Effect of immune globulin intravenous on opsonization of bacteria by classic and alternative complement pathways in premature serum

The mechanisms involved in the effect of immune globulin intravenous (IGIV) on bacterial opsonization by both complement pathways in premature serum were elucidated in this study. Of the bacteria used, Staphylococcus aureus and Salmonella enteritidis were nonen-capsulated while Streptococcus pyogenes and Escherichia coli 07 Kl were encapsulated. As demonstrated by indirect immunofluorescence, IGIV showed specific antibody titers of 1:32 for S. aureus and S. enteritidis and of 1:8 for S. pyogenes and E. coli 07 Kl. IGIV alone had no direct opsonic activity against these organisms. Addition of IGIV did not alter the opsonic activity of normal adult serum against these organisms. In contrast, addition of IGIV promoted the opsonic activity of premature serum against the nonencapsulated bacteria to levels matching that in normal adult serum. The IGIV preparation significantly improved the opsonization of bacteria by the classic (from 39 to 68% of that in adult serum) and alternative (from 22 to 97% of that in adult serum) complement pathways in premature serum. IGIV also markedly augmented C3 deposition on the bacteria by both complement pathways. These studies suggest that IGIV containing high titers of specific antibodies promote opsonization of bacteria by the enhancement of complement pathway activation, especially the alternative pathway, in premature serum.