Nervenheilkunde 2010; 29(11): 723-728
DOI: 10.1055/s-0038-1628848
Update Neurologie
Schattauer GmbH

Klinische Studien und Therapieoptionen bei Immunneuropathien

Clinical studies and treatment options for immune neuropathies
B. C Kieseier
1   Neurologische Klinik; Heinrich-Heine-Universität Düsseldorf
,
H. C Lehmann
1   Neurologische Klinik; Heinrich-Heine-Universität Düsseldorf
,
G Meyer zu Hörste
1   Neurologische Klinik; Heinrich-Heine-Universität Düsseldorf
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Eingegangen am: 18. Januar 2010

angenommen am: 29. Januar 2010

Publikationsdatum:
31. Januar 2018 (online)

Zusammenfassung

Immunneuropathien stellen eine äußerst heterogene Gruppe von akut, zum überwiegenden Teil aber chronisch verlaufenden Erkrankungen mit gravierender Morbidität dar, die das periphere Nervensystem in verschiedenen Facetten betreffen. In klinischen Studien konnte die Bedeutung immunmodulierender und -supprimierender Therapiestrategien unterstrichen werden, wobei weiterhin Bedarf zur Entwicklung wirksamerer Therapieoptionen besteht, um diese mit Langzeitbehinderung assoziierten Erkrankungen besser behandeln zu können.

Summary

Immune neuropathies are a clinical heterogeneous group of different inflammatory diseases of the peripheral nervous system, mostly with a chronic progression. There are reliable data on the treatment using immunosuppressive or -modulatory drugs. But there is still an urgent need for more effective longterm treatment options.

