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Intravenous Immunoglobulins as a Treatment for Alzheimer’s Disease

Rationale and Current Evidence

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Abstract

Current treatment options for Alzheimer’s disease (AD) exert only a shortlived effect on disease symptoms. Active and passive immunotherapy have both been shown to be effective in clearing plaques, removing β-amyloid (Aβ) and improving behaviour in animal models of AD. Although the first active immunization trial in humans was discontinued because of severe adverse effects, several new approaches are currently being investigated in clinical trials. Recently, commercially available intravenous immunoglobulins (IVIG) have been used in small pilot trials for the treatment of patients with AD, based on the hypothesis that IVIG contains naturally occurring auto-antibodies (nAbs-Aβ) that specifically recognize and block the toxic effects of Ab. Furthermore, these nAbs-Aβ are reduced in AD patients compared with healthy controls, supporting the notion of replacement with IVIG. Beyond the occurrence of nAbs-Aβ, evidence for several other mechanisms associated with IVIG in AD has been reported in preclinical experiments and clinical studies. In 2009, a phase III clinical trial involving more than 360 AD patients was initiated and may provide conclusive evidence for the effect of IVIG as a treatment option for AD in 2011. In this article, we review the current knowledge and scientific rationale for using IVIG in patients with AD and other neurodegenerative disorders.

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Acknowledgements

We thank Jennifer Manne for language editing. RD and MB hold patents on immunization in AD. RD and MB have received honoraria for presentations and research grants from several companies producing IVIG. The other authors have no conflicts of interest that are relevant to the content of this review. No sources of funding were used to assist in the preparation of this review.

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Authors and Affiliations

  1. Department of Neurology, Philipps-University Marburg, Rudolf-Bultmannstr. 8, 35039, Marburg, Germany

    Richard Dodel, Frauke Neff, Carmen Noelker, Michael Bacher & Wolfgang Oertel

  2. Department of Neurology, Hannover Medical School, Hannover, Germany

    Refik Pul

  3. Department of Neurology, Indiana University, Indianapolis, Indiana, USA

    Yansheng Du

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  1. Richard Dodel
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Correspondence to Richard Dodel.

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Dodel, R., Neff, F., Noelker, C. et al. Intravenous Immunoglobulins as a Treatment for Alzheimer’s Disease. Drugs 70, 513–528 (2010). https://doi.org/10.2165/11533070-000000000-00000

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