The use of IVIG for allergy consultants

Authors

  • Bruce D. Mazer, MD McGill University, Montreal, Quebec; Research Institute of the McGill University Health Centre Research Institute; COVID Immunity Task Force

DOI:

https://doi.org/10.58931/cait.2023.3356

Abstract

IgG plays multiple roles in the immune system. Best known as an effector molecule in host defence, infusions of polyclonal IgG have been employed as the mainstay of treatment for patients with immunodeficiency diseases affecting the humoral immune system. IgG preparations are fractionated from pools of several hundred to several thousand donors or more and therefore contain a broad spectrum of antibodies, capable of providing protection against many bacterial and viral diseases. Preparations of human IgG are available for intravenous (IVIG) or subcutaneous (SCIG) administration, allowing individuals with both primary and secondary immune defects to have significantly fewer infections, decreased hospitalizations and overall improved quality of life (QOL). Moreover, IVIG has been employed as a regulator of a large number of autoimmune and inflammatory conditions since the 1980s.

Author Biography

Bruce D. Mazer, MD, McGill University, Montreal, Quebec; Research Institute of the McGill University Health Centre Research Institute; COVID Immunity Task Force

Bruce Mazer Is a Pediatric Allergist and Immunologist and Professor of Medicine at McGill University, Senior Scientist at the Research Institute of the McGill University Health Center and is currently the Associate Scientific Director (Strategy) of Canada’s COVID-19 Immunity Task Force. He is a graduate of McGill’s Faculty of Medicine and Health Sciences and has been a faculty member in the Department of Pediatrics since 1991. From 2000 to 2015, he served as Division Head of Allergy and Immunology at the MCH. In 2015, he was appointed Head of Child Health Research at the Research Institute of the McGill University Health Centre (RI-MUHC). In October 2016, he became Interim Executive Director and Chief Scientific Officer of the RI-MUHC, a role he held until July 2020. He has published over 120 papers and held continuous research funding since 1993. Dr. Mazer’s research focuses on the role of B-cells in regulating inflammation in allergic diseases and antibody responses in immune-deficient patients. His early research on intravenous immunoglobulin influenced the treatment of asthma, Kawasaki disease and immune defects in children. Dr Mazer later led the creation of Canada’s first food allergy consortium which led to multiple food allergy oral immunotherapy trials and genetic biomarkers of food allergy. This CIHR-funded network is generating new insights into life-threatening food reactions and testing new treatments – some based on studies by the Mazer lab. An award-winning mentor who held many leadership positions at McGill, Dr Mazer has played a national role in pandemic-related research as director of scientific strategy for the Canadian COVID-19 Immunity Task Force.

References

Arumugham V, Rayi A. Intravenous immunoglobulin (IVIG). StatPearls [Internet]. StatPearls Publishing; 2022. June 2022.

Perez EE, Orange JS, Bonilla F, Chinen J, Chinn IK, Dorsey M, El-Gamal Y, Harville TO, Hossny E, Mazer B, Nelson R. Update on the use of immunoglobulin in human disease: a review of evidence. Journal of Allergy and Clinical Immunology. 2017 Mar 1;139(3):S1-46. doi:10.1016/j.jaci.2016.09.023

Gelfand EW. Intravenous immune globulin in autoimmune and inflammatory diseases. New England Journal of Medicine. 2012 Nov 22;367(21):2015-25. doi:10.1056/NEJMra1009433

N’kaoua E, Attarian S, Delmont E, Campana-Salort E, Verschueren A, Grapperon AM, Mestivier E, Roche M. Immunoglobulin shortage: Practice modifications and clinical outcomes in a reference centre. Revue Neurologique. 2022 Jun 1;178(6):616-23. doi:10.1016/j.neurol.2021.10.004

Orange JS, Ballow M, Stiehm ER, Ballas ZK, Chinen J, De La Morena M, Kumararatne D, Harville TO, Hesterberg P, Koleilat M, McGhee S. Use and interpretation of diagnostic vaccination in primary immunodeficiency: a working group report of the Basic and Clinical Immunology Interest Section of the American Academy of Allergy, Asthma & Immunology. Journal of Allergy and Clinical Immunology. 2012 Sep 1;130(3):S1-24. doi:10.1016/j.jaci.2012.07.002

Otani IM, Lehman HK, Jongco AM, Tsao LR, Azar AE, Tarrant TK, Engel E, Walter JE, Truong TQ, Khan DA, Ballow M. Practical guidance for the diagnosis and management of secondary hypogammaglobulinemia: a work group report of the AAAAI primary immunodeficiency and altered immune response committees. Journal of Allergy and Clinical Immunology. 2022 May 1;149(5):1525-60. doi:10.1016/j.jaci.2022.01.025

