Abstract
This introductory chapter describes how the training of young investigators by experienced mentors can lead to translation of chance observations within practical clinical science. Substitutive administration of a new concentrate of a human immunoglobulin (IgG) preparation resulted in regular minimal platelet increases in a child with a primary immunodeficiency and low platelet counts despite normal platelet production. The investigators concluded that this phenomenon might also be possible in children with immune thrombocytopenia (ITP). This translation became a reality, first by a pilot study comparing children with ITP versus aplastic anemia with disturbed platelet production, followed by a confirmatory study, where children with newly diagnosed or chronic ITP consecutively showed dramatic platelet increase by IgG administration, and, later, by a controlled randomized cooperative study in children with ITP. Since the pathophysiology of ITP is similar to many other autoimmune or chronic inflammatory disorders, the new therapeutic phenomenon evoked worldwide clinical and laboratory research. The story is presented with citations of the first publication.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
References
Abe T, Matsuda J, Kawasugi K, Yoshimura Y, Kinoshita T, Kazama M. Clinical effect of intravenous immunoglobulin on chronic idiopathic thrombocytopenic purpura. Blut. 1983;47(2):69–75.
Blanchette V, Imbach P, Andrew M, Adams M, McMillan J, Wang E, Milner R, Ali K, Barnard D, Bernstein M, Chan KW, Esseltine D, de Veber B, Israels S, Kobrinsky N, Luke B. Randomised trial of intravenous immunoglobulin G, intravenous anti-D, and oral prednisone in childhood acute immune thrombocytopenic purpura. Lancet. 1994;344:703–7.
Bussel JB, Hilgartner MW. The use and mechanism of action of intravenous immunoglobulin in the treatment of immune haematologic disease. Br J Haematol. 1984;56(1):1–7.
Fehr J, Hofmann V, Kappeler U. Transient reversal of thrombocytopenia in idiopathic thrombocytopenic purpura by high-dose intravenous gamma globulin. N Engl J Med. 1982;306:1254–8.
Imbach P, Barandun S, Baumgartner C, Hirt A, Hofer F, Wagner HP. High-dose intravenous gammaglobulin therapy of refractory, in particular idiopathic thrombocytopenia in childhood. Helv Paediatr Acta. 1981a;46:81–6.
Imbach P, Barandun S, d’Apuzzo V, Baumgartner C, Hirt A, Morell A, Rossi E, Schoeni M, Vest M, Wagner HP. High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet. 1981b;317:1228–31.
Imbach P, Wagner HP, Berchtold W, Gaedicke G, Hirt A, Joller P, Mueller-Eckhardt C, Müller B, Rossi E, Barandun S. Intravenous immunoglobulin versus oral corticosteroids in acute immune thrombocytopenic purpura in childhood. Lancet. 1985;2(8453):464–8.
Imbach P, Tani P, Berchtold W, Blanchette V, Burek-Kozlowska A, Gerber H, Jacobs P, NewIand A, Turner C, McMillan R. Different forms of chronic childhood immune thrombocytopenic purpura defined by antiplatelet autoantibodies. J Pediatr. 1991;118:535–9.
Newland AC, Treleaven JG, Minchinton RM, Waters AH. High-dose intravenous IgG in adults with autoimmune thrombocytopenia. Lancet. 1983;1(8316):84–7.
Further Reading
Imbach P, Lazarus AH, Kühne T. Intravenous immunoglobulins induce potentially synergistic immunomodulations in autoimmune disorders. Vox Sang. 2010;98(3 Pt 2):385–94. Review.
Imbach P, Crowther M. Thrombopoietin-Receptor Agonists for Primary Immune Thrombocytopenia. N Engl J Med. 2011;365:734–41.
Imbach P, Kabus K, Toenz O. Successful treatment of a severe drowning accident after 20 minutes submersion. Schweiz Med Wochenschr. 1975;105(48):1605–11.
Imbach P, Odavic R, Bleher EA, Bucher U, Deubelbeiss KA, Wagner HP. Autologous bone marrow reimplantation in children with advanced tumor. First experiences of feasibility. Schweiz Med Wochenschr. 1979;109(8):283–7.
Imbach P, Kuehne T, Arceci RJ. Pediatric Oncology: A Comprehensive Guide, Third Edition, Springer 2014.
Acknowledgment
The author thanks Adrian C. Newland, London, UK, for his corrections and suggestions of the chapter text.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Imbach, P. (2018). The Clinical Translation of Intravenous Immunoglobulin from Substitution to Immunomodulation. In: Imbach, P. (eds) Antibody Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-68038-5_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-68038-5_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-68037-8
Online ISBN: 978-3-319-68038-5
eBook Packages: MedicineMedicine (R0)