Anti-idiotypes against autoantibodies and alloantibodies to VIII:C (anti-haemophilic factor) are present in therapeutic polyspecific normal immunoglobulins.

Therapeutic, polyspecific, normal immunoglobulins (IVIg) suppress anti-factor VIII (VIII:C) activity of anti-VIII:c autoantibodies in vivo and in vitro. In the present study anti-VIII:C activity was found to be inhibited by two different preparations of IVIg in the plasma of three of four patients with autoantibodies and two of three patients with alloantibodies. F(ab')2 fragments from IVIg inhibited anti-VIII:C activity in F(ab')2 fragments from the plasma of the patients. In patients in whom anti-VIII:C activity was inhibited by IVIg, anti-VIII:C F(ab')2 antibodies were specifically retained on an affinity column of Sepharose-bound F(ab')2 from IVIg. In patients in whom anti-VIII:C activity was not suppressed by IVIg in vitro, no binding of anti-VIII:C antibodies to Sepharose-bound IVIg was observed. In a patient in whom anti-VIII:C activity was only suppressed by one preparation of IVIg, specific binding of anti-VIII:C antibodies was only observed with that preparation but not with another. These results indicate that IVIg contain anti-idiotypes against autoantibodies and alloantibodies to VIII:C. The capacity of IVIg to inhibit anti-VIII:C activity in vitro is directly related to the presence of demonstrable anti-idiotypes against anti-VIII:C antibodies. The finding of anti-idiotypes against anti-VIII:C alloantibodies in IVIg suggests that, in addition to autoantibodies, some alloantibodies may be suppressed in vivo by IVIg.