Abstract • 20

Immunoglobulin (IG) is used in immunodeficiency, immunoregulatory disorders, and prevention of certain infections. Although usually given systemically by the intravenous or intramuscular route, other routes have been used, including subcutaneous, intranasal, aerosolized to the lung, intrathecal and intraarticular. Slow subcutaneous infusions of immunoglobulin are widely used in Europe in the treatment of immunodeficient subjects with less side effects and better patient acceptance than IVIG infusions. Oral IG has been used for rotavirus, necrotizing enterocolitis cryptosporidia and other GI infections.

Intranasal IG may prevent respiratory infections. Animal studies suggest that aerosolised IG may be of benefit in certain types of pneumonia. Monoclonal antibodies, usually mouse-human hybrid antibodies, are rapidly being introduced into clinical medicine. These include anti-infective (Anti-RSV), anti-cytokine (anti-TNF), immunosuppressive (anti IL-2R), anti-tumor (Herceptin for Breast Cancer) and anti-allergic (anti-IgE) monoclonal antibodies. An overview of these approaches will be discussed.