免疫介在性ニューロパチーの病態と治療
「はじめに」免疫機構は生体内で普遍的に機能しているが, その異常が中心的な役割を担って発症する末梢神経疾患が免疫介在性ニューロパチーである. 免疫介在性ニューロパチーには, 免疫学的な機序を介して末梢神経線維に対する障害が直接加わるGuillain-Barre症候群(Guillain-Barre syndrome: GBS)や慢性炎症性脱髄性ニューロパチー(chronic inflammatory demyelinating polyneuropathy: CIDP), 多巣性運動ニューロパチー(multifocal motor neuropathy: MMN)以外に, 末梢神経を構成する神経...
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| Published in | 神経治療学 Vol. 39; no. 4; pp. 444 - 446 |
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| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本神経治療学会
2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0916-8443 2189-7824 |
| DOI | 10.15082/jsnt.39.4_444 |
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| Abstract | 「はじめに」免疫機構は生体内で普遍的に機能しているが, その異常が中心的な役割を担って発症する末梢神経疾患が免疫介在性ニューロパチーである. 免疫介在性ニューロパチーには, 免疫学的な機序を介して末梢神経線維に対する障害が直接加わるGuillain-Barre症候群(Guillain-Barre syndrome: GBS)や慢性炎症性脱髄性ニューロパチー(chronic inflammatory demyelinating polyneuropathy: CIDP), 多巣性運動ニューロパチー(multifocal motor neuropathy: MMN)以外に, 末梢神経を構成する神経線維以外の成分に対する免疫反応の結果, 末梢神経線維が障害される血管炎性ニューロパチー等が代表的である. |
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| AbstractList | 「はじめに」免疫機構は生体内で普遍的に機能しているが, その異常が中心的な役割を担って発症する末梢神経疾患が免疫介在性ニューロパチーである. 免疫介在性ニューロパチーには, 免疫学的な機序を介して末梢神経線維に対する障害が直接加わるGuillain-Barre症候群(Guillain-Barre syndrome: GBS)や慢性炎症性脱髄性ニューロパチー(chronic inflammatory demyelinating polyneuropathy: CIDP), 多巣性運動ニューロパチー(multifocal motor neuropathy: MMN)以外に, 末梢神経を構成する神経線維以外の成分に対する免疫反応の結果, 末梢神経線維が障害される血管炎性ニューロパチー等が代表的である. |
| Author | 藤岡, 俊樹 |
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| References | 5) Koski CL : Characterization of complement–fixing antibodies to peripheral nerve myelin in Guillain–Barre syndrome. Ann Neurol 27 Suppl : S44–S47, 1990 2) Toscano G, Palmerini F, Ravaglia S et al : Guillain–Barre Syndrome Associated with SARS–CoV–2. N Engl J Med 382 : 2574–2576, 2020 4) Luijten LWG, Leonhard SE, van der Eijk AA et al : Guillain–Barre syndrome after SARS–CoV–2 infection in an international prospective cohort study. Brain 144 : 3392–3404, 2021 8) Eftimov F, Vermeulen M, van Doorn PA et al : Long–term remission of CIDP after pulsed dexamethasone or short–term prednisolone treatment. Neurology 78 : 1079–1084, 2012 11) Shimizu S, Iijima M, Fukami Y et al : Efficacy and Safety of Rituximab in Refractory CIDP With or Without IgG4 Autoantibodies (RECIPE) : Protocol for a Double–Blind, Randomized, Placebo–Controlled Clinical Trial. JMIR Res Protoc 9 : e17117, 2020 1) Yuki N, Hartung HP : Guillain–Barre syndrome. N Engl J Med 366 : 2294–2304, 2012 17) Uncini A, Vallat JM : Autoimmune nodo–paranodopathies of peripheral nerve : the concept is gaining ground. J Neurol Neurosurg Psychiatry 89 : 627–635, 2018 18) 竹下幸男，神田 隆：血管炎性ニューロパチーの診断と治療．Spinal Surgery 34 : 20–24, 2020 14) Cats EA, van der Pol WL, Piepers S et al : Correlates of outcome and response to IVIg in 88 patients with multifocal motor neuropathy. Neurology 75 : 818–825, 2010 9) Nobile–Orazio E, Cocito D, Jann S et al : Frequency and time to relapse after discontinuing 6–month therapy with IVIg or pulsed methylprednisolone in CIDP. J Neurol Neurosurg Psychiatry 86 : 729–734, 2015 6) https://clinicaltrials.gov/ct2/show/NCT04752566?term=Eculizumab&draw=2 : 2022/3/31 19) Nishi R, Koike H, Ohyama K et al : Association Between IL–5 Levels and the Clinicopathologic Features of Eosinophilic Granulomatosis With Polyangiitis. Neurology 96 : 226–229, 2021 13) https://clinicaltrials.gov/ct2/show/NCT05084053 : 2022/3/31 12) Heo YA : Efgartigimod : First Approval. Drugs 82 : 341–348, 2022 3) Keddie S, Pakpoor J, Mousele C et al : Epidemiological and cohort study finds no association between COVID–19 and Guillain–Barre syndrome. Brain 144 : 682–693, 2021 15) Cocito D, Merola A, Romagnolo A et al : Subcutaneous immunoglobulin in CIDP and MMN : a different long–term clinical response? J Neurol Neurosurg Psychiatry 87 : 791–793, 2016 16) Querol L, Devaux J, Rojas–Garcia R et al : Autoantibodies in chronic inflammatory neuropathies : diagnostic and therapeutic implications. Nat Rev Neurol 13 : 533–547, 2017 7) Van den Bergh PYK, van Doorn PA, Hadden RDM et al : European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy : Report of a joint Task Force–Second revision. Eur J Neurol 28 : 3556–3583, 2021 10) Bus SRM, Broers MC, Lucke IM et al : Clinical outcome of CIDP one year after start of treatment : a prospective cohort study. J Neurol 269 : 945–955, 2022 |
