CIDP is a complex disease with multiple underlying drivers, all of which may contribute to a
pro-inflammatory environment4-9

These drivers can include:

T-cells reduction impairs the ability to regulate autoreactive cells, inflammation, and immune homeostasis

T cell (Tregs) reduction

T cell (Tregs) reduction
Impairs ability to regulate autoreactive cells, inflammation, and immune homeostasis7
B cells can differentiate into plasma cells that release autoantibodies

B cell production
of autoantibodies

B cell production of autoantibodies
B cells can differentiate into plasma cells that release autoantibodies8
Pathogenic antibodies contribute to demyelination and axonal damage

Pathogenic antibodies

Pathogenic antibodies
Contribute to demyelination and axonal damage9
Complement activation assoicated with macrophagemediated demyelination

Complement activation

Complement activation
Associated with macrophage-mediated demyelination6

Ig works beyond FcRn antagonism alone3,9*

Pathogenic
mechanisms
of CIDP

Mechanisms of Ig8-14

Complement
antagonism

T cell (Tregs)
increase

FcγR
antagonism

Neutralization
via Fab

FcRn
antagonism

T cell (Tregs)
reduction
icon Dot
B cell production
of autoantibodies
icon Dot icon Dot
Pathogenic
antibodies
icon Dot icon Dot
Complement
activation
icon Dot

Mechanisms of Ig8-14

Pathogenic mechanisms of CIDP

T cell (Tregs)
reduction
B cell production
of autoantibodies
Pathogenic
antibodies
Complement
activation

Complement
antagonism

icon Dot

T cell (Tregs)
increase

icon Dot

FcγR
antagonism

icon Dot

Neutralization
via Fab

icon Dot icon Dot

FcRn
antagonism

icon Dot

Differences in the clinical presentation of CIDP and a wide range of responses suggest a variety of mechanisms are at play.15

Ig activity involves both the Fc Constant Region and the Fab Variable Regions. By inducing a range of mechanisms thought to help inhibit and block the pathogenic effects of demyelination, Ig therapy reduces or prevents further nerve damage without suppressing the immune system.5,9

*The mechanisms of action have not been fully elucidated, but may include immunomodulatory effects.

CIDP=chronic inflammatory demyelinating polyneuropthy;

Fab=fragment antigen-binding; Fc=fragment crystallizable;

FcyR=Fc gamma receptor; FcRn=neonatal Fc receptor; Tregs=T regulatory cells.

Understanding Immunoglobulin G (IgG), also commonly referred to as Ig

Watch this video to explore the proposed mechanism of action of Ig*

*HIZENTRA supplies a broad spectrum of opsonizing and neutralizing IgG antibodies against a wide variety of bacterial and viral agents.
The mechanism of action of Ig has not been fully elucidated, but may include immunomodulatory effects.

Explore how Hizentra may be right for your CIDP patients

See the benefits

Consider the profiles of patients who could benefit

Optimize the Ig experience
References: 1. Berger M, McCallus DE, Lin CS. Rapid and reversible responses to IVIG in autoimmune neuromuscular diseases suggest mechanisms of action involving competition with functionally important antibodies. J Peripher Nerv Syst. 2013;18(4):275-296. 2. Sevim E, Kobrin D, Casal-Dominguez M, Pinal-Fernandez I. A comprehensive review of dermatomyositis treatments – from rediscovered classics to promising horizons. Expert Rev Clin Immunol. 2024;20(2):197-209. 3. Dalakas MC, Latov N, Kuitwaard K. Intravenous immunoglobulin in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): mechanisms of action and clinical and genetic considerations. Expert Rev Neurother. 2022;22(11-12):953-962. 4. Dalakas MC. Advances in the diagnosis, pathogenesis and treatment of CIDP. Nat Rev Neurol. 2011;7(9):507-517. 5. Querol L, Lleixà C. Novel immunological and therapeutic insights in Guillain-Barré Syndrome and CIDP. Neurotherapeutics. 2021;18(4):2222-2235. 6. Querol LA, Hartung HP, Lewis RA, et al. The Role of the Complement System in Chronic Inflammatory Demyelinating Polyneuropathy: Implications for Complement-Targeted Therapies. Neurotherapeutics. 2022;19(3):864-873. 7. Goswami TK, Singh M, Dhawan M, et al. Regulatory T cells (Tregs) and their therapeutic potential against autoimmune disorders - Advances and challenges. Hum Vaccin Immunother. 2022;18(1):2035117. 8. Tackenberg B, Nimmerjahn F, Lünemann JD. Mechanisms of IVIG efficacy in chronic inflammatory demyelinating polyneuropathy. J Clin Immunol. 2010;30 Suppl 1:S65-S69. 9. Schwab I, Nimmerjahn F. Intravenous immunoglobulin therapy: how does IgG modulate the immune system? Nat Rev Immunol. 2013;13(3):176-189. 10. Trinath J, Hegde P, Sharma M, et al. Intravenous immunoglobulin expands regulatory T cells via induction of cyclooxygenase-2-dependent prostaglandin E2 in human dendritic cells. Blood. 2013;122(8):1419-1427. 11. Lutz HU, Späth PJ. Anti-inflammatory effect of intravenous immunoglobulin mediated through modulation of complement activation. Clin Rev Allergy Immunol. 2005;29(3):207-212. 12. Dalakas MC. Update on Intravenous Immunoglobulin in Neurology: Modulating Neuro-autoimmunity, Evolving Factors on Efficacy and Dosing and Challenges on Stopping Chronic IVIg Therapy. Neurotherapeutics. 2021;18(4):2397-2418. 13. Ritter C, Bobylev I, Lehmann HC. Chronic inflammatory demyelinating polyneuropathy (CIDP): change of serum IgG dimer levels during treatment with intravenous immunoglobulins. J Neuroinflammation. 2015;12:148. 14. Allen JA, Berger M, Querol L, Kuitwaard K, Hadden RD. Individualized immunoglobulin therapy in chronic immune-mediated peripheral neuropathies. J Peripher Nerv Syst. 2018;23(2):78-87. 15. Mathey EK, Park SB, Hughes RA, et al. Chronic inflammatory demyelinating polyradiculoneuropathy: from pathology to phenotype. J Neurol Neurosurg Psychiatry. 2015;86(9):973-985.
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