 
  • Literatur

  • 1 Hughes R. A. C, Cornblath D. R. Guillain-Barré syndrome. Lancet 2005; 366: 1653-1666.
  • 2 Köller H. et al. Chronic inflammatory demyelinating polyneuropathy. N Engl J Med 2005; 352: 1343-1356.
  • 3 Lehmann H. C. et al. Plasma exchange in neuroimmunological disorders: part 2. Treatment of neuromuscular disorders. Arch Neurol 2006; 63: 1066-1071.
  • 4 The French Cooperative Group on Plasma Exchange in Guillain-Barré Syndrome. Appropriate number of plasma exchanges in Guillain-Barré syndrome. Ann Neurol 1997; 41: 298-306.
  • 5 Gold R, Stangel M, Dalakas M. C. Drug Insight: the use of intravenous immunoglobulin in neurologytherapeutic considerations and practical issues. Nat Clin Pract Neurol 2007; 03: 36-44.
  • 6 Pritchard J. et al. A randomized controlled trial of recombinant interferon-beta 1a in Guillain-Barre syndrome. Neurology 2003; 61: 1282-1284.
  • 7 Jacobs B. C. et al. Campylobacter jejuni infections and anti-GM1 antibodies in Guillain-Barre syndrome. Ann Neurol 1996; 40: 181-187.
  • 8 Rotta F. T. et al. The spectrum of chronic inflammatory demyelinating polyneuropathy. J Neurol Sci 2000; 173: 129-139.
  • 9 Yuki N. et al. Clinical features and response to treatment in Guillain-Barre syndrome associated with antibodies to GM1b ganglioside. Ann Neurol 2000; 47: 314-321.
  • 10 Kieseier B. C. et al. Advances in understanding and treatment of immune-mediated disorders of the peripheral nervous system. Muscle Nerve 2004; 30: 131-156.
  • 11 Hughes R. A. C. et al. Immunotherapy for Guillain-Barre syndrome: a systematic review. Brain 2007; 130: 2245-2257.
  • 12 Guillain-Barré Syndrome Steroid Trial Group. Double-blind trial of intravenous methylprednisolone in Guillain-Barré syndrome. Lancet 1993; 341: 586-590.
  • 13 Van Koningsveld R. et al. Effect of methylprednisolone when added to standard treatment with intravenous immunoglobulin for Guillain-Barré syndrome: randomised trial. Lancet 2004; 363: 192-196.
  • 14 Köller H. et al. Chronic inflammatory demyelinating neuropathy – update on pathogenesis, diagnostic criteria and therapy. Current Opinion in Neurology 2005; 18: 273-278.
  • 15 Kieseier B. C, Wiendl H, Hartung H. P. The inflamed peripheral nervous system: update on immune therapies. Current Opinion in Neurology 2006; 19: 433-436.
  • 16 Gold R, Kieseier B. C. Therapy of immune neuropathies with intravenous immunoglobulins. Journal of Neurology 2006; 253: 59-63.
  • 17 Hughes R. et al. Intravenous immune globulin (10% caprylatechromatography purified) for the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (ICE study): a randomised placebocontrolled trial. Lancet Neurol 2008; 07: 136-144.
  • 18 Köller H. et al. Subcutaneous self-infusions of immunoglobulins as a potential therapeutic regimen in immune-mediated neuropathies. J Neurol 2006; 253 (11) 1505-1506.
  • 19 Lee D. H. et al. Subcutaneous immunoglobulin infusion: A new therapeutic option in chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2008; 37 (03) 406-409.
  • 20 Kieseier B. C, Dalakas M. C, Hartung H. P. Immune mechanisms in chronic inflammatory demyelinating neuropathy. Neurology 2002; 59: 7-12.
  • 21 Nobile-Orazio E, Cappellari A, Priori A. Multifocal motor neuropathy: current concepts and controversies. Muscle Nerve 2005; 31 (06) 663-680.
  • 22 Federico P. et al. Multifocal motor neuropathy improved by IVIg. Randomized, double-blind, placebo-controlled study. Neurology 2000; 55: 1256-1262.
  • 23 Koski C. L. Initial and long-term management of autoimmune neuropathies. CNS Drugs 2005; 19: 1033-1048.
  • 24 Umapathi T. et al. Immunosuppressive treatment for multifocal motor neuropathy. Cochrane Database Syst Rev 2002; D003217.
  • 25 Lehmann H. C. et al. The clinical value of therapeutic plasma exchange in multifocal motor neuropathy. Journal of the Neurological Sciences 2008; 271: 34-39.
  • 26 Dyck P. J. et al. Plasma exchange in chronic inflammatory demyelinating polyradiculoneuropathy. N Engl J Med 1986; 314: 461-465.
  • 27 Hahn A. F. et al. Plasma-exchange therapy in chronic inflammatory demyelinating polyneuropathy. A double-blind, sham-controlled, cross-over study. Brain 1996; 119 (04) 1055-1066.
  • 28 Lehmann H. C, Hartung H. P, Hetzel G. R, Kieseier B. C. Plasmapherese als Therapieoption bei neurologischen Erkrankungen. Der Nervenarzt 2007; 78: 166-170.
