In:
European Journal of Immunology, Wiley, Vol. 52, No. 4 ( 2022-04), p. 609-617
Abstract:
Clinical efficacy of intravenous immunoglobulin treatment (IVIg) is related to its pharmacokinetic (PK) profile. Its usual evaluation, by measuring serum total IgG levels, is imprecise, because IVIg cannot be distinguished from endogenous IgG. We developed ELISAs to specifically monitor the PK of IVIg using the polymorphic determinants G1m(a), G1m(x), and G1m(f). The specificity of the IgG1 allotype assays was sufficient to determine IVIg concentrations as low as 0.1 mg/mL in sera from individuals not expressing the respective markers. IVIg was quantified in posttreatment serum from patients with Guillain–Barré syndrome (GBS) by measuring IgG1 allotypes not expressed endogenously. After serotyping, 27/28 GBS patients were found eligible for IVIg monitoring using one or two genetic markers. In 17 cases, IVIg levels could be determined by both anti‐G1m(a) and anti‐G1m(x) measurement, showing significant correlation. Longitudinal monitoring of IVIg PK in seven GBS patients showed potential differences in clearance of total IgG versus IVIg‐derived IgG, highlighting that total IgG measurements may not accurately reflect IVIg PK. To summarize, anti‐IgG1 allotype assays can discriminate between endogenous IgG and therapeutic polyclonal IgG. These assays will be an important tool to better understand the variability in IVIg PK and treatment response of all patients treated with IVIg.
Type of Medium:
Online Resource
ISSN:
0014-2980
,
1521-4141
DOI:
10.1002/eji.202149653
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
1491907-2