IMMUNOGLOBULINS

• Are Y-shaped proteins of the immune system found in the human

blood plasma.
• 5 types;
• IgG
• IgA
• IgM
• IgE
• IgD
Normal Human Immunoglobulins -NHIgs
• Pharmaceutical formulations
containing pooled human
immunoglobulins derived from
the plasma of healthy donors.
• Also known as immunoglobulin
preparations or immunoglobulin
products.
• Usually IgG, (95-99%) but also
small amounts of other isotypes
like IgA and IgM.
 Types of NHIgs
• Intravenous Immunoglobulin (IVIG): Via
infusion into a vein over a period of several
hours. Requires access to a vein and
infusion equipment.
• Subcutaneous Immunoglobulin (SCIG):
injection into the fatty tissue beneath the
skin using a small needle or infusion pump.
Can be self-administered by patients.
Types of NHIgs …
• Hyperimmune Immunoglobulins: contain high levels of specific
antibodies against particular pathogens. Used for passive
immunization and prophylaxis against specific infectious diseases e.g
hepatitis B, rabies.

• Specific Immunoglobulin Preparations: specific to particular antigens

or toxins. Eg anti-D immunoglobulin and varicella-zoster
immunoglobulin (VZIG) used for post-exposure prophylaxis of VZV.
Modes of action
• Immunomodulation -Neutralization of pathogens,
inhibition of complement activation, blockade of Fc
receptors.

• Replacement therapy - In patients with primary and

secondary immunodeficiency disorders.

• Anti-inflammatory Effects - Inhibit the activation of

immune cells, such as T cells and macrophages, and
downregulate the production of pro-inflammatory
cytokines.

• Immune tolerance induction- In certain autoimmune

diseases
Uses of NHIgs
• Immune deficiencies eg. X-linked
agammaglobulinemia

• Autoimmune disease eg.

Guillain-Barré syndrome,
Idiopathic Thrombocytopenic
Purpura (ITP)

• Acute infections eg. VZV,

Hepatitis
WHO standards for preparation of NHIgs

• Should consist of 90% intact IgG.

• All IgG subclasses should be
present.
• Should have low concentration
of IgA.