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. 2011;33(5):377-82.
doi: 10.5581/1516-8484.20110102.

Immunoglobulin: production, mechanisms of action and formulations

Marcia Cristina Zago Novaretti  1 , Carla Luana Dinardo
Affiliations

Immunoglobulin: production, mechanisms of action and formulations

Marcia Cristina Zago Novaretti et al. Rev Bras Hematol Hemoter. 2011.

Abstract

Human immunoglobulin (Ig) began to be applied in the clinical practice with the treatment of primary immunodeficiencies. Quickly, applications of Ig increased, as its anti-inflammatory and immunomodulatory functions were elucidated. Currently, Ig is the most commonly used blood product. Ig is obtained by processing plasma; methods, in particular, techniques to reduce plasma viral loads have been evolving over the years and include: pasteurization, solvent/ detergent treatment, caprylic acid treatment and nanofiltration. These methods contribute to increased safety and quality of blood products. The mechanisms of action of Ig not only involve the blockade of Fc receptors of phagocytes, but also control complement pathways, idiotype-anti-idiotype dimer formation, blockage of superantigen binding to T cells, inhibition of dendritic cells and stimulation of regulatory T cells (Tregs). There are several formulations of Ig available, each one with its own peculiar characteristics. In Brazil, there is stringent legislation regulating the quality of Ig. Only Ig products that completely fulfill the quality control criteria are released for use. These standards involve different tests from visual inspection to determination of anti-complementary activity. This paper will further review the history and current status of Ig, including its production and mechanisms of action. The formulations available in Brazil and also the criteria of quality control currently applied will be presented.

Keywords: Antibodies; Hemoderivate drugs; Immune system; Immunoglobulins; Immunoglobulins, intravenous/ pharmacokinetics; Immunoglobulins, intravenous/therapeutic use; Plasma.

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Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interest

Figures

Figure 1
Figure 1
Fc receptor blockade of phagocytes by Ig in a patient with immune thrombocytopenic purpura (presence of anti-platelet antibodies).
Figure 2
Figure 2
Multiple actions of Ig: formation of idiotype-anti-idiotype dimers, blocking the binding of superantigens to T cells, inhibition of dendritic cells, stimulation of Regulatory T cells (Tregs)
See this image and copyright information in PMC

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