In vivo and in vitro blocking of human lymphocyte Fc gamma-receptors by intravenous gammaglobulin.

Lymphocyte subpopulations were measured in patients with idiopathic thrombocytopenic purpura before and immediately after high dose intravenous gammaglobulin (IV-IgG) therapy. A significant relative and absolute reduction in the Fc gamma-receptor bearing lymphocyte subpopulation was observed in 5 out of 7 patients tested. In vivo modulation of lymphocyte Fc gamma-receptors therefore probably occurs: an effect which may be attributable to the Fc gamma R-blocking anti-lymphocytic antibodies found in IV-IgG preparations. In vitro studies showed that IV-IgG preparations also contain antibodies with the capacity to block Fc gamma-receptors on human monocytes and polymorphs and that these antibodies can inhibit the T cell response to phytohaemagglutinin. These anti-lymphocyte antibodies may be important in the mode of action of high dose IV-IgG therapy.