Breakthrough study: Immune therapy helps chronic pain
This is the kind of news we like the most on InteractMD.com--applying a known existing therapy in a new and unexpected way. This time it's using IVIg to treat a chronic pain syndrome known as Complex Regional Pain Syndrome.
Complex Regional Pain Syndrome is a constellation of pain symptoms and extremity swelling. I don't see it in routine practice, though it may be more common than we realize. The patient handout for the article over at Annals of Internal Medicine said that the idea for this treatment came from giving a patient an IVIg treatment for another reason, and finding that his chronic severe pain went away coincidentally.
IVIg is just what it says: intravenous immunoglobulins or gamma globulin. These are antibodies pooled from different human donors, then purified and washed. We use it in hematology often to regulate the immune system, typically for immune thrombocytopenia (low platelets) and hemolytic anemias. It can also help boost the immune systems in patients that have weakened antibody production from lymphoma. I have seen it cause kidney problems and allergic reactions, though it is mostly pretty innocuous stuff.
Researchers in Liverpool report a success rate of 50% with their new treatment. The findings were reported in a prominent mainstream medical journal.
I suspect that part of the problem is that IVIg is not really a standardized concoction. You are depending on the antibody production by the donors, and that in turn depends on what pathogens they have been exposed to over their lifetimes. I guess the other part of the problem is that IVIg is frightfully expensive.
Still, the concept that the immune system can be manipulated to treat pain is completely out of left field, and worthy of following further. One hates to use the word "breakthrough" on a study that only involved 13 patients, but that appears to fit in this case.
