Intravenous immunoglobulin (IVIg) is a plasma-derived drug used to treat a wide range of conditions and demand for this expensive product keeps growing. In Canada, IVIg is provided to hospitals by Canadian Blood Services. The Centre for Innovation facilitates research into IVIg to understand the pathogenesis of immune conditions treated by IVIg [e.g. immune thrombocytopenia (ITP) and fetal and neonatal alloimmune thrombocytopenia (FNAIT)], explain the poorly understood mechanisms of action of IVIg, and develop IVIG alternatives.
Our scientists have published several paradigm-altering studies. A previously unknown mechanism of platelet destruction in ITP was uncovered that suggests new ways to diagnose and treat this bleeding disorder. In a mouse model of FNAIT, IVIg restored blood vessel formation, preventing intracranial hemorrhage and improving placenta function. In another study, researchers learned how hemolytic disease of the fetus and newborn (HDFN) is prevented by anti-D (a specific type of IVIg), and discovered that mixtures of recombinant antibodies might be an effective substitute. In searching for potential IVIg replacements, several have been identified [e.g. CD44 antibodies, a fusion protein, phagocytosis inhibitors and desialylation inhibitors]. Our researchers have discovered predictive factors to help identify patients who will respond poorly to IVIg thus potentially reducing adverse outcomes and costs.
Based on this research, three patents were filed for treatment of autoimmune disease using IVIg substitutes. If these drugs are found safe and effective in patients, they could provide lower cost alternatives to IVIg. The research will also inform clinical practice.