ABSTRACT
Intravenous immunoglobulin (IVIG) treatment now has an established role in the therapy of immunologically mediated demyelinating disorders including Guillain-Barré syndrome (GBS) and its subtypes, chronic inflammatory demyelinating polyneuritis (CIDP) and multi-focal motor neuropathy (for review see references 1 and 2). Both humoral and cell-mediated immune mechanisms are operative in these syndromes. Antibodies to different gangliosides were found in 30-40% of GBS patients. Immunoglobulin G (IgG) antibodies can access the peripheral nerve at its most proximal and distal parts, where the blood-nerve barrier is lacking. In addition, IgG antibodies may also interfere with neuromuscular transmission, as shown for sera from adult patients with GBS of the acute inflammatory demyelinating type3. There is overwhelming evidence that IVIG can manipulate the immune system at several levels, which may contribute to its therapeutic efficacy in GBS and its subtypes.
