entering the circulation, can activate the complement cascade and the effector cells of the immune system. As a consequence, anaphylactoid reactions may result from the release of anaphylatoxins in the circulation. Therefore, classic immunoglobulin preparations can be used by intramuscular administration only (IMIG). One of the limitations of this route of administration is that pain can be present at the site of injection due to viscosity of the solution (16.5{\%} of IgG), which may cause sterile abscesses, damage to peripheral nerves, or tissue necrosis, although this is rare. Furthermore, only small volumes can be injected because of excessive pain and poor compliance, resulting in low dosages of IgG. It follows that satisfactory IgG serum levels or effective antibody titers or both are difficult and slow to achieve because absorption is unpredictable and local proteolysis with degradation of antibody molecules may occur. To solve these problems, efforts have been aimed at obtaining immunoglobulin preparations suitable for intravenous use (IVIG). These preparations have now been available for more than 10 years and have constituted an important achievement in the treatment of humoral immunodeficiencies, having also resulted, in some cases, in a dramatic improvement in prognosis.",
author = "Ugazio, {A. G.} and M. Duse and Notarangelo, {L. D.}",
year = "1989",
language = "English",
volume = "1",
pages = "5--12",
journal = "Current Opinion in Pediatrics",
issn = "1040-8703",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Intravenous immunoglobulin and immunodeficiency in children

AU - Ugazio, A. G.

AU - Duse, M.

AU - Notarangelo, L. D.

PY - 1989

Y1 - 1989

N2 - Immunoglobulins, obtained from human plasma by ethanol extraction (Cohn fraction II), have been used for 40 years in substitution therapy for antibody deficiencies and as prophylaxis for and treatment of several infectious diseases [1]. Cohn fraction II contains over 90% IgG; 10% to 15% of IgG is present as aggregates which, upon entering the circulation, can activate the complement cascade and the effector cells of the immune system. As a consequence, anaphylactoid reactions may result from the release of anaphylatoxins in the circulation. Therefore, classic immunoglobulin preparations can be used by intramuscular administration only (IMIG). One of the limitations of this route of administration is that pain can be present at the site of injection due to viscosity of the solution (16.5% of IgG), which may cause sterile abscesses, damage to peripheral nerves, or tissue necrosis, although this is rare. Furthermore, only small volumes can be injected because of excessive pain and poor compliance, resulting in low dosages of IgG. It follows that satisfactory IgG serum levels or effective antibody titers or both are difficult and slow to achieve because absorption is unpredictable and local proteolysis with degradation of antibody molecules may occur. To solve these problems, efforts have been aimed at obtaining immunoglobulin preparations suitable for intravenous use (IVIG). These preparations have now been available for more than 10 years and have constituted an important achievement in the treatment of humoral immunodeficiencies, having also resulted, in some cases, in a dramatic improvement in prognosis.

AB - Immunoglobulins, obtained from human plasma by ethanol extraction (Cohn fraction II), have been used for 40 years in substitution therapy for antibody deficiencies and as prophylaxis for and treatment of several infectious diseases [1]. Cohn fraction II contains over 90% IgG; 10% to 15% of IgG is present as aggregates which, upon entering the circulation, can activate the complement cascade and the effector cells of the immune system. As a consequence, anaphylactoid reactions may result from the release of anaphylatoxins in the circulation. Therefore, classic immunoglobulin preparations can be used by intramuscular administration only (IMIG). One of the limitations of this route of administration is that pain can be present at the site of injection due to viscosity of the solution (16.5% of IgG), which may cause sterile abscesses, damage to peripheral nerves, or tissue necrosis, although this is rare. Furthermore, only small volumes can be injected because of excessive pain and poor compliance, resulting in low dosages of IgG. It follows that satisfactory IgG serum levels or effective antibody titers or both are difficult and slow to achieve because absorption is unpredictable and local proteolysis with degradation of antibody molecules may occur. To solve these problems, efforts have been aimed at obtaining immunoglobulin preparations suitable for intravenous use (IVIG). These preparations have now been available for more than 10 years and have constituted an important achievement in the treatment of humoral immunodeficiencies, having also resulted, in some cases, in a dramatic improvement in prognosis.

UR - http://www.scopus.com/inward/record.url?scp=0024828926&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024828926&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0024828926

VL - 1

SP - 5

EP - 12

JO - Current Opinion in Pediatrics

JF - Current Opinion in Pediatrics

SN - 1040-8703

IS - 1

ER -