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Immunotherapy in Peripheral Neuropathies.

Jean-Marc Léger1, Raquel Guimarães-Costa2, Cristina Muntean2

  • 1National Referral Center for Rare Neuromuscular Diseases, Institut Hospitalo-Universitaire de Neurosciences, University Hospital Pitié-Salpêtrière and University Pierre et Marie Curie (Paris VI), Paris, France. jean-marc.leger@aphp.fr.

Neurotherapeutics : the Journal of the American Society for Experimental Neurotherapeutics
|November 26, 2015
PubMed
Summary

Immunotherapy shows promise for certain peripheral neuropathies, like Guillain-Barré syndrome. However, varied responses highlight the need for better understanding and management of these immune-mediated nerve disorders.

Keywords:
Chronic inflammatory demyelinating polyradiculoneuropathyGuillain-Barré syndromeIgM anti-myelin-associated-glycoprotein neuropathyImmune-mediated neuropathiesImmunomodulatory treatmentsMultifocal motor neuropathy

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Area of Science:

  • Neurology
  • Immunology
  • Peripheral Nervous System Disorders

Background:

  • Peripheral neuropathies, including Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy, often exhibit immune-mediated pathogenesis.
  • Both cell-mediated immunity and antibody responses targeting peripheral nerve components contribute to nerve damage.

Purpose of the Study:

  • To review the role of immunotherapy in specific peripheral neuropathies.
  • To discuss the immunopathogenesis and treatment strategies for these conditions.
  • To highlight challenges in managing chronic forms and improving patient outcomes.

Main Methods:

  • Review of experimental studies and clinical data on immunotherapy for peripheral neuropathies.
  • Analysis of the immune mechanisms involved in nerve damage.
  • Evaluation of treatment responses across different neuropathy phenotypes.

Main Results:

  • Immunotherapy has been explored in Guillain-Barré syndrome and chronic forms like CIDP, multifocal motor neuropathy, and anti-MAG neuropathy.
  • Evidence strongly suggests an immune basis for these conditions, involving aberrant immune responses.
  • Variability in treatment response exists due to diverse disease phenotypes.

Conclusions:

  • Immunotherapy targets various steps in the pathogenic process of immune-mediated peripheral neuropathies.
  • Further research is needed to enhance understanding and long-term management, particularly for chronic subtypes.
  • Optimizing immunotherapy requires addressing phenotypic variations and improving treatment efficacy.