Status: Funded - Open
Investigating the effect of Intravenous immunoglobulin (IVIG) treatment on the immunological and inflammatory response in childhood encephalitis
BACKGROUND: Encephalitis is a serious neurological disorder that affects children. Mortality and morbidity rates are as high as 10% and 60% respectively, despite standard treatment. A balance between an effective immunological response and limited tissue damage is critical in infections of the central nervous system due to its limited regenerative capacity. Regulatory T cells (Tregs) are important in determining this balance, thereby limiting the progression of clinical disease and tissue damage.
GAP: There is evolving evidence of a beneficial role of IVIG in encephalitis from both small scale and experimental studies. IVIG up regulates Treg function in other conditions that bear similar pathogenesis to encephalitis. However, the mechanism of action of IVIG in childhood encephalitis is unknown.
HYPOTHESIS: We hypothesize that IVIG modulates the immune response in encephalitis by increasing the frequency and suppressive function of Tregs.
METHODS: A parent Phase III efficacy trial of IVIG in encephalitis is underway. In the parent study, children (aged 6 weeks to 16 years) will be randomised to receive IVIG or placebo in addition standard treatment. For the current project, blood samples will be obtained before and after study treatment from fourteen children in each parent study treatment arm (n=28). We aim to characterise the effect of IVIG on the inflammatory and immunological response in children with encephalitis by exploring its effect on the Treg population.
IMPACT: Data derived from this project will provide additional evidence to characterise the role of IVIG in encephalitis and may identify immunomodulatory pathways that could serve as key targets for treatment thus supporting the use of other readily available specific treatment and/or future research work into identifying newer treatment for childhood encephalitis