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Neonatal Fc receptor (FcRn)-A Novel Therapeutic Approach for Autoimmune Disease Hiroyuki Murai 1 , Daisuke Harada 2 1Department of Neurology, International University of Health and Welfare 2argenx Japan K.K. Keyword: FcRn , IgG , リサイクリング , 自己免疫疾患 , FcRn阻害薬 , recycling , autoimmune disease , FcRn inhibitor pp.183-191
Published Date 2024/2/1
DOI https://doi.org/10.11477/mf.1416202582
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Abstract

Neonatal Fc receptor (FcRn) is involved in recycling of IgG. Recycling begins with IgG-uptake into the cell through pinocytosis. Subsequently, IgG binds to FcRn in acidic vesicles, which results in the recycling of the FcRn-IgG complex to cell surface, and the release of IgG in blood with neutral pH. Whereas IgG unbound to FcRn is not recycled and thus degraded in lysosomes. Therefore, FcRn plays a critical role in maintaining IgG levels in the blood. Recently, FcRn has been considered a therapeutic target for autoimmune diseases caused by IgG autoantibodies, and FcRn inhibitors are developed as therapeutic agents for the diseases. As one example, the administration of an FcRn inhibitor, efgartigimod, reduced IgG and anti-acetylcholine receptor antibody levels in patients with generalized myasthenia gravis (gMG), and improved Myasthenia Gravis Activities of Daily Living score in the phase III trial. In 2022, Efgartigimod Alfa was approved for the treatment of gMG (only when treatment with steroids or non-steroidal immunosuppressive drugs do not lead to sufficient response), regardless of antibody status in Japan. Since FcRn inhibitors have just begun to be used in clinical practice, it is important to accumulate real-world data regarding their efficacy and safety.

(Received August 21, 2023; Accepted October 6, 2023; Published February 1, 2024)


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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