| References_xml | – reference: 15) Cocito D, Merola A, Romagnolo A et al : Subcutaneous immunoglobulin in CIDP and MMN : a different long–term clinical response? J Neurol Neurosurg Psychiatry 87 : 791–793, 2016 – reference: 2) Toscano G, Palmerini F, Ravaglia S et al : Guillain–Barre Syndrome Associated with SARS–CoV–2. N Engl J Med 382 : 2574–2576, 2020 – reference: 4) Luijten LWG, Leonhard SE, van der Eijk AA et al : Guillain–Barre syndrome after SARS–CoV–2 infection in an international prospective cohort study. Brain 144 : 3392–3404, 2021 – reference: 10) Bus SRM, Broers MC, Lucke IM et al : Clinical outcome of CIDP one year after start of treatment : a prospective cohort study. J Neurol 269 : 945–955, 2022 – reference: 19) Nishi R, Koike H, Ohyama K et al : Association Between IL–5 Levels and the Clinicopathologic Features of Eosinophilic Granulomatosis With Polyangiitis. Neurology 96 : 226–229, 2021 – reference: 11) Shimizu S, Iijima M, Fukami Y et al : Efficacy and Safety of Rituximab in Refractory CIDP With or Without IgG4 Autoantibodies (RECIPE) : Protocol for a Double–Blind, Randomized, Placebo–Controlled Clinical Trial. JMIR Res Protoc 9 : e17117, 2020 – reference: 13) https://clinicaltrials.gov/ct2/show/NCT05084053 : 2022/3/31 – reference: 7) Van den Bergh PYK, van Doorn PA, Hadden RDM et al : European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy : Report of a joint Task Force–Second revision. Eur J Neurol 28 : 3556–3583, 2021 – reference: 14) Cats EA, van der Pol WL, Piepers S et al : Correlates of outcome and response to IVIg in 88 patients with multifocal motor neuropathy. Neurology 75 : 818–825, 2010 – reference: 3) Keddie S, Pakpoor J, Mousele C et al : Epidemiological and cohort study finds no association between COVID–19 and Guillain–Barre syndrome. Brain 144 : 682–693, 2021 – reference: 8) Eftimov F, Vermeulen M, van Doorn PA et al : Long–term remission of CIDP after pulsed dexamethasone or short–term prednisolone treatment. Neurology 78 : 1079–1084, 2012 – reference: 9) Nobile–Orazio E, Cocito D, Jann S et al : Frequency and time to relapse after discontinuing 6–month therapy with IVIg or pulsed methylprednisolone in CIDP. J Neurol Neurosurg Psychiatry 86 : 729–734, 2015 – reference: 12) Heo YA : Efgartigimod : First Approval. Drugs 82 : 341–348, 2022 – reference: 18) 竹下幸男，神田 隆：血管炎性ニューロパチーの診断と治療．Spinal Surgery 34 : 20–24, 2020 – reference: 1) Yuki N, Hartung HP : Guillain–Barre syndrome. N Engl J Med 366 : 2294–2304, 2012 – reference: 17) Uncini A, Vallat JM : Autoimmune nodo–paranodopathies of peripheral nerve : the concept is gaining ground. J Neurol Neurosurg Psychiatry 89 : 627–635, 2018 – reference: 16) Querol L, Devaux J, Rojas–Garcia R et al : Autoantibodies in chronic inflammatory neuropathies : diagnostic and therapeutic implications. Nat Rev Neurol 13 : 533–547, 2017 – reference: 5) Koski CL : Characterization of complement–fixing antibodies to peripheral nerve myelin in Guillain–Barre syndrome. Ann Neurol 27 Suppl : S44–S47, 1990 – reference: 6) https://clinicaltrials.gov/ct2/show/NCT04752566?term=Eculizumab&draw=2 : 2022/3/31 |
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| SubjectTerms | biological drug chronic inflammatory demyelinating polyneuropathy (CIDP) Guillain–Barré syndrome SARS–Cov–2 pandemic vasculitic neuropathy |
| Title | 免疫介在性ニューロパチーの病態と治療 |
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