Résumé
Intravenous immunoglobulins (IVIg) are therapeutic preparations of normal human IgG obtained from pools of more than 1000 healthy blood donors and thus contain a wide range of IgG reactivities directed towards external antigens and self-antigens. IVIg bind to a diverse panel of self-antigens, mainly functional molecules of the immune system, comprising soluble molecules, as well as cell surface molecules including adhesion molecules, CD4 antigen, cytokines, MHC class I-derived peptides, Fas, CCR5, CD40 and cytoskeletal proteins. In addition, some of the autoantigens recognized by IVIg are also targets of autoantibodies in autoimmune diseases, including thyroperoxidase, myeloperoxidase, DNA and coagulaton factor VIII. Thus, neutralizing autoantibodies are detected in IVIg and could play a role in the therapeutic effects of IVIg preparations by modulating the idiotypic network.