IVIG Reduces Persistent Immune Activation.

[Remy]

This article seems very applicable to MECFS as well as to CVID (a serious form of immune deficiency where the B cells needed to fight infections are absent or markedly reduced). But the benefits of IVIG seem to go beyond just mere replacement of missing antibodies and extend into immune modulating territory as well. This would likely have benefits for MECFS as well even though the results of trials have been mixed thus far.

With the advent of subQ IgG replacement (Hizentra), it would seem that IVIG should be in reach for a lot more patients in our cohort. I think getting IgG levels (both total and subclasses) is a very important laboratory test that seems to be mostly overlooked in our population.

In the case of CVID, IVIg has mainly been seen as reconstitution therapy, providing patients with pathogen-specific antibodies. Recent evidence shows that IVIg has diverse effects on the immune system of CVID patients, and one important component is that IVIg alleviates the state of chronic immune activation. In this review, we will discuss causes and consequences of persistent immune activation in CVID, possible underlying mechanisms for how IVIg treatment reduces immune activation, and implications for our understanding of primary as well as acquired immune deficiencies.

 

[Cort]

This article seems very applicable to MECFS as well as to CVID (a serious form of immune deficiency where the B cells needed to fight infections are absent or markedly reduced). But the benefits of IVIG seem to go beyond just mere replacement of missing antibodies and extend into immune modulating territory as well. This would likely have benefits for MECFS as well even though the results of trials have been mixed thus far.

With the advent of subQ IgG replacement (Hizentra), it would seem that IVIG should be in reach for a lot more patients in our cohort. I think getting IgG levels (both total and subclasses) is a very important laboratory test that seems to be mostly overlooked in our population.

I think they just need to subset their patients properly and they'll get excellent results. There may be several immune subsets - one with immune exhaustion - and one with auto-inflammatory processes in ME/CFS. In the first one you want an immune booster such as IVIG and in the second one you want to put the brakes on the immune system.

IVIG is the treatment of choice apparently for small fiber neuropathy which appears to occur in at least 40% of the FM population. When some doctors look at the SFN in FM found apparently all over the body the first thing they think is the immune system.....

 

[Who Me?]

And this is why I did not have the dumb ass immunologist, who wanted me to have a psych consult to make sure my symptoms were idiopathic, before he would treat me, and wanted me would have been clueless in how to use this for my benefit and not make me hugely ill.

I've also seen IVIG used for CMV. I though I had a link. I'll look for it again later.

 

[IrisRV]

I think getting IgG levels (both total and subclasses) is a very important laboratory test that seems to be mostly overlooked in our population.

I agree. Many of us have not been tested. Among those who have, however, there seems to be an unusually high number who have some kind of Ig abnormality. My IgM is very low while my IgG and a subclass or two (I forget which) started out in the low normal range but dropped steadily over several years. We wouldn't have known about the decline if we hadn't tested a couple of times a year. Finally my IgG dropped low enough that I was put on IVIG last summer.

I think they just need to subset their patients properly and they'll get excellent results. There may be several immune subsets - one with immune exhaustion - and one with auto-inflammatory processes in ME/CFS

I'm thinking the same way, that there are multiple immune subsets. The immune system is so complex that I'm not so sure that it's going to be as simple as immune exhaustion or auto-inflammatory. However it works out, we need those subsets because treatment strategies could be very different for different subsets. We need a lot more research on the immune aspect of this illness. Surprise, surprise.

Can anyone give me the Idiot's Guide to Immunology version of the differences and similarities between autoimmune and auto-inflammatory?

 

[weyland]

Can anyone give me the Idiot's Guide to Immunology version of the differences and similarities between autoimmune and auto-inflammatory?

I may be way off, but the way I understand it is autoimmune = adaptive immune response to self, i.e. antibodies formed against self proteins. Autoinflammatory = innate immune response to self, incorrect attack on tissue by innate immune factors. It looks like most diseases described as autoinflammatory are mostly genetic in origin and involve defects in the genes controlling the innate immune response. I think autoinflammatory is a term that is misused often.

 

[Strike me lucky]

Hook me up. The anti inflammatory effects would be good.

Is there any carry over effects to improving t cell numbers and or function? Maybe immune exhaustion?? My immunoglobulin testing and sub classes have always been normal.