The future of immunoglobulin therapy: An overview of the 2nd international workshop on natural antibodies in health and disease

On March 15-17th, 2012 the 2nd international workshop on natural antibodies sponsored by CSL Behring AG took place in Bern, Switzerland. The focus of this workshop centered on new directions and in particular explored the "Future of Immunoglobulin Therapy". Our international speakers addressed the major themes of understanding the origins of the immunoglobulin (Ig) repertoire and how we use it in our everyday lives to maintain homeostasis and fight infections and diseases. This Ig repertoire is already used as a therapeutic tool in the form of intravenous immunoglobulin (IVIG) for patients suffering from immunodeficiency and autoimmune disorders. The question now arises: what else can we learn and apply for the future of Ig therapy? Are there new directions, new ways of using the repertoire? These questions were discussed in sections covering modified Igs with modified efficacy including catalytic antibodies, the role of Fc receptors and complement inducing autoimmune mediated damage, Ig therapy beyond IgG in particular taking a look at the role of IgA and the therapeutic consequences of the different etiologies of excess amyloid beta in Alzheimer's disease and patients with Downs' syndrome. A major topic addressed the application of biornarkers to define new autoimmune diseases, to refine current therapies with a view to optimising the management of chronic diseases using both genetic and biomarker profiles to forewarn of possible future complications and to monitor fluctuations in disease status. Indeed, some of these topics push the frontiers of autoimmunity beyond its traditional scope and serve the purpose of making us re-evaluate the potential of using the Ig repertoire. (C) 2013 Elsevier B.V. All rights reserved.