[PAGID] IVIG and endogenous antibody production

[Howard Lederman]

There are two types of relevant articles:

1.  There is data from Mathu Santosham (studies of hyperimmune globulin given to Apache Indian babies to decrease the risk of pneuomococcal and H influenzae b sepsis and meningitis) that clearly show that gamma globulin interferes with the immunogenicity of live viral vaccines (e.g., MMR and varicella).  That is probably a special case as only a small amount of neutralizing Ab can block replication of vaccine virus and therefore interfere with antigenicity.

2.  There are also old studies comparing IVIG to placebo in premature infants as a way to prevent neonatal sepsis.  Some of those studies looked at subsequent responses to vaccines in the first 6 months of life  (all killed vaccines) and found no deleterious effect of the IVIG.  I don't remember a specific author, but can try to find the articles when I am in my office tomorrow.

Howard
________________________________________
From: pagid-bounces at list.clinimmsoc.org [pagid-bounces at list.clinimmsoc.org] On Behalf Of raas0027 at umn.edu [raas0027 at umn.edu]
Sent: Tuesday, April 27, 2010 5:18 PM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] IVIG and endogenous antibody production

Hello everyone,

I am struggling to find data or literature (e.g. through OVID, PubMed)
supporting the following statements that I find repeatedly in
textbooks/journal review articles:


1. administration of passive antibodies [e.g. IVIG] to antigens that a
patient has not previously encountered can suppress his or her endogenous
capacity to produce antibodies


or in numerous patient-oriented websites:


2. '...If your child is receiving IVIG, there is a risk that it may
interfere with the effectiveness of certain vaccines, even causing the
vaccine to fail.'


Although these seem plausible, are any of you aware of published studies
that demonstrate this with IVIG? I would love to read them.

I would also be interested in anecdotal comments.


Thanks,

Jason

--
Jason Raasch, MD

Midwest Immunology Clinic
15700 37th Ave N
Suite 110
Plymouth, MN 55446

(Phone) 763.577.0008
(FAX)   763.5770192