PMID- 26142065
OWN - NLM
STAT- MEDLINE
DCOM- 20170206
LR  - 20220316
IS  - 1559-0267 (Electronic)
IS  - 1080-0549 (Linking)
VI  - 51
IP  - 3
DP  - 2016 Dec
TI  - Impact of Immunoglobulin Therapy in Pediatric Disease: a Review of Immune 
      Mechanisms.
PG  - 303-314
AB  - Intravenous immunoglobulin (IVIG) provides replacement therapy in 
      immunodeficiency and immunomodulatory therapy in inflammatory and autoimmune 
      diseases. This paper describes the immune mechanisms underlying six major 
      non-primary immunodeficiency pediatric diseases and the diverse immunomodulatory 
      functions of IVIG therapy. In Kawasaki disease, IVIG plays a major, proven, and 
      effective role in decreasing aneurysm formation, which represents an aberrant 
      inflammatory response to an infectious trigger in a genetically predisposed 
      individual. In immune thrombocytopenia, IVIG targets the underlying increased 
      platelet destruction and decreased platelet production. Although theoretically 
      promising, IVIG shows no clear clinical benefit in the prophylaxis and treatment 
      of neonatal sepsis. Limitations in research design combined with the unique 
      neonatal immunologic environment offer explanations for this finding. 
      Inflammation from aberrant immune activation underlies the myelinotoxic effects 
      of Guillain-Barre syndrome. HIV-1 exerts a broad range of immunologic effects and 
      was found to decrease serious bacterial infections in the pre-highly active 
      anti-retroviral therapy (HAART) era, although its practical relevance in the 
      post-HAART era has waned. Clinical and experimental data support the role of 
      immune mechanisms in the pathogenesis of childhood epilepsy. IVIG exerts 
      anti-epileptic effects through targeting upregulated cytokine pathways and 
      antibodies thought to contribute to epilepsy. Applications in six additional 
      pediatric diseases including pediatric asthma, atopic dermatitis, cystic 
      fibrosis, pediatric autoimmune neuropsychiatric disorders associated with 
      streptococcal infection (PANDAS), autism, and transplantation will also be 
      briefly reviewed. From autoimmunity to immunodeficiency, a dynamic immunologic 
      basis underlies major pediatric diseases and highlights the broad potential of 
      IVIG therapy.
FAU - Wong, Priscilla H
AU  - Wong PH
AD  - Department of Allergy-Immunology, Wilford Hall Ambulatory Surgical Center, San 
      Antonio, TX, USA. priscilla.wong@us.af.mil.
AD  - , 2200 Bergquist Drive, Suite 1, Lackland AFB, TX, 78236, USA. 
      priscilla.wong@us.af.mil.
FAU - White, Kevin M
AU  - White KM
AD  - Department of Allergy-Immunology, Wilford Hall Ambulatory Surgical Center, San 
      Antonio, TX, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Clin Rev Allergy Immunol
JT  - Clinical reviews in allergy & immunology
JID - 9504368
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Adaptive Immunity
MH  - Adolescent
MH  - Age Factors
MH  - Autoimmune Diseases/diagnosis/*drug therapy/*immunology/mortality
MH  - Child
MH  - Child, Preschool
MH  - Clinical Trials as Topic
MH  - Humans
MH  - Immunity, Innate
MH  - Immunoglobulins, Intravenous/administration & dosage/adverse effects/*therapeutic 
      use
MH  - Infant
MH  - Infant, Newborn
MH  - Inflammation/diagnosis/*drug therapy/*immunology/mortality
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Autoimmune
OT  - Immunomodulation
OT  - Inflammatory diseases
OT  - Intravenous immunoglobulin therapy
OT  - Pediatric diseases
EDAT- 2015/07/05 06:00
MHDA- 2017/02/07 06:00
CRDT- 2015/07/05 06:00
PHST- 2015/07/05 06:00 [pubmed]
PHST- 2017/02/07 06:00 [medline]
PHST- 2015/07/05 06:00 [entrez]
AID - 10.1007/s12016-015-8499-2 [pii]
AID - 10.1007/s12016-015-8499-2 [doi]
PST - ppublish
SO  - Clin Rev Allergy Immunol. 2016 Dec;51(3):303-314. doi: 10.1007/s12016-015-8499-2.