Polyclonal immunoglobulins and hyperimmune globulins in prevention and management of infectious diseases.

Immunoglobulin replacement has long been used in the prevention and treatment of infectious diseases. In the late 1800s, scientists first recognized the protective effect of sera obtained from rabbits immunized with tetanus toxin. This finding led to an initial interest in curative sera, which were primarily antitoxins obtained from animals. Complications from serum sickness, however, limited the use of these products and prompted investigation of human convalescent sera. During World War I, there was widespread use of curative sera for treatment of tetanus, diphtheria, and pneumococcal disease. Immunoglobulin replacement therapy was greatly improved in the 1930s and 1940s when fractionation techniques were developed that allowed separation of plasma proteins into stable fractions with different biologic functions, including targeted treatment of poliomyelitis, measles, mumps, pertussis, and hepatitis A. Although largely replaced by vaccines, this foundation for the production of polyclonal immunoglobulins remains in use today and has lead to the development of multiple applications of immunoglobulin therapy for infectious and noninfectious diseases.