  • 29 Mehndiratta M. M, Hughes R. A. Corticosteroids for chronic inflammatory demyelinating polyradiculoneuropathy. Cochrane Database Syst Rev 2002; CD002062.
  • 30 Lopate G, Pestronk A, Al-Lozi M. Treatment of chronic inflammatory demyelinating polyneuropathy with high-dose intermittent intravenous methylprednisolone. Arch Neurol 2005; 62: 249-254.
  • 31 Dyck P. J. et al. Combined azathioprine and prednisone in chronic inflammatory-demyelinating polyneuropathy. Neurology 1985; 35: 1173-1176.
  • 32 Hughes R. A. C. et al. Practice parameter: Immunotherapy for Guillain-Barre syndrome: Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2003; 61: 736-740.
  • 33 Fialho D. et al. Treatment of chronic inflammatory demyelinating polyradiculoneuropathy with methotrexate. J Neurol Neurosurg Psychiatry 2006; 77: 544-547.
  • 34 Mahattanakul W. et al. Treatment of chronic inflammatory demyelinating polyneuropathy with cyclosporin-A. J Neurol Neurosurg Psychiatry 1996; 60: 185-187.
  • 35 Visudtibhan A, Chiemchanya S, Visudhiphan P. Cyclosporine in chronic inflammatory demyelinating polyradiculoneuropathy. Pediatr Neurol 2005; 33: 368-372.
  • 36 Frohman E. M. et al. Mycophenolate mofetil in multiple sclerosis. Clin Neuropharmacol 2004; 27: 80-83.
  • 37 Schneider-Gold C, Hartung H. P, Gold R. Mycophenolate mofetil and tacrolimus: New therapeutic options in neuroimmunological diseases. Muscle Nerve 2006; 34: 284-291.
  • 38 Gorson K. C, Amato A. A, Ropper A. H. Efficacy of mycophenolate mofetil in patients with chronic immune demyelinating polyneuropathy. Neurology 2004; 63: 715-717.
  • 39 Piepers S, van den Berg-Vos R, van der Pol W. L. Mycophenolate mofetil as adjunctive therapy for MMN patients: a randomized, controlled trial. Brain 2007; 130: 2004-2010.
  • 40 Gladstone D. E, Prestrud A. A, Brannagan T. H. Highdose cyclophosphamide results in long-term disease remission with restoration of a normal quality of life in patients with severe refractory chronic inflammatory demyelinating polyneuropathy. J Peripher Nerv Syst 2005; 10: 11-16.
  • 41 Glennie M. J. et al. Mechanisms of killing by anti- CD20 monoclonal antibodies. Mol Immunol 2007; 44 (16) 3823-3837.
  • 42 Renaud S. et al. Rituximab in the treatment of polyneuropathy associated with anti-MAG antibodies. Muscle Nerve 2003; 27: 611-615.
  • 43 Renaud S. et al. High-dose rituximab and anti- MAG-associated polyneuropathy. Neurology 2006; 66: 742-744.
  • 44 Ruegg S. J, Fuhr P, Steck A. J. Rituximab stabilizes multifocal motor neuropathy increasingly less responsive to IVIg. Neurology 2004; 63: 2178-2179.
  • 45 Broglio L, Lauria G. Worsening after rituximab treatment in anti-mag neuropathy. Muscle Nerve 2005; 32: 378-379.
  • 46 Browning J. L. B cells move to centre stage: novel opportunities for autoimmune disease treatment. Nat Rev Drug Discov 2006; 05: 564-576.
  • 47 Meyer Gzu Hörste, Hartung H. P, Kieseier B. C. From bench to bedside – experimental rationale for immune-specific therapies in the inflamed peripheral nerve. Nature Clinical Practice Neurology 2007; 03: 198-211.
  • 48 Hirst C, Raasch S, Llewelyn G, Robertson N. Remission of chronic inflammatory demyelinating polyneuropathy after alemtuzumab (Campath 1H). J Neurol Neurosurg Psychiatry 2006; 77: 800-802.
  • 49 Report from an ad hoc subcommittee of the American Academy of Neurology AIDS Task Force. Research criteria for diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). Neurology 1991; 41: 617-618.
  • 50 Hughes R. A. C. et al. Randomized controlled trial of intravenous immunoglobulin versus oral prednisolone in chronic inflammatory demyelinating polyradiculoneuropathy. Ann Neurol 2001; 50: 195-201.
  • 51 Wolf C. et al. No efficacy of natalizumab in a patient with chronic inflammatory demyelinating polyneuritis. Arch Neurol. 2010 im Druck..
  • 52 Kieseier B. C, Lehmann H, Hartung H. P. Immunneuropathien – von der Pathogenese zur Therapie. Akt Neurol 2008; 35: 177-184.
  • 53 Engelhardt A. Immunvermittelte Polyneuropathien. Nervenheilkunde 2007; 26 (07) 567-571.
  • 54 Hahn K, Husstedt I, Arendt G. HIV-assoziierte Neuropathien. Nervenheilkunde 2008; 27 (10) 889-897.
  • 55 Dörr J, Zipp F. Guillain-Barré-Syndrom – Aktuelle Aspekte der Pathogenese, Diagnostik und Therapie. Nervenheilkunde 2007; 26 (07) 560-566.