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Hello. My name is Shaye Kivity,
I'm a Rheumatologist from the Center of Autoimmune Diseases, Tel HaShomer.
I will talk to you about intravenous immunoglobulins,
which from now on I will call IVIg,
their clinical evidence and some more.
First, we will talk about the history of IVIg,
the proposed mechanisms of its action,
therapeutic indications for the use of IVIg,
which are divided into established indications and
less established indications, and common side effects of IVIg treatment.
So, the history of IVIg use and manufacturing is very interesting.
It started with Edwin Joseph Cohn,
who was a scientist working at Harvard University.
He was asked before World War II by the American National Research Council
to identify a stable blood derivative that could be
stockpiled in advance and given to soldiers on the battlefield.
So, actually, he developed a novel technique
that would isolate albumin from the blood plasma,
and this was used to maintain osmotic pressure in wounded soldiers,
and thus, rescued thousands of soldiers from shock.
He did this by using ethanol, in elevating doses,
which was able to fractionate the blood without damaging the blood;
and he noticed that besides albumin,
he had some more fractions,
Cohn fraction number two,
was what it was called, historically, included globulin.
After the war, fraction number two was used to prevent or attenuate viral diseases,
such as measles, polio, and hepatitis.
But, later on, when vaccines were invented,
the use of globulins at this stage for infections was less popular.