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慢性炎症性脱髄性疾患における自己抗体は徐々に解明されつつある。中でも,近年ランヴィエ絞輪部構成蛋白が標的抗原として注目されている。慢性炎症性脱髄性多発根ニューロパチーにおけるコンタクチン1やニューロファシン155はその主なものである。これらの自己抗体は病態を反映していることが多く,治療法選択や予後予測に重要である。
Abstract
Autoantibodies in chronic demyelinating neuropathies have been explored for several years. Recently, the peptides in the nodes of Ranvier have been the focus of attention in finding targets of autoantibodies. Until now, the most popular autoantibodies have been contactin-1 and neurofascin-155 for chronic demyelinating polyradiculoneuropathy (CIDP), GM1-ganglioside for multifocal motor neuropathy, and myelin-associated glycoprotein for polyneuropathy associated with monoclonal gammopathy of unknown significance. IgG is restricted to the IgG4 subtype in CIDP, indicating anti-inflammatory mechanisms related to the functional modification of the nodes of Ranvier. The clinical characteristics are also correlated with the presence of each of the autoantibodies, indicating the importance of auto-antibody screening in the development of suitable therapeutic strategies for each patient.
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