Intravenous immunoglobulin (
IVIg) is used successfully for
therapy of inflammatory and
autoimmune diseases, especially in cases of conventional
therapy resistance. Within the broad spectrum of immunoregulatory activities of
IVIg in vitro and in vivo, the anti-idiotypic activity neutralizing the related idiotypes is one of the main mechanisms. Furthermore,
IVIg addresses
integrins associated with
inflammation and immune response
thrombosis, such as the RGD (
Arg-Gly-Asp) motif, expressed on a large number of cell surface and matrix
proteins. In addition, during the last years, anti-Fas activity of
IVIg was reported. We fractionated
IVIg specific preparation (sIVIg) based on the multispecificities of the
IVIg compound. We have generated an
IVIg fraction that will show specific activity for lupus idiotypes in vitro. In NZBxW.F1 mice, results showed 200 times more beneficial effect. Using a
peptide phage display library technology, we have identified a panel of lupus-related synthetic idiotypes that are mimetics of the idiotypes presented in patients with
systemic lupus erythematosus. A column composed of these synthetic lupus-related idiotypes was used to prepare a large amount lupus-specific
IVIg. Using the same approach, we prepared anti-anti-beta-2-glycoprotein-I (beta2GPI) specific
IVIg for
antiphospholipid syndrome (APS). This APS-specific
IVIg reduced the fetal loss induced by anti-beta2GPI
antibodies by improving the implantation process in a mouse model. Others prepared specific preparations of
IVIg to RGD or for Fas. The molecular targeting with specific
IVIg may be used for therapeutical purposes, using a smaller amount of
IVIg, and targeting more specifically
autoimmune diseases,
thrombosis, or inflammatory condition.