Result card

  • ETH4: Are there any other hidden or unintended consequences of IGG and its applications for different stakeholders (patients/users, relatives, other patients, organisations, commercial entities, society etc.)?
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Are there any other hidden or unintended consequences of IGG and its applications for different stakeholders (patients/users, relatives, other patients, organisations, commercial entities, society etc.)?

Authors: Plamen Dimitrov, Anelia Koteva

Internal reviewers: Pseudo99 Pseudo99

Due to the still unknown etiology and pathogenesis of Alzheimer’s disease, namely whether beta-amyloid protein is a key cause of the disease or its consequence, currently to both physicians and patients may be unclear if the proposed therapy will affect the specific pathology, i.e. if the new treatment will be etiopathogenetic or only symptomatic. Only by thorough testing of the method will it be possible to check the plausibility of the amyloid hypothesis.

 

Despite the initial scientific enthusiasm regarding immunotherapy and the very first promising results, medical literature maintains that immunotherapy potential in relation to Alzheimer’s disease should not be generalized. Suspected, however, still unknown are some side effects or complications that may occur during treatment, such as autoimmune diseases, brain inflammation, microhemorhages, increased amyloid angiopathy, residual neurofibrillary tangles, brain volume reductions and problems with blood-brain barrier passage of antibodies. Given that, immunotherapy should not be seen as a universal therapeutic strategy on the principle “One size fits all.” and it is not advisable that IVIG be the first choice for AD patients.

 

The authors[1] warn that even passive immunization may pose a risk for humans and recommend quite cautious application of the method only after extensive testing on nonmurine animal species such as primates.

 

[1] Foster, J.K., G. Verdile, K.A. Bates and R.N. Martins, “Immunization in Alzheimer’s Disease: Naïve Hope or Realistic Clinical Potential?”, “Molecular Psychiatry” (2009) 14, 239-251, available at:  http://www.nature.com/mp/journal/v14/n3/full/mp2008115a.html .

Dimitrov P, Koteva A Result Card ETH4 In: Dimitrov P, Koteva A Ethical analysis In: Jefferson T, Cerbo M, Vicari N [eds.]. Use of Intravenous immunoglobulins for Alzeheimer’s disease including Mild Cognitive Impairment [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 30 October 2020]. Available from: http://corehta.info/ViewCover.aspx?id=267