Intravenous immunoglobulin ameliorates ITP via activating Fc gamma receptors on dendritic cells.

Abstract:

:Despite a more than 20-year experience of therapeutic benefit, the relevant molecular and cellular targets of intravenous immunoglobulin (IVIg) in autoimmune disease remain unclear. Contrary to the prevailing theories of IVIg action in autoimmunity, we show that IVIg drives signaling through activating Fc gamma receptors (Fc gammaR) in the amelioration of mouse immune thrombocytopenic purpura (ITP). The actual administration of IVIg was unnecessary because as few as 10(5) IVIg-treated cells could, upon adoptive transfer, ameliorate ITP. IVIg did not interact with the inhibitory Fc gammaRIIB on the initiator cell, although Fc gammaRIIB does have a role in the late phase of IVIg action. Notably, only IVIg-treated CD11c+ dendritic cells could mediate these effects. We hypothesize that IVIg forms soluble immune complexes in vivo that prime dendritic-cell regulatory activity. In conclusion, the clinical effects of IVIg in ameliorating ITP seem to involve the acute interaction of IVIg with activating Fc gammaR on dendritic cells.

journal_name

Nat Med

journal_title

Nature medicine

authors

Siragam V,Crow AR,Brinc D,Song S,Freedman J,Lazarus AH

doi

10.1038/nm1416

subject

Has Abstract

pub_date

2006-06-01 00:00:00

pages

688-92

issue

6

eissn

1078-8956

issn

1546-170X

pii

nm1416

journal_volume

12

pub_type

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