Immune complex therapies for treatment of immune thrombocytopenia

Approximately 30% of patients with chronic immune thrombocytopenia (ITP), a common autoimmune disease, are refractory to standard therapies. In the last several years, several published reports have suggested that gamma globulin immune complexes may inhibit pathways of platelet destruction in ITP, attenuating thrombocytopenia in human patients and in animal models of ITP. This chapter reviews the literature associated with the use of immune complexes as a treatment of ITP, including a discussion of immune complex therapies that are in current clinical use (e.g., IVIG, anti-D), mechanisms proposed for the effects of immune complexes in ITP, possible adverse effects associated with immune complexes, and translational considerations for the development of novel immune complex therapies (e.g., antibody-coated liposomes).