Thirty years of supplying the missing link. History of gamma globulin therapy for immunodeficient states.

Man has been injecting himself with gamma globulin for almost 100 years. As a result, both the benefits and the hazards of such therapy have been convincingly demonstrated. For 30 years physicians have realized that one group of patients must receive regular injections of this material to avoid death from overwhelming bacterial infections. The health of subjects with congenital or acquired hypogammaglobulinemia is directly related to the successful administration of adequate amounts of immunoglobulin G (IgG). Three phases are easily recognizable when examining the history of how physicians have accomplished such replacement therapy. Initially, therapy was limited to frequent and painful intramuscular injections of concentrated immune serum globulin. In some patients, the administration of monthly infusions of fresh plasma from "buddies" supplied a better approach. Now, the elusive goal of having a concentrated form of gamma globulin suitable for intravenous administration has been reached. Such preparations are revolutionizing the treatment of human immune deficiencies and expanding the therapeutic potential of gamma globulin itself.