Aerosol delivery of Rhodoccocus equi IgG to the lungs of ponies

The objective of this study was to determine if R. equi IgG purified from commmercially available hyperimmune R. equi plasma and delivered to the lungs of adult ponies would cause a local inflammatory response and if increases in total and R. equi specific IgG occurred post administration. IgG was purified and concentrated from plasma via protein G affinity chromatography. A cross over study was performed. Eight healthy adult ponies were randomly assigned to two groups of four; each pony acted as its own control. Either the IgG product or 0.9% Saline was delivered via a vibrating mesh nebulizer during the first treatment phase. During the second treatment phase ponies recieved the oppostie treatment. A 4 week washout period was allowed between phases. Bronchoalveolar fluid was recovered using a low volume endoscopic technique prior to aerosolization (time 0), and at 1 hr, 6 hrs, and 24 hours post administration. The BAL fluid total IgG concentration and R. equi specific IgG titers were determined via ELISA and cytologic analysis was performed. No clinically significant local inflammatory response was identified in response to IgG treatment. While total IgG concentrations were increased at T1 compared to T0, no significant effects of time were found (P=0.19). However, overall significantly higher concentrations of total IgG were found after administration of saline when compared to IgG administration (P=0.023).  While the R. equi specific titer increased at T1 after IgG administration, no significant difference was identified between treatment or time (P=0.261). Overall the individual response to IgG was variable. It is possible that the protein rich IgG acted as a relatively hypertonic solution and caused fluid influx from the pulmonary parenchyma after treatment thereby diluting the total IgG present when compared to saline administration. This conclusion cannot be verified as BAL dilution correction was not performed. However, it is unknown what titer or level of increased IgG is nessecary to assist with prevention of disease. Future research should focus on the effect of R. equi specific IgG on pulmonary cells to determine if administration of local R. equi specific IgG would alter intrapulmonary immune responses to R. equi.