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Vol. 29, No. 3, 2011
Issue release date: April 2011
Fetal Diagn Ther 2011;29:229–232

Accumulation of Fetal IgG in Immunoglobulin Injection into the Fetal Abdominal Cavity Is Proven

Yoshida M. · Matsuda H. · Hasegawa Y. · Yoshinaga Y. · Asai K. · Kawashima A. · Furuya K.
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Objective: There have been a number of studies on immunoglobulin injection into fetuses or mothers during pregnancy for the treatment of congenital cytomegalovirus infection. However, no study has examined the effect of injected immunoglobulin on fetal hemodynamics. In this study, we examined the effect of immunoglobulin injection on fetal hemodynamics by retrospectively measuring the concentrations of several IgG subclasses in stored umbilical cord blood sera collected during fetal therapy. Methods: Five patients who underwent immunoglobulin injection into the fetal abdominal cavity (IFAC) as a fetal therapy during pregnancy were included in this study. Frozen-stored umbilical venous blood samples collected from these patients during IFAC were measured for serum concentrations of each IgG subclass. Results: The largest change was observed in the IgG2 concentration, with a mean increase of 221% following IFAC. The IgG4 concentration also showed a mean increase of 63%. In contrast, the concentration of IgG1, which has the strongest physiological activity of all IgG subclasses examined, only exhibited an overall mean increase of 1.4%. Conclusion: Our results confirmed that immunoglobulins are incorporated into the fetal circulation following IFAC.

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  1. Negishi H, Yamada H, Hirayama E, et al: Intraperitoneal administration of cytomegalovirus hyperimmunoglobulin to the cytomegalovirus-infected fetus. J Perinatol 1998;18:466–469.
  2. Matsuda H, Kawakami Y, Furuya K, et al: Intrauterine therapy for a cytomegalovirus-infected symptomatic fetus. BJOG 2004;111:756–757.
  3. Matsuda H, Sakaguchi K, Shibasaki T, et al: Intrauterine therapy for parvovirus B19-infected symptomatic fetus using B19 IgG-rich high titer gammaglobulin. J Perinat Med 2005;33:561–563.
  4. Nigro G, Adler SP, La Torre R, et al: Passive immunization during pregnancy for congenital cytomegalovirus infection. N Engl J Med 2005;353:1350–1362.
  5. Adler SP, Nigro G: Findings and conclusions from CMV hyperimmune globulin treatment trials. J Clin Virol 2009;46(suppl 4):S54–S57.
  6. Luppi P: How immune mechanisms are affected by pregnancy. Vaccine 2003;21:3352–3357.
  7. Simister NE: Placental transport of immunoglobulin G. Vaccine 2003;21:3365–3369.
  8. Gitlin D, Boesman M: Serum α-fetoprotein, albumin, and γ-globulin in the human conceptus. J Clin Invest 1966;45:1826–1838.
  9. Gitlin D, Biasucci A: Developent of γG, γA, γM, βIC-βIA, C1 esterase inhibitor, ceruloplasmin, transferrin, hemopexin, heptoglobin, fibrinogen, plasminogen, α1-antitrypsin, orosomucoid, β-lipoprotein, α2-macroglobulin, and prealbumin in the human conceptus. J Clin Invest 1969;48:1433–1446.
  10. Israel EJ, Simister N, Freiberg E, et al: Immunoglobulin G binding sites on the foetal intestine: a possible mechanism for the passive transfer of immunity from mother to infant. Immunology 1993;79:77–81.
  11. Cederqvist LL, Ewool LC, Bonsnes RW, et al: Detectability and pattern of immunoglobulins in normal amniotic fluid throughout gestation. Am J Obstet Gynecol 1978;130:220–224.
  12. Malek A: Ex vivo human placenta models: transport of immunoglobulin G and its subclasses. Vaccine 2003;21:3362–3364.
  13. Garty BZ, Ludomirsky A, Danon YL, et al: Placental transfer of immunoglobulin G subclasses. Clin Diagn Lab Immunol 1994;1:667–669.
  14. Shrim A, Garcia-Bournissen F, Maxwell C, et al: Favorable pregnancy outcome following trastuzumab (Herceptin) use during pregnancy: case report and updated literature review. Reprod Toxicol 2007;23:611–613.
  15. Roopenian DC, Akilesh S: FcRn: the neonatal Fc receptor comes of age. Nat Rev Immunol 2007;7:715–725.
  16. Burns JC, Capparelli EV, Brown JA, et al: Intravenous γ-globulin and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group. Pediatr Infect Dis J 1998;17:1144–1148.

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