Efficacy of IVIG affinity-purified anti-double-stranded DNA anti-idiotypic antibodies in the treatment of an experimental murine model of systemic lupus erythematosus.

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Abstract
Since the idiotypic network is an important mechanism for controlling the immune repertoire, we tested anti‐idiotypic modulation employing concentrated specific natural polyclonal anti‐double‐stranded (ds) DNA anti‐idiotypic antibodies obtained from a commercial IVIG in the treatment of experimental systemic lupus erythematosus (SLE). Specific natural polyclonal anti‐dsDNA anti‐idiotypic antibodies (IVIG‐ID) were affinity purified from IVIG on an anti‐dsDNA–Sepharose column constructed from anti‐dsDNA idiotypes (ID) affinity purified from 55 patients with active SLE. NZB/W F1 mice were treated i.v. with 3 weekly injections of IVIG‐ID (2 mg/kg/injection) or regular IVIG (400 mg/kg/injection) both before (age 8 weeks) and after developing anti‐dsDNA antibodies at the age of 21–22 weeks. The IVIG‐ID‐treated mice showed a decline in the titer of anti‐dsDNA antibodies during the treatment, reaching maximum suppression 1 week after the last injection. A significant difference in the proteinuria level in the IVIG‐ID‐treated group compared to the control group was observed. Immunohistology showed different patterns of IgG deposition, with mesangial and capillary wall deposits in controls and in the IVIG‐treated group, but only mesangial deposits in the IVIG‐ID‐treated group. The survival time of the IVIG‐ID‐treated group was longer than the IVIG‐treated group. Treatment with concentrated specific anti‐dsDNA anti‐ID prepared from commercial IVIG is more effective in suppressing the humoral reaction and clinical signs of SLE than native IVIG. These results point to the considerable regulatory role of anti‐ID in the mechanism of action of IVIG in SLE.

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