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Anti-idiotypic suppression of autoantibodies to factor VIII (antihaemophilic factor) by high-dose intravenous gammaglobulin

Sultan, Y.; Kazatchkine, M.D.; Maisonneuve, P.; Nydegger, U.E.

Lancet 2(8406): 765-768

1984

ISSN/ISBN: 0140-6736
PMID: 6148519
Document Number: 224913
In 2 patients with high-titer autoantibodies to antihemophilic factor (VIIc), treatment with high-dose i.v. Ig (IVIg) resulted in rapid and prolonged, although not total, suppression of antibody. IVIg also inhibited anti-VIIIc activity in patients' plasma in vitro; IVIg and F(ab')2 fragments from IVIg inhibited anti-VIIc activity of the IgG fraction and of the Fab'2 fragments of the IgG fraction from patients' plasma, indicating that the in-vivo effect of IVIg was due to the presence in the therapeutic Ig of anti-idiotypic antibodies against idiotypes expressed by anti-VIIIc autoantibodies. IVIg had little or no effect on antibody titer in 2 hemophilic patients with anti-VIIIc alloantibodies. IVIg contains anti-idiotypes against autoantibodies and may be effective in the treatment of some autoimmune diseases through idiotypic/anti-idiotypic interactions.

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