Updates in the Understanding of Immunoglobulin Replacement Therapy in Primary Immune Deficiency Disorders : Function, Composition, and Role in Reconstitution and Immunomodulation - 12/03/25

Doi : 10.1016/j.iac.2025.01.007

Talal Mousallem, MD ^a, Geoffrey Hall, DO ^a, Alice Pan, CPP ^b, Eveline Y. Wu, MD, MSCR ^c,^d,^⁎
^a Division of Allergy/Immunology, Department of Pediatrics, Duke University Medical Center, 133 MSRB, Box 2644, Durham, NC 27710, USA
^b Department of Pharmacy, UNC Health, 030 MacNider Hall, CB #7231, Chapel Hill, NC 27599, USA
^c Division of Pediatric Rheumatology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
^d Division of Pediatic Allergy/Immunology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

^∗Corresponding author. 030 MacNider Hall, CB #7231, Chapel Hill, NC 27599.030 MacNider Hall, CB #7231Chapel HillNC27599

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 12 March 2025

Résumé

Clinical indications for immunoglobulin therapy can be broadly classified into replacement therapy for immunodeficiencies, immunomodulatory treatment of inflammatory conditions, and hyperimmune therapy against specific infectious agents. When starting immunoglobulin therapy, there are important considerations for the clinician including indication and function, composition, dosing, route, and safety. Immunoglobulin therapy should be tailored to an individual patient. This review discusses our current understanding and practical considerations for using immunoglobulin therapy for both humoral immune reconstitution and immunomodulation.

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Keywords : Immunoglobulin replacement therapy, Intravenous immunoglobulin, Primary immunodeficiencies, Subcutaneous immunoglobulin, Immunomodulation