Autoantibodies in chronic inflammatory neuropathies: diagnostic and therapeutic implications

@article{Querol2017AutoantibodiesIC,
  title={Autoantibodies in chronic inflammatory neuropathies: diagnostic and therapeutic implications},
  author={Luis A Querol and J{\'e}r{\^o}me Devaux and Ricard Rojas-Garc{\'i}a and Isabel Illa},
  journal={Nature Reviews Neurology},
  year={2017},
  volume={13},
  pages={533-547}
}
The chronic inflammatory neuropathies (CINs) are rare, very disabling autoimmune disorders that generally respond well to immune therapies such as intravenous immunoglobulin (IVIg). The most common forms of CIN are chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy, and polyneuropathy associated with monoclonal gammopathy of unknown significance. The field of CIN has undergone a major advance with the identification of IgG4 autoantibodies directed… 

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References

SHOWING 1-10 OF 166 REFERENCES

Paranodal and other autoantibodies in chronic inflammatory neuropathies.

The heterogeneity of chronic inflammatory neuropathies is being unraveled with the description of specific autoantibodies and their association with small disease subtypes, and the recently described paranodal autoantibia anti-CNTN1 and NF155 have direct clinical value and seem to determine response to treatment.

Autoantibodies to nodal isoforms of neurofascin in chronic inflammatory demyelinating polyneuropathy

The data demonstrate that the pathogenic mechanisms responsible for chronic inflammatory demyelination polyneuropathy are broad and may include dysfunctions at the nodes of Ranvier in a subgroup of patients and that autoantibody depletion and recovery of conduction block and distal motor amplitude suggest a nodo-paranodopathy.

Chronic inflammatory demyelinating polyradiculoneuropathy: from pathology to phenotype

In this review, the roles of the cellular and humoral immune systems in the pathogenesis of CIDP will be discussed and delineation of clinical phenotypes and the underlying disease mechanisms might help guide diagnostic and individualised treatment strategies for CIDs.

Autoimmune antigenic targets at the node of Ranvier in demyelinating disorders

The molecular anatomy of the node of Ranvier is explored, focusing on proteins with extracellular domains that could serve as antigens, and the clinical implications of node-specific antibody responses are addressed.

Diagnosis and treatment of chronic acquired demyelinating polyneuropathies

  • N. Latov
  • Medicine, Biology
    Nature Reviews Neurology
  • 2014
Chronic neuropathies are operationally classified as primarily demyelinating or axonal, on the basis of electrodiagnostic or pathological criteria, and hereditary or acquired—this distinction is important, because the acquired neuro Pathies are immune-mediated and, thus, amenable to treatment.

Chronic inflammatory demyelinating polyradiculoneuropathy and variants: where we are and where we should go

Several data support the role of the immune system in the pathogenesis of CIDP even if the precise targets and actors (antibodies and lymphocytes) of this immune response remain uncertain.

Pathogenesis and Treatment of Anti-MAG Neuropathy

  • M. Dalakas
  • Biology, Medicine
    Current treatment options in neurology
  • 2010
Open label studies and a recent randomized controlled trial indicate that rituximab is emerging as the best agent available, providing long-term benefits to almost half of these patients, and encouraging results need confirmation with a larger trial.

Neurofascin as a target for autoantibodies in peripheral neuropathies

Autoantibodies to NF are detected in a very small proportion of patients with AIDP and patients with CIDP, but may nevertheless be pathogenic in these cases.

Heterogeneity of Polyneuropathy Associated with Anti-MAG Antibodies

The data suggest that polyneuropathy associated with anti-MAG antibodies is less homogeneous than previously said and that the pathophysiology of the condition is likely to be heterogeneous as well with the self-antigen being MAG in most of the patients but possibly being another component of myelin in the others.
...