Labrosse R, Haddad E. Immunodeficiency secondary to biologics. Journal of Allergy and Clinical Immunology. 2023 Mar 1;151(3):686-90. doi:10.1016/j. jaci.2023.01.012

Kaufman GN, Massoud AH, Dembele M, Yona M, Piccirillo CA, Mazer BD. Induction of regulatory T cells by intravenous immunoglobulin: a bridge between adaptive and innate immunity. Frontiers in Immunology. 2015 Sep 11;6:469. doi:10.3389/fimmu.2015.00469

Jutras C, Robitaille N, Sauthier M, Du Pont-Thibodeau G, Lacroix J, Trottier H, Zarynchansky R, Tucci M. Intravenous Immunoglobulin Use In Critically Ill Children. Clinical and Investigative Medicine. 2021 Oct 3;44(3):E11-18. doi:10.25011/cim.v44i3.36532

Farrugia A, Bansal M, Marjanovic I. Estimation of the latent therapeutic demand for immunoglobulin therapies in autoimmune neuropathies in the United States. Vox Sanguinis. 2022 Feb;117(2):208-19. doi:10.1111/vox.13134

Bayry J, Ahmed EA, Toscano-Rivero D, Vonniessen N, Genest G, Cohen CG, Dembele M, Kaveri SV, Mazer BD. Intravenous immunoglobulin: mechanism of action in autoimmune and inflammatory conditions. The Journal of Allergy and Clinical Immunology: In Practice. 2023 Apr 14. doi:10.1016/j.jaip.2023.04.002

Aggarwal R, Charles-Schoeman C, Schessl J, Bata-Csörgő Z, Dimachkie MM, Griger Z, Moiseev S, Oddis C, Schiopu E, Vencovský J, Beckmann I. Trial of intravenous immune globulin in dermatomyositis. New England Journal of Medicine. 2022 Oct 6;387(14):1264-78. doi:10.1056/NEJMoa2117912

Goussen C, Simoneau S, Bérend S, Jehan-Kimmel C, Bellon A, Ducloux C, You B, Paolantonacci P, Ollivier M, Burlot L, Chtourou S. Biological safety of a highly purified 10% liquid intravenous immunoglobulin preparation from human plasma. BioDrugs. 2017 Jun;31:251-61. doi:10.1007/s40259-017-0222-9

Belem WF, Liu CH, Hu YT, Burnouf T, Lin LT. Validation of Viral Inactivation Protocols for Therapeutic Blood Products against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Viruses. 2022 Oct 31;14(11):2419. doi:10.3390/v14112419

Bégin P, Callum J, Jamula E, Cook R, Heddle NM, Tinmouth A, Zeller MP, Beaudoin-Bussières G, Amorim L, Bazin R, Loftsgard KC. Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial. Nature Medicine. 2021 Nov;27(11):2012-24. doi:10.1038/s41591-021-01488-2

Liu J, Chen Y, Li R, Wu Z, Xu Q, Li Z, Annane D, Feng H, Huang S, Guo J, Zhang L. Intravenous immunoglobulin treatment for patients with severe COVID-19: a retrospective multicentre study. Clinical Microbiology and Infection. 2021 Oct 1;27(10):1488-93. doi:10.1016/j.cmi.2021.05.012

Kwapisz D, Bogusławska J. Intravenous immunoglobulins (IVIG) in severe/ critical COVID-19 adult patients. Biomedicine & Pharmacotherapy. 2023 May 5:114851. doi:10.1016/j.biopha.2023.114851

Harahsheh AS, Portman MA, Khoury M, Elias MD, Lee S, Lin J, McCrindle BW. Management of MIS-C (Multi-system Inflammatory Syndrome in Children): Decision-making regarding a new condition in the absence of clinical trial data. Canadian Journal of Cardiology. 2022 Nov 29. doi:10.1016/j.cjca.2022.11.011

Menegale F, Manica M, Zardini A, Guzzetta G, Marziano V, d’Andrea V, Trentini F, Ajelli M, Poletti P, Merler S. Evaluation of Waning of SARS- CoV-2 Vaccine–Induced Immunity: A Systematic Review and Meta-analysis. JAMA Network Open. 2023 May 1;6(5):e2310650-:e2310650. doi:10.1001/ jamanetworkopen.2023.10650

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Published

2023-12-13

How to Cite

1.
Mazer BD. The use of IVIG for allergy consultants. Can Allergy Immunol Today [Internet]. 2023 Dec. 13 [cited 2024 Nov. 21];3(3):5–8. Available from: https://canadianallergyandimmunologytoday.com/article/view/3-3-mazer

Issue

Volume 3, Issue 3, December 2023

Section

Articles