How Do Immune Globulins Work?

Immune globulins (also called gamma globulin or immunoglobulin) are made from human blood plasma. The plasma processed from donated human blood contains antibodies (substances made by the body’s immune system in response to bacteria, viruses, fungus, or cancer cells) that protect the body against diseases. These immune globulins are collected from the pooled blood of donors and purified to prevent the passage of diseases to the person who receives them. This therapy is useful in people with weakened immune systems to fight in the following cases: thrombocytopenia (low blood platelet count), postexposure prophylaxis in certain serious viral infections (cytomegalovirus, hepatitis, measles, tetanus, and rubella), hemolytic disease, neurological diseases, organ transplantations, etc.

Over the course of life, the body produces thousands of different antibodies as and when exposed to different infectious organisms that the body considers to be "foreign."

The five major types of antibodies are:

• IgA: found in the nose, breathing passages, digestive tract, ears, eyes, and vagina. Approximately 10% to 15% of the antibodies present in the body are IgA antibodies.
• IgG: found in all the body fluids and is the most commonly found antibody (75% to 80% of all the antibodies in the body). These are the only type of antibodies that can cross the placenta in a pregnant woman to help protect their baby.
• IgM: found in the blood and lymph fluid and is the first type of antibody made in response to an infection, approximately 5% to 10% of all antibodies in the body.
• IgE: found in the lungs, skin, and mucous membranes. IgE antibody levels are often high in people with allergies and involved in allergic reactions to milk, some medicines, and poisons.
• IgD: found in small amounts in the tissues that line the abdomen or chest. 
• Immunoglobulins are prescription-only medicines and are administered via intravenous route (through a vein) in an infusion that usually takes one to four hours and intramuscular route (injected into a muscle).

Immunoglobulins work in the following ways:

• They are made from healthy human blood that has a high level of certain defensive substances (antibodies) that help fight off infections during the transplant process, as the body's defense system (immune system) is weakened to prevent the body from attacking (rejecting) the new organ as the immune system treats the new organ as an invader.
• They reduce the body’s natural defense system which helps in preventing the body from rejecting the kidney transplant so that it can work normally.
• Immunoglobulin provides short-term protection against or reduces the severity of certain diseases.
• They decrease the immune system’s ability to attack body tissues in some cases of autoimmune diseases (a condition in which the immune system mistakenly attacks the healthy cells in the body).
• In addition, they help in conditions wherein there is an inherited inability to produce antibodies or those who are having treatment for certain types of cancer.

Immune globulins are used in conditions such as:

• Primary immunodeficiency syndrome (rare, genetic disorders that impair the immune system)
• Immune thrombocytopenic purpura (a blood disorder characterized by a decrease in the blood platelet count that can lead to easy or excessive bruising and bleeding)
• Aplastic anemia (a condition that damages stem cells in the bone marrow)
• Chronic inflammatory demyelinating polyneuropathy (a neurological disorder characterized by progressive weakness and impaired sensory function in the legs and arms)
• B-cell chronic lymphocytic leukemia (a cancer of lymphocytes [a type of white blood cell involved in the body’s immune system])
• Multifocal motor neuropathy (a disease that affects the body’s motor nerves [nerves that control muscles])
• Dermatomyositis (a rare disease that causes muscle inflammation and skin rash)
• Guillain-Barre syndrome (a rare neurological disorder in which the body's immune system mistakenly attacks part of its peripheral nervous system)
• Lambert-Eaton myasthenic syndrome (a condition in which the immune system attacks the neuromuscular junctions—the areas where the nerves and muscles connect)
• Stiffman syndrome (a rare acquired neurological disorder characterized by progressive muscle stiffness [rigidity] and repeated episodes of painful muscle spasms)
• Neonatal hemochromatosis (a disorder affecting fetuses and newborns. It is characterized by liver disease associated with the accumulation of excess iron in the liver and other areas of the body)
• Administration to mother to prevent hemolytic disease in newborn
• Abortion/miscarriage
• Rh sensitization (when an Rh-negative woman becomes pregnant with an Rh-positive fetus [which can occur when the father’s blood is Rh-positive]; the pregnant woman’s immune system makes antibodies that can destroy the fetus’s blood in a future pregnancy)
• Myelodysplastic syndrome (conditions that can occur when the blood-forming cells in the bone marrow become abnormal)
• Graft versus host disease (a life-threatening complication that can occur after certain stem cell or bone marrow transplants)
• Acute renal graft rejection (when the immune system identifies a grafted organ as foreign and attacks it)
• Kawasaki disease (an illness that causes inflammation [swelling and redness] in blood vessels throughout the body, most commonly affects infants and young children)
• Myositis (chronic, progressive inflammation of the muscles)
• Multiple sclerosis (a potentially disabling disease of the brain and spinal cord) 
• Myasthenia gravis (a rare neuromuscular disorder that causes weakness in the skeletal muscles)
• Lupus (a chronic autoimmune condition that can cause inflammation throughout the body)
• Prophylaxis in organ transplantation:
  • Kidney
  • Heart
  • Lungs
  • Liver
  • Pancreas
  • Bone marrow
• As postexposure prophylaxis for viral infections such as:
  • Cytomegalovirus (CMV)
  • CMV pneumonia (a type of viral pneumonitis and occurs because of infection with CMV)
  • Hepatitis A 
  • Hepatitis B 
  • Rubella
  • Varicella
  • Tetanus
  • Rabies
  • Vaccinia

