Systemic Inflammation as a Modulator of FcRn-dependent IgG Pharmacokinetics: Implications for bNAbs in HIV Prevention

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This review examines how systemic inflammation alters the persistence of broadly neutralizing antibodies (bNAbs) for HIV prevention by affecting FcRn-mediated IgG recycling. Clinical and mechanistic data indicate inflammation downregulates FCGRT and promotes competitive saturation of FcRn pathways, accelerating antibody clearance and risking subtherapeutic exposures with standard dosing—particularly in high-inflammation populations such as women in sub-Saharan Africa.

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