Intravenous immunoglobulin and cytokines: focus on tumor necrosis factor family members BAFF and APRIL.

The presence of natural autoantibodies against cytokines has been reported in healthy individuals. Because circulating cytokines may be implicated in the clinical outcome of numerous diseases, the mode of action of intravenous immunoglobulin (IVIg) (pooled from sera over a thousand normal individuals) may involve immunomodulation of the cytokine network. We review the anti-cytokine effects of IVIg as well as the consequences of IVIg infusions on cytokine production. Furthermore, IVIg exerts therapeutic effects in autoimmune diseases and lymphoid malignancies. These two conditions have in common an overproduction of BAFF (for B-cell-activating factor of the TNF family). The presence of antibodies with BAFF and APRIL (a proliferation-inducing ligand) specificity was investigated. We found that IVIg recognizes BAFF and APRIL and that IVIg binding prevents BAFF from exerting its antiapoptotic effect on B cells. These anti-BAFF IgGs might prevent the deleterious effects of BAFF in B-cell-mediated autoimmune diseases.