Common side effects include:

• Abdominal pain 
• Asthenia (physical weakness or a lack of energy)
• Chills 
• Diarrhea 
• Dyspnea (shortness of breath)
• Fever 
• Headache 
• Malaise (a feeling of weakness, overall discomfort, and illness)
• Nausea
• Vomiting
• Flushing
• Muscle cramps
• Back/joint pain 
• Drowsiness (feeling abnormally sleepy during the day)
• Pain/tenderness at the injection site

Other rare side effects include:

• Hyperkalemia (high potassium levels)
• Leukopenia (reduced number of white blood cells)
• Peripheral edema (swelling of lower legs or hands)
• Tachycardia (a fast heart rate—more than 100 beats per minute)
• Thrombocytopenia (low blood platelet count)
• Dizziness (feeling faint, weak, or unsteady)
• Increased sweating
• Urinary tract infection
• Hypertension (high blood pressure)
• Rapid and shallow breathing
• Chest pain/heaviness
• Swelling of the ankles, feet, and hands
• Signs of kidney problems
• Change in the amount of urine
• Pink/bloody/frothy urine

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of immune globulins include:

• Antithymocyte globulin rabbit
• Asceniv
• ATG rabbit
• BabyBIG
• Bivigam
• Botulism immune globulin iv
• Carimune
• Carimune NF
• Cmv ig
• Cutaquig
• Cuvitru
• CytoGam
• Cytomegalovirus immune globulin (CMV IG)
• Flebogamma
• Flebogamma 10% DIF
• Flebogamma 5% DIF
• GamaSTAN
• GamaSTAN S/D
• Gammagard
• Gammagard liquid SC
• Gammagard S/D
• Gammaked
• Gammaplex
• Gamulin Rh
• Gamunex-C
• Gamunex-C SC
• H big
• Hep B gammagee
• HepaGam B
• Hepatitis B immune globulin (HBIG)
• Hizentra
• Hyper tet
• HyperHep
• HyperHEP B S/D
• HyperRAB S/D
• HyperRHO
• HyperTET S/D
• HypRho D
• HyQvia
• IM Immune globulins
• Immune globulin IM (IGIM)
• Immune globulin IV (IGIV)
• Immune globulin SC
• Immune globulin SC-klhw
• Imogam rabies HT
• ISG
• IV Immune globulin
• IVIG
• KedRab
• MicRhoGAM
• Octagam
• Panzyga
• Privigen
• Rabies immune globulin, human (RIG)
• Rhesonativ
• Rho(D) immune globulin
• RhoGAM
• Rhophylac
• RIG
• Tetanus immune globulin (TIG)
• Thymoglobulin
• TIG
• Vaccinia immune globulin intravenous
• Varicella zoster immune globulin, human
• VariZIG
• VIGIV
• WinRho SDF
• Xembify