Has anyone taken oral immunoglobulins?

April 3, 2008 2:06 PM

Has anyone taken oral immunoglobulins (capsules, etc)? What for? Did you benefit noticeably? Any other opinions on them?

One of my doctors suggested Xymogen's Igg 2000, for IBS & celiac symptoms (although I adhere to a strict diet that usually keeps these away).

Gracias, hive mind.

posted by bitterkitten to health & fitness (8 comments total)

I'm pretty sure that immunoglobulins are digestible, i.e., are degraded by the stomach.
posted by neuron at 2:14 PM on April 3, 2008

Seconding what neuron said.

Immunoglobulins are composed of polypeptides (proteins, chains of amino acids). The stomach contains acid hydrolases which include proteases. In simpler terms, that means that the stomach is a highly acidic environment which contains acid-activated chemicals that are capable of breaking down proteins into amino acids.

So basically, your body just gets some amino acids which it can then use to make its own proteins. You could get the same effect from eating a steak or something.

Whoever markets this product should be sued.
posted by david06 at 8:18 PM on April 3, 2008

Put it this way: if my doctor recommended this I'd find another doctor.
posted by drpynchon at 8:45 PM on April 3, 2008

I'd never heard of oral immunoglobulin before, although intravenous immunoglobulin is a remarkable treatment, especially for a number of autoimmune disorders (though I'm not sure how effective it is in IBS).

A look at the literature does show that this treatment has been evaluated for the prevention of neonatal colitis (under the rationale that IgA is in mother's milk, so perhaps ingesting immunoglobulin (IgA and/or IgG) might produce a protective effect). However, in this review, the authors conclude: The administration of oral immunoglobulin did not reduce the incidence of definite NEC, suspected NEC, surgery related NEC, or death from NEC, either during or after the study period.

As far as using oral immunoglobulin for IBS, the only decent information I could find was on a Patent site. It appears that the patent was issued in 2002/2003 after positive results in a couple of case studies (two 18-19 y/o girls with Crohn's disease, reference here). I could find nothing further, though, and without a proper clinical trial, you can't consider it a tried and true treatment.

As for IgG 2000 DF, from the brochure (I'm not going to link to it, it's found easily enough on google) it looks pretty mickey mouse ("ImmunoBar, convenient "on the go" nutrition for optimal immune support"). The only trial data they provide is that it's safe for digestion, nothing on clinical efficacy against IBS (or any other disease, for that matter). Frankly, it looks like an expensive chocolate bar.

I'm with drpynchon, change doctors.
posted by kisch mokusch at 11:21 PM on April 4, 2008

kisch mokusch, it helps to know that neonates can actually move immunoglobulins from their digestive tract (from mother's milk) into their bloodstream. They lose this ability rapidly; children and adults can't do it at all, or at least that's what I was taught in med school. The period during which they're absorbing maternal immunoglobulins is a period in which their own immunoglobulin production is nearly nil; most docs think this probably isn't a coincidence.
posted by ikkyu2 at 12:55 AM on April 5, 2008

Sorry, I didn't mean to imply that orally taken IgG would become intravenous IgG. I just wanted the poster to be aware of the difference if he/she was doing their own research on the topic (especially since intravenous IG does appear to have worked as a treatment for IBS, at least for some Crohn's cases).

As far as the uptake of maternal immunoglobulins (and thank you for making me look this up, it's quite interesting), what they taught you in med school is true for IgG (and occurs via the neonatal Fc receptor present in the duodenum), although this is apparently far more prominent in mice than humans. This doesn't appear to be true for IgA:

Milk contains secretory Ig (S-Ig)A and S-IgM Abs that bind enteric pathogens or their toxins, which are partly induced in the maternal intestinal lymphoid follicles. Milk IgA and IgM are not absorbed significantly in any species and act locally in the intestinal lumen (11).

11. Rejnek, J., J. Travnicek, J. Kostka, J. Sterzl, A. Lanc. 1968. Study of the effect of antibodies in the intestinal tract of germ-free baby pigs. Folia Microbiol. 13: 36-42.

