[Pathogenesis and treatment of neuropathy--recent advances]

Wide variety of underlying mechanisms are present for pathogenesis and pathophysiology of neuropaties, some of the which are being elucidated recently. Remarkable recent advances are discovery of causative gene mutations of various hereditary neuropathies and elucidation of pathogenic mechanism of inflammatory demyelinating neuropathy. Particularly, causative gene mutations for Charcot-Marie-Tooth (CMT) disease and pathogenic role of glycolipid antigens for Guillain-Barré syndrome have recently been documented. Moreover, efficacious treatment based on the background pathophysiology have also been developed, such as intravenous immunoglobulin infusion and plasmapheresis for inflammatory demyelinating neuropathy, and liver transplantation for familial amyloid polyneuropathy. These advances on the understanding of pathogenic mechanisms and development of treatment have changed the clinical approach to peripheral neuropathies. In this review, I overviewed the recent advances on three neuropathies, familial amyloid polyneuropathy, chronic inflammatory demyelinating polyneuropathy, and Charcot-Marie-Tooth disease with special reference to pathogenic mechanism and treatment.