Immune Complex Therapies for Treatment of Immune Thrombocytopenia
Approximately 30% of patients with chronic immune thrombocytopenia (ITP), a common autoimmune disease, are refractory to standard therapies. In the last several years, several published reports have suggested that gamma globulin immune complexes may inhibit pathways of platelet destruction in ITP, attenuating thrombocytopenia in human patients and in animal models of ITP. This chapter reviews the literature associated with the use of immune complexes as a treatment of ITP, including a discussion of immune complex therapies that are in current clinical use (e.g., IVIG, anti-D), mechanisms proposed for the effects of immune complexes in ITP, possible adverse effects associated with immune complexes, and translational considerations for the development of novel immune complex therapies (e.g., antibody-coated liposomes).
KeywordsImmune Complex Immune Thrombocytopenia Antiplatelet Antibody IVIG Preparation Soluble Immune Complex
This work has been supported by NIH/NHLBI grant number HL67347 (to JPB).
- Deng R, Balthasar JP (2007b) Pharmacokinetic/pharmacodynamic modeling of IVIG effects in a murine model of immune thrombocytopenia. J Pharm Sci 96(6):1625–1637Google Scholar
- Goldsby RA, Kindt TJ, Osborne BA (2000) Hypersensitive reactions. In: Goldsby RA, Kindt TJ, Osborne BA (eds) Kuby immunology, 4th edn. WH Freeman and Company, New YorkGoogle Scholar
- Jones HW, Tocantins LM (1933) The history of purpura hemorrhagica. Ann Med Hist 5:349–359Google Scholar
- Lamoureux J, Aubin E, Lemieux R (2004) Autoantibodies purified from therapeutic preparations of intravenous immunoglobulins (IVIg) induce the formation of autoimmune complexes in normal human serum: a role in the in vivo mechanisms of action of IVIg? Int Immunol 16:929–936PubMedCrossRefGoogle Scholar
- Spycher MO, Bolli R, Hodler G (1999) Well-tolerated liquid intravenous immunoglobulin G preparations(IVIGs) have a low immunoglobulin G dimer content. J Autoimmun 96(suppl):96 abstractGoogle Scholar