Possible Mechanism of Action of IV Immunoglobulin in GBS

Administering intravenous immunoglobulin (IVIg) to patients with Guillain-Barré syndrome (GBS) is one of two treatments of choice; the other is plasma exchange (PE). How IVIg works in this disorder is not clear. To depict possible mechanisms, these investigators measured serum levels of pro-inflammatory cytokines interleukin-1β (IL)-1β, IL-2, and tumor necrosis factor-α (TNF)-α, the anti-inflammatory cytokine IL-10, and the soluble p55 receptor for TNF. Soluble TNF-reception levels were used to calculate unbound and presumably active TNF. Measurements were made before and during therapy with IVIg in 21 patients with GBS. There were two comparison groups: Seven patients treated with PE and 12 patients with mild disease who received no immuno…