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Am J Hematol. 2015 May;90(5):381-5. doi: 10.1002/ajh.23956. Epub 2015 Apr 1.

Single-dose intravenous gammaglobulin can stabilize neutrophil Mac-1 activation in sickle cell pain crisis.

Author information

1
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York.
2
Department of Cell Biology, Albert Einstein College of Medicine, Bronx, New York
3
Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, New York
4
Department of Anesthesiology, Mount Sinai School of Medicine, New York, New York
5
Department of Medicine, Mount Sinai School of Medicine, New York, New York
6
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
7
Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
8
Ruth L. and David S. Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York
9
New York Blood Center, New York, New York

Abstract

Intravenous immunoglobulin (IVIG) decreases neutrophil adhesion to endothelium and red blood cell-neutrophil interactions in sickle cell mice undergoing vaso-occlusion. In this Phase I clinical trial of sickle cell anemia (SCA) patients admitted with pain crisis, we evaluated the status of adhesion molecules on neutrophils in control and IVIG-treated subjects pre- and post-infusion up to 800 mg/kg, the same dose used in murine studies. Mac-1 function significantly decreased from baseline in the low-dose IVIG (200-400 mg/kg) cohorts. IVIG-related adverse events may have occurred in the high-dose (600-800 mg/kg) cohorts. There were no significant increases in neutrophil and leukocyte counts, suggesting that IVIG may more selectively inhibit Mac-1 function as opposed to neutrophil adhesion. This study provides the first in-human validation of pre-clinical murine studies that IVIG can decrease Mac-1 function.

PMID:
25616042
PMCID:
PMC4409477
DOI:
10.1002/ajh.23956
[Indexed for MEDLINE]
Free PMC Article

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