Therapeutic Approach

The first thought is remove the complexes! This will have transient therapeutic efficacy only because the underlying causes of formation of immune complexes continue their activity. Knowing the triggering antigen means targeting therapy to the root. If the antigen is an infectious agent, then anti-infectious therapy is the center core of any approach, even if the disease is already complicated by vasculitis, arthritis, proteinuria or peripheral blood cytopenia. In patients with high levels of CIC, sometimes revealing cryoglobulins, plasma exchange therapy as a palliative measure is indicated but this must be integrated into an overall therapeutic concept that avoids re-formation of CIC. Now knowing the involved antigen in CIC the therapeutic schemes are inspired from treatment strategies used in autoimmune diseases: corticosteroids, aspirin derivatives (azulfidine), mild immunosuppressants (chloroquine, methotrexate), cytostatics (azathioprin) and monoclonal antibodies.

The second thought is make complexes innocuous! Treatment with endoglycosidases (EndoS) secreted by streptococci remove the capacities of IC to bind to FcR and complement thus mitigating pathogenic power (www.genovis.com). Such treatment is currently under study for its suitability to clinical application in human diseases.

Download IVIG_Indications.pdf, please!

Animation (new window)

Immune Complexes shown here flowing in a vessel from top to bottom. Three different approaches are shown:
inhibit the inflammatory potential of the complexes by reducing the antibody portion, by reducing complement activation or by deliberately removing them using plasma exchange (PEX).

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