How intravenous immunoglobulin therapy works in pemphigus

High-dose intravenous immunoglobulin (HD-IVIg) is one of potential therapy to accelerate the pathogenic antibody degradation in pemphigus. Advantage and benefits of this therapy are non-immunosuppressive and less adverse effects. The clinical trial of HD-IVIg for pemphigus has proved that 400mg/kg/d...

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Bibliographic Details
Published inNihon rinshō Vol. 70; no. 8; p. 1437
Main Author Aoyama, Yumi
Format Journal Article
LanguageJapanese
Published Japan 01.08.2012
Subjects
Aged
Autoantibodies
Clinical Trials as Topic
Desmoglein 1 - immunology
Histocompatibility Antigens Class I - physiology
Humans
Immunoglobulin G - blood
Immunoglobulins, Intravenous - administration & dosage
Immunoglobulins, Intravenous - adverse effects
Male
Monitoring, Physiologic
Pemphigus - diagnosis
Pemphigus - drug therapy
Pemphigus - immunology
Pulse Therapy, Drug
Receptors, Fc - physiology
Severity of Illness Index
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Summary:High-dose intravenous immunoglobulin (HD-IVIg) is one of potential therapy to accelerate the pathogenic antibody degradation in pemphigus. Advantage and benefits of this therapy are non-immunosuppressive and less adverse effects. The clinical trial of HD-IVIg for pemphigus has proved that 400mg/kg/day for 5 days administration of IVIg is effective as an adjuvant therapy with systemic steroid therapy and/or immunosuppressive agents. Among the several mechanisms to explain the mode of action of IVIg, the neonatal Fc receptor for IgG (FcRn) plays important role for rapid clearance of pathogenic antibody in pemphigus induced by HD-IVIg. To monitor the serum IgG levels is necessary to predict the timing that the titer of anti-Dsg1 antibody starts to increase. Furthermore, the sufficient suppression of the antibody production in patients with severe disease activity is a key point for successful treatment with IVIg.
ISSN:0047-1852