INTRAVENOUS IMMUNE SERUM GLOBULIN FOR HYPOGAMMAGLOBULINEMIA: A COMPARISON OF OPSONIZING CAPACITY IN RECIPIENT SERA

Abstract

Twelve severely hypogammaglobulinemic patients received infusions of alkylated immune globulin and two other non-alkylated products. Administration was separated by an interval of 3 weeks. Serum was obtained prior to and at 24 hours and 3 weeks after each infusion for measurement of total IgG, specific and opsonizing antibodies. The latter was accomplished against S. pneumoniae types 5, 12F and 14 and zymosan using chemiluminescence methodology.

Changes in total IgG concentrations were comparable for the three products. Prior to enrollment, IgG levels averaged 115±72 mg/dl, increasing to 779±399 at 24 hours postinfusion, and were 337±200 after 3 weeks. No differences among the products was seen in their ability to produce antibodies against Herpes simplex virus types 1 and 2, rubella, toxoplasma, cytomegalovirus or tetanus. However, differences in opsonizing antibody were observed between alkylated and native IgG preparations. Peak chemiluminescence responses of neutrophils following opsonization of S. pneumoniae with native immune globulin were significantly higher than with alkylated IgG, indicating greater functional capacity. These studies suggest that native immune serum globulin provides a greater potential for augmenting host defense mechanisms against pneumococcal infection in hypogammaglobulinemic patients.

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