Taken together, this implies that not only can immunoglobulin mediate local effects, but that (in neonates at least), immunoglobulin can even survive the acidity of the stomach (although perhaps only when in [alkaline] milk, but that's me hypothesising out of my arse). So although this treatment in particular sounds pretty bogus, the evidence doesn't really say one way or the other whether orally administered immunoglobulin might actually work in IBS (the two case studies mentioned in the patent link were also being treated with sulfasalazine and prednisolone when they got their IgG+IgA, so it's hardly what you'd call convincing data).
posted by kisch mokusch at 3:33 AM on April 5, 2008

Yeah, I thought the neonatal transfer was IgG-only, but I wasn't sure and I didn't want to embarrass myself.

It's quite clear that bottle fed infants have a much greater incidence of ear infection than breastfed ones do; the lack of immunoglobulin in formula is usually cited to explain this difference. However, the old breast-vs-bottle debate is another one of these Mac vs PC, gun control, abortion type things that is super polarized.

Celiac is an IgA mediated disease, we think. It's pretty clear that not all protein is degraded into its component amino acids in the gut; the gluten fragments that cause the reaction in celiac disease are very resistant to degradation.

At the end of the day my "gut" feeling is that oral immunoglobulins won't do much, but I certainly wouldn't take that to the bank.
posted by ikkyu2 at 10:47 AM on April 5, 2008

I have been researching the use of oral immunoglobulin for the past 12 years. The Xymogen IgG 2000 DF product (and recommendations of the doctor) is an extension of the research we have done so I can speak to the scientific support. Our research has been conducted largely in collaboration with independent university research groups who have the right to publish positive or negative results. I am glad to provide a list of independent researchers that have conducted studies evaluating the use of immunoglobulin concentrates. The studies have been published mainly in the Journal of Nutrition, American Journal of Clinical Nutrition and Journal of Animal Science. All are well-respected, peer-reviewed journals. Admittedly, the science of immunoglobulin supplementation is not yet well known in the medical field while the use of this concept is routine in animal health. We clearly know the nutritional requirements and specific needs of animals more than we do humans and immunonutrition is an example of that.

The above comments on immunoglobulin supplementation are a little discouraging when read by one who has invested most of his career in the field. They appear to be based on quick searches on PubMed. But, they are fair comments as I was taught the same science 25 years ago. The comments help me understand how far we have to go in the education and publication process. The science on the role of immunoglobulin the digestive tract and immune function is subject to change. I would not invest the time and money ($3-4 million) on the concept of oral immunoglobulin if comments above were accurate and if the preliminary results were not promising for a number of human conditions. I have presented the concept to some of the finest researchers in the country. The first comment raised is always the first question I receive when I have the chance to speak. Does immunoglobulin pass the stomach? It has been known for quite some time that more than 50% of the dose of oral immunoglobulin survives the stomach. In a summary of 12 studies, I have calculated that approximately 25% of the dose of immunoglobulin administered survives through the entire digestive tract and can be recovered in stool, far higher than many drugs. Few researchers in the field, if any, remain concerned that the product is simply digested after reviewing the data. Animal studies consistently demonstrate a reduction in inflammation in the gut with oral immunoglobulin supplementation via food or water. In humans, we have conducted a clinical study in individuals with diarrhea-predominant IBS with good results. We observed a significant reduction in days with symptoms. I apologize for not getting the study published but we issued a press release to make the results available. Evidently, the searches above did not find the press release or summary. Nevertheless, I ask for your patience and open-mind as the research continues. As you may know, clinical research is very costly so it takes place over time. But, many people who suffer from gut health issues related to immune deficiences, bacterial overgrowth, and inflammatory conditions and there are surprisingly few promising cost-effective, supportive therapies in research. Nutritional supplements or modifications that include immunoglobulin supplementation to reduce intestinal inflammation and pro-inflammatory cytokine production is very promising. But, with a lack of information or mis-information, some of these people may miss out on an opportunity for improved quality of life.

Feel free to contact us at Immunolin.com for the information I have referenced.
posted by EWPHD at 8:26 AM on June 11, 2008 [2 favorites has favorites]