Use of Intravenous Immunoglobulin in Clinical Dermatology PDF
Preview Use of Intravenous Immunoglobulin in Clinical Dermatology
Intravenous Imunoglobulin in Dermatology Intravenous Immunoglobulin in Dermatotogy Edited by STEPHEN JOLLES MSc PhD MRCP MRCPath LRF FELLOW & HONORARY CONSULTANT IN IMMUNOLOGY & ALLERGY NATIONAL INSTITUTE OF MEDICAL RESEARCH AND ROYAL HOSPITAL LONDON UK LONDON AND NEW YORK © 2003 Martin Dunitz, an imprint of the Taylor & Francis Group First published in the United Kingdom in 2003 by Martin Dunitz, an imprint of the Taylor & Francis Group, 11 New Fetter Lane, London EC4P 4EE Tel.: +44 (0) 20 7583 9855 Fax.: +44 (0) 20 7842 2298 E-mail: [email protected] Website: http://www.dunitz.co.uk This edition published in the Taylor & Francis e-Library, 2005. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. A CIP record for this book is available from the British Library. ISBN 0-203-62705-9 Master e-book ISBN ISBN 0-203-63089-0 (Adobe eReader Format) ISBN 1 84184 136 6 (Print Edition) Distributed in the USA by Fulfilment Center Taylor & Francis 10650 Tobben Drive Independence, KY 41051, USA Toll Free Tel.: +1 800 634 7064 E-mail: [email protected] Distributed in Canada by Taylor & Francis 74 Rolark Drive Scarborough, Ontario M1R 4G2, Canada Toll Free Tel.: +1 877 226 2237 E-mail: [email protected] Distributed in the rest of the world by Thomson Publishing Services iv Cheriton House North Way Andover, Hampshire SP10 5BE, UK TeL: +44 (0)1264 332424 E-mail: [email protected] Composition by Wearset Ltd, Boldon, Tyne and Wear Contents Contributors vi Preface viii 1 Intravenous immunoglobulins— mechanisms of action 1 Hans-Peter HartungBernd C Kieseier 2 The role of high-dose intravenous immunoglobulin in 19 dermatomyositis Marinos C Dalakas 3 Chronic urticaria 29 Brigid F O’Donnell 4 Atopic dermatitis—role of hdIVIg 47 Samantha EismanMalcolm HA Rustin 5 Kawasaki disease 56 Andrew J CantLaura Jones 6 Toxic epidermal necrolysis 71 Nicholas M Craven 7 Intravenous immunoglobulin in the treatment of 85 scleromyxoedema, scleroderma, pyoderma gangrenosum and pretibial myxoedema Stephen Jolles 8 IVIg therapy in autoimmune mucocutaneous blistering diseases 98 A Razzaque AhmedNaveed Sami 9 Safety and tolerability of intravenous immunoglobulins 119 Turf D Martin Index 134 Contributors A Razzaque Ahmed MD Department of Oral Medicine Harvard School of Dental Medicine Boston, MA USA Andrew J Cant Paediatric Immunology & Infectious Diseases Unit Newcastle General Hospital Westgate Road Newcastle upon Tyne UK Nicholas M Craven Honorary Consultant Dermatologist Dermatology Centre Hope Hospital Salford Manchester UK Marinos C Dalakas MD National Institutes of Neurological Disorders and Stroke National Institutes of Health Bethesda, MD USA Samantha Eisman MBChB MRCP Specialist Registrar in Dermatology Royal Free Hospital London UK Hans-Peter Hartung MD Department of Neurology Heinrich-Heine-University vii Düsseldorf Germany Laura Jones Clinical Research Fellow Child Health Sir James Spence Institute Royal Victoria Infirmary, Newcastle upon Tyne UK Stephen Jolles PhD MRCP MRCPath LRF Fellow & Honorary Consultant in Immunology & Allergy National Institute of Medical Research and Royal Free Hospital London UK Bernd C Kieseier MD Department of Neurology Heinrich-Heine-University Düsseldorf Germany Turf D Martin Genesis Medical Marketing Consultants, LLC Sedalia, Missouri USA Brigid F O’Donnell MD MRCPI DCH Consultant Dermatologist The Children’s University Hospital Temple Street, Dublin Ireland Malcolm HA Rustin MBChB FRCP Consultant Dermatologist Royal Free Hospital London UK Naveed Sami MD Department of Oral Medicine Harvard School of Dental Medicine Boston, MA USA Preface The major clinical specialties using intravenous immunoglobulin (IVIg) have been immunology, neurology and haematology. More recently, however, there has been an increase in the dermatological use of high dose IVIg (hdIVIg). This book is broadly based on a symposium held at the Dermatology 2000 meeting in Vienna, Austria and aims to provide a critical summary of the current data concerning the use of hdIVIg in the major dermatological conditions to which it has been applied. HdIVIg is already an established treatment in some of these conditions such as Kawasaki disease and therapy resistant dermatomyositis, however the data in many others is derived from small studies and case reports. There are very few double-blind randomized studies of the use of hdIVIg in dermatological disorders and it is becoming clear that a number of the conditions described in this book have accrued sufficient evidence of benefit in smaller studies to warrant similarly designed studies. These studies will need to address a number of questions not only of efficacy but also which other agents should be chosen when hdIVIg is used adjunctively, what is the mechanism of action and how long should it be continued. Studies using IVIg in the treatment of inflammatory or autoimmune disease have led to a better understanding of the pathogenic mechanisms underlying these disorders and hence new potential treatment modalities. The future may see genetically engineered components of IVIg such as Fc or monoclonal antibodies used for specific indications. It is hoped that readers find the book helpful in distilling the current evidence for the use of hdIVIg in dermatological conditions as well as understanding its mechanism(s) of action in these diseases. Stephen Jolles 1 Intravenous immunoglobulins— mechanisms of action Hans-Peter Hartung and Bernd C Kieseier ADCC: antibody-dependent cellular cytotoxicity; IFN: interferon; LFA: lymphocyte function-associated antigen; MAC: membrane attack complex; MHC: major histocompatibility complex Intravenous immunoglobulins (IVIg) were initially used as a replacement therapy in patients with hypogammaglobulinaemia. Fortuitously, in 1981 Imbach and colleagues1 discovered that these preparations exhibited beneficial therapeutic effects in idiopathic thrombocytopenic purpura. Since this observation, IVIg has been tested at least experimentally in numerous disorders of presumed autoimmune genesis. Although the complete spectrum of mechanisms of action of IVIg is not yet completely understood, experimental and clinical studies have elucidated a number of mechanisms by which IVIg may modify disease. The following chapter aims to provide insight into the present status of knowledge on mechanisms of action of IVIg, based on immunological concepts relevant in the pathogenesis of immune-mediated disorders. Immunoglobulins in the immune system The immune system is an organization of cells and molecules with specialized tasks in defending the organism from external agents, usually infectious but also toxic. Moreover, the immune system plays a pivotal role in maintaining antigenic homeostasis in the body. Based on the formation of immunological memory, the immune system has traditionally been divided into innate and adaptive systems, each of which contains different cellular and molecular components and thus performs different functions. The main distinction between these two systems lies in the mechanisms and receptors used for immune recognition.2,3 The adaptive immune system is based on two classes of highly specialized cells, T and B lymphocytes. Each of these cells expresses a single kind of structurally unique receptor, resulting in a broad and extremely diverse repertoire of antigen recognition.
The list of books you might like
