Study Evaluates IVIG in Treating Multisystem Inflammatory Syndrome in Children

Intravenous immune globulin (IVIG) is able to target activated neutrophils that express interleukin 1 beta (IL-1β), thereby showing promise treating inflammation in Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C), according to a study published in the Journal of Clinical Investigation.

The study was funded by the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Heart, Lung, and Blood Institute, and the National Institute of General Medical Sciences.

MIS-C impacts school-age children with mild or no COVID-19 symptoms. The condition typically involves severe inflammation of 2 or more parts of the body, such as the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal organs. MIS-C and KD have some symptoms in common; therefore, treatments for MIS-C are based in part by findings regarding the treatment of KD.

The researchers noted that IVIG is comprised of antibodies purified from blood products and works by depleting neutrophils. IVIG has previously been found to be an effective treatment for heart complications caused by KD, according to the study.

However, among patients with MIS-C, IVIG monotherapy does not always resolve symptoms. As such, these patients may require additional anti-inflammatory drugs.

To gain knowledge into how IVIG functions and to enhance treatments for children with MIS-C, the research team, led by Ben A. Croker, PhD, and Jane C. Burns, MD, from the University of California San Diego School of Medicine, profiled immune cells from patients with MIS-C or KD.

The investigators sampled cells prior to treatment initiation and again 2 to 6 weeks after patients were administered IVIG. They found that neutrophils from these patients were highly activated and a major source of IL-1β, which is a driver of inflammation. Following treatment with IVIG, activated neutrophils were significantly diminished in patients with MIS-C or KD.

The study authors said their findings are the first to show why IVIG is effective for both conditions; however, further research is required to evaluate how IVIG causes cell death in activated neutrophils and why certain patients with MIS-C need additional anti-inflammatory treatments. They added that this research will aid health care providers in determining the most effective methods to treat patients with MIS-C.

Reference

Antibody treatment for MIS-C works by depleting inflammatory immune cells. National Institutes of Health. https://www.nih.gov/news-events/news-releases/antibody-treatment-mis-c-works-depleting-inflammatory-immune-cells. October 15, 2021. Accessed November 11, 2021.