Effects of high-dose intravenous immunoglobulin on lipopolysaccharide-induced acute lung injury.

Abstract: Purpose: Intravenous immunoglobulin (IVIG) therapy is used in inflammatory diseases but the use of immunoglobulin as a treatment for acute lung injury (ALI) has not been previously studied. Transforming growth factor beta (TGF-β) plays a critical role in the pathogenesis of of ALI. Therefore we examined the levels of TGF-β and lung inflammation scores in IVIG treated ALI models. Methods: Intratracheal lipopolysacccharide was given to rats. Groups 1 and 3 received saline, whereas group 2 received IVIG. 24h later saline was given to groups 1 and 2 and IVIG to group 3. Blood samples and bronchoalveolar lavage (BAL) fluids were obtained from each group and sacrificed for pathological evaluation. Results: BAL TGF-β levels of groups 2 and 3 on day 30, were lower compared to their levels of day 2 (p=0.01, p=0.01). BAL TGF-β levels of groups 2 and 3 were lower than the levels of group 1 on day 30 (p=0.002, p=0.001). Pathological examination revealed that the inflammation scores of groups 2 and 3 on day 30, were lower than the scores of day 2 (p=0.02, p=0.01). Inflammation scores of group 2 were lower than group 1 on day 30 (p=0.02). Moderate fibrosis was seen in half of the rats from group 1 and one rat from group 2. Conclusion: High-dose IVIG decreased lung inflammation scores and BAL TGF-β1 levels and this therapy would give even better results if it is given earlier. [Copyright &y& Elsevier]