Naturally occurring autoantibodies mediate ischemia/reperfusion-induced tissue injury.

Ischemia and reperfusion events within the heart and brain and similar trauma-induced ischemia/reperfusion events lead to significant morbidity and mortality. In the past two decades, an excessive innate immune response has been identified as the mediator of reperfusion-induced tissue damage. Recent evidence indicates that naturally occurring autoantibody (NAb) activation of complement is a major mechanism of injury due to ischemia/reperfusion. This chapter focuses on the antigens exposed by ischemia and recognized by NAbs, the mechanism of complement activation by damaging NAbs and the protective role of IVIG in ischemia/reperfusion-induced pathology.