Understanding the Mechanism of Action of Intravenous Immunoglobulins: A Ten Years Experience in Treating Guillain Barré Syndrome

Guillain Barr syndrome is an acute immune-mediated, heterogeneous disease that affects the peripheral nervous system and is characterized by rapidly progressive motor deficit, diminished reflexes, cranial nerve involvement, respiratory failure, sometimes with involvement of autonomic nervous system which contribute to the mortality rate. Both T-cells and B-cells are involved in its pathogenesis, finally leading to myelin destruction or axonal damage. The present paper underlines the effect of intravenous immunoglobulins in treating this disease by discussing the pathophysiology of Guillain Barr syndrome with the participation of immune system and the mechanism of action of intravenous immunoglobulins with the reduction of autoantibodies, down regulation of macrophage activity, reduction of inflammatory cytokine levels and cell adhesion molecules thus limiting the self-harm and the passage of autoimmune cells through the blood-nerve barrier.