Immunotherapy in Peripheral Neuropathies

Neurotherapeutics. 2016 Jan;13(1):96-107. doi: 10.1007/s13311-015-0401-7.

Abstract

Immunotherapy has been investigated in a small subset of peripheral neuropathies, including an acute one, Guillain-Barré syndrome, and 3 chronic forms: chronic inflammatory demyelinating polyradiculoneuropathy, multifocal motor neuropathy, and neuropathy associated with IgM anti-myelin-associated glycoprotein. Several experimental studies and clinical data are strongly suggestive of an immune-mediated pathogenesis. Either cell-mediated mechanisms or antibody responses to Schwann cell, compact myelin, or nodal antigens are considered to act together in an aberrant immune response to cause damage to peripheral nerves. Immunomodulatory treatments used in these neuropathies aim to act at various steps of this pathogenic process. However, there are many phenotypic variants and, consequently, there is a significant difference in the response to immunotherapy between these neuropathies, as well as a need to improve our knowledge and long-term management of chronic forms.

Keywords: Chronic inflammatory demyelinating polyradiculoneuropathy; Guillain-Barré syndrome; IgM anti-myelin-associated-glycoprotein neuropathy; Immune-mediated neuropathies; Immunomodulatory treatments; Multifocal motor neuropathy.

Publication types

  • Review

MeSH terms

  • Guillain-Barre Syndrome / therapy
  • Humans
  • Immunologic Factors / therapeutic use
  • Immunotherapy*
  • Peripheral Nervous System Diseases / therapy*
  • Plasma Exchange
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / therapy

Substances

  • Immunologic Factors