H Shoham-Kessary1, H Gershon. 1. Department of Immunology, Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Abstract
BACKGROUND AND OBJECTIVES: IVIg, while generally a safe therapy for a variety of immunological disorders, can have detrimental effects on erythrocyte (RBC) homeostasis. We studied the mediation of erythrophagocytosis by isoantibodies in IVIg. MATERIALS AND METHODS: RBC were exposed to IVIg and binding of IgG determined by flow cytometry. In vitro phagocytosis of these RBC was assayed. RESULTS: Anti-A and anti-B in IVIg mediate Fc-dependent erythrophagocytosis even in the presence of excess IVIg. Removal of these isoantibodies from IVIg prevents IgG binding and erythrophagocytosis. Complement enhances IVIg-mediated RBC sequestration. CONCLUSION: It may be desirable to remove isoantibodies from IVIg especially for anemic patients or those who respond to the IVIg with a hemolytic episode.
BACKGROUND AND OBJECTIVES: IVIg, while generally a safe therapy for a variety of immunological disorders, can have detrimental effects on erythrocyte (RBC) homeostasis. We studied the mediation of erythrophagocytosis by isoantibodies in IVIg. MATERIALS AND METHODS: RBC were exposed to IVIg and binding of IgG determined by flow cytometry. In vitro phagocytosis of these RBC was assayed. RESULTS: Anti-A and anti-B in IVIg mediate Fc-dependent erythrophagocytosis even in the presence of excess IVIg. Removal of these isoantibodies from IVIg prevents IgG binding and erythrophagocytosis. Complement enhances IVIg-mediated RBC sequestration. CONCLUSION: It may be desirable to remove isoantibodies from IVIg especially for anemicpatients or those who respond to the IVIg with a hemolytic episode.
Authors: Joseph Kahwaji; Eva Barker; Sam Pepkowitz; Ellen Klapper; Rafael Villicana; Alice Peng; Robert Chang; Stanley C Jordan; Ashley A Vo Journal: Clin J Am Soc Nephrol Date: 2009-10-15 Impact factor: 8.237