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RESEARCH PRODUCT

The influence of high dose intravenous immunoglobulins on immunological and metabolic pattern in newly diagnosed type I diabetic patients

Maria Pia AmatoFelicia PantCarla GiordanoAlberto PuglieseGiuseppa D'acquisitoM. DonatelliAldo Galluzzo

subject

AdultMalemedicine.medical_specialtyAdolescentmedicine.medical_treatmentPhagocytosisImmunologyCellAutoimmune DiseasesRandom AllocationAntigenInternal medicinemedicineHumansInsulinImmunology and AllergyChildAutoantibodiesGlycemicAutoimmune diseaseC-Peptidebiologybusiness.industryInsulinImmunization PassiveReceptors Interleukin-2medicine.diseaseDiabetes Mellitus Type 1medicine.anatomical_structureEndocrinologyIntravenous ImmunoglobulinsChild Preschoolbiology.proteinFemaleAntibodybusiness

description

In autoimmune disease the functional deficiency of T suppressor cells, also described in Type I diabetes, may be restored through immunoglobulin (Ig) infusion, which increases antigen phagocytosis, NK activity, cell clones and antibody anti-idiotype responses. Sixteen Type I diabetic patients were studied: eight were treated soon after the initial correction of disease-onset glycemic deterioration with intensive intravenous (i.v.) 7S Ig treatment (0.4 g/kg/BW) for 1 week and once per week for 6 months, whilst the remaining patients constituted the control group. All patients were evaluated during the study for metabolic and immunological parameters. A reduction in insulin requirement compared to conventionally treated patients was observed at the third (0.17 +/- 0.06 vs 0.44 +/- 0.08 IU/kg/BW; P less than 0.02) and at the sixth month of therapy (0.19 +/- 0.07 vs 0.54 +/- 0.07 IU/kg/BW; P less than 0.005). Two patients ceased to require insulin therapy within the BW; P less than 0.005). Two patients ceased to require insulin therapy within the first month, showing a prolonged restoration of B-cell function. Serum C-peptide values were also significantly higher in the Ig-treated group compared to the control group after 3 and 6 months. As regards immunological parameters, patients showed a decrease in insulin antibody levels and a reduction in TAC+ cells. Intravenous Ig therapy seems able to affect positively the first phases of metabolic and immunological deterioration of Type I diabetes.

https://doi.org/10.1016/s0896-8411(05)80025-3