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Intravenous IgG (IVIG) appears to have a place in management of severe asthma High dose IVIG prevents immune damage by scavenging complement fragments C3b and C4b, and now in vitro studies using mast cells have shown that intracellular calcium flux caused by C3a and C5a anaphylotoxins can also be inhibited by IVIG. Thromboxane generation and histamine release from mast cells and basophils can likewise be suppressed. Other studies have shown that IVIG can decrease serum IgE levels and increase glucocorticoid binding affinity. In clinical studies, IVIG use in severe, steroid-dependent asthma can reduce steroid requirement and number of hospitalisations, although lung function tests may remain relatively unchanged. Read more: Intern Med J 2003;33:341-4 Nat Med 2003;9:431-8 Chest 2003;123:1254-65 Allergy Asthma Proc 2001;22:11-15 Allergy 1999;54:662-8 |