Chronisch inflammatorische demyelinisierende Polyneuropathie

H. C. Lehmann

doi:10.1055/s-0038-1627709

Nervenheilkunde, Table of Contents

Nervenheilkunde 2014; 33(07/08): 535-539
DOI: 10.1055/s-0038-1627709

Fortbildung Karlsruhe

Schattauer GmbH

Chronisch inflammatorische demyelinisierende Polyneuropathie

Aktuelle Entwicklungen bei Diagnose und TherapieRecent developments in diagnosis and therapy of chronic inflammatory demyelinating polyneuropathy

H. C. Lehmann

¹Klinik und Poliklinik für Neurologie, Uniklinik Köln

› Author Affiliations

Abstract

Zusammenfassung

Die chronisch inflammatorische demyelinisierende Polyneuropathie (CIDP) ist eine sporadisch auftretende, chronisch progredient oder schubförmige verlaufende entzündliche periphere Neuropathie. Klinische und experimentelle Daten belegen, dass die CIDP eine autoimmun-vermittelte Neuropathie ist, bei der eine aberrante humorale und zelluläre Immunantwort gegen Bestandteile peripherer Nerven entscheidend beteiligt sind. In den vergangenen Jahren sind weitere Erkenntnisse hinsichtlich der Epidemiologie und der Pathogenese dieser Erkrankung erzielt worden. Von klinischer Seite wird zunehmend der Stellenwert bildgebende Verfahren zur Diagnostik der CIDP wissenschaftlich untersucht. Ergänzt werden diese Fortschritte durch die Ergebnisse neuerer Therapiestudien, die zu einer Verbesserung der Langzeitbehandlung von CIPD-Patienten führen. Die vorliegende Arbeit gibt einen Überblick über diese neuesten Entwicklungen auf dem Gebiet der CIDP.

Summary

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a sporadically occurring, chronic progressive or relapsing inflammatory peripheral neuropathy. There is clinical and experimental evidence that CIDP is caused by an aberrant humoral and cellular immune response against components of peripheral nerve tissue. In the last years substantial progress has been made for further characterization of the epidemiology and the pathogenesis of the disease. Likewise, there are clinical approaches that are aimed to decipher the utility of nerve imaging as additional diagnostic measure in CIDP. These advancements are complemented by the results from recent treatment trials that will help to optimize long-term treatment of CIDP patients. This review summarizes some of those recent developments in the field of CIDP.

Schlüsselwörter

Neuropathie - Immunglobuline - Inflammation

Keywords

Neuropathy - immunoglobulins - inflammation

Full Text

References

Literatur
1 Lehmann HC. et al. Pathogenesis and treatment of immune-mediated neuropathies. Ther Adv Neurol Dis 2009; 02: 261-281.
2 Mygland A, Monstad P. Chronic polyneuropathies in vest-agder, norway. Eur J Neurol 2001; 08: 157-165.
3 Kusumi M. et al. Epidemiology of inflammatory neurological and inflammatory neuromuscular diseases in tottori prefecture, japan. Psychiatry Clin Neurosci 1995; 49: 169-174.
4 Iijima M. et al. Prevalence and incidence rates of chronic inflammatory demyelinating polyneuropathy in the japanese population. J Neurol Neurosurg Psychiatry 2008; 79: 1040-1043.
5 Mahdi-Rogers M, Hughes RA. Epidemiology of chronic inflammatory neuropathies in south-east england. Eur J Neurol 2014; 21: 28-33.
6 Laughlin RS. et al. Incidence and prevalence of cidp and the association of diabetes mellitus. Neurology 2009; 73: 39-45.
7 Vallat JM, Sommer C, Magy L. Chronic inflammatory demyelinating polyradiculoneuropathy: Diagnostic and therapeutic challenges for a treatable condition. Lancet Neurol 2010; 09: 402-412.
8 Sasaki M, Ohara S, Oide T, Hayashida K, Hayashi R. An autopsy case of chronic inflammatory demyelinating polyradiculoneuropathy with respiratory failure. Muscle Nerve 2004; 30: 382-387.
9 Chiang MC. et al. Cutaneous innervation in chronic inflammatory demyelinating polyneuropathy. Neurology 2002; 59: 1094-1098.
10 Kim HJ, Jung CG, Jensen MA, Dukala D, Soliven B. Targeting of myelin protein zero in a spontaneous autoimmune polyneuropathy. J Immunol 2008; 181: 8753-8760.
11 Ubogu EE, Yosef N, Xia RH, Sheikh KA. Behavioral, electrophysiological, and histopathological characterization of a severe murine chronic demyelinating polyneuritis model. J Peripher Nerv Syst 2012; 17: 53-61.
12 Winer J, Hughes S, Cooper J, Ben-Smith A, Savage C. Gamma delta t cells infiltrating sensory nerve biopsies from patients with inflammatory neuropathy. J Neurol 2002; 249: 616-621.
13 Sainaghi P. et al. The expression pattern of inflammatory mediators in cerebrospinal fluid differentiates guillain-barré syndrome from chronic inflammatory demyelinating polyneuropathy. Cytokine 2010; 51: 138-143.
14 Csurhes PA. et al. T cell reactivity to p0, p2, pmp-22, and myelin basic protein in patients with guillain-barre syndrome and chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Neurosurg Psychiatry 2005; 76: 1431-1439.
15 Lehmann HC. et al. Plasma exchange in neuroimmunological disorders. Part 2 treatment of neuromuscular disorders. Arch Neurol 2006; 63: 1066-1071.
16 Benedetti L. et al. Rituximab in patients with chronic inflammatory demyelinating polyradiculoneuropathy: A report of 13 cases and review of the literature. J Neurol Neurosurg Psychiatry 2011; 82: 306-308.
17 Yan WX. et al. Passive transfer of demyelination by serum or igg from chronic inflammatory demyelinating polyneuropathy patients. Ann Neurol 2000; 47: 765-775.
18 Sanvito L. et al. Humoral and cellular immune responses to myelin protein peptides in chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Neurosurg Psychiatry 2009; 80: 333-338.
19 Sanvito L. et al. Circulating subsets and cd4(+) cd25(+) regulatory t cell function in chronic inflammatory demyelinating polyradiculoneuropathy. Autoimmunity 2009; 42: 667-677.
20 Querol L. et al. Antibodies to contactin-1 in chronic inflammatory demyelinating polyneuropathy. Ann Neurol 2013; 73: 370-380.
21 PNS JTFotEat. European federation of neurological societies/peripheral nerve society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint task force of the european federation of neurological societies and the peripheral nerve society – first revision. J Peripher Nerv Syst 2010; 15: 1-9.
22 Breiner A, Brannagan TH. Comparison of sensitivity and specificity among 15 criteria for chronic inflammatory demyelinating polyneuropathy. Muscle Nerve. 2013 doi: 10.1002/mus.24088.
23 Mathys C. et al. Peripheral neuropathy: Assessment of proximal nerve integrity by diffusion tensor imaging. Muscle Nerve 2013; 48: 889-896.
24 Kakuda T. et al. Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: A feasibility study. Neuroradiology 2011; 53: 955-960.
25 Goedee HS, Brekelmans GJ, Visser LH. Multifocal enlargement and increased vascularization of peripheral nerves detected by sonography in cidp: A pilot study. Clin Neurophysiol 2013; 125: 154-159.
26 Kerasnoudis A. Nerve ultrasound in a case of chronic inflammatory demyelinating neuropathy. Muscle Nerve 2013; 47: 443-446.
27 Gorson KC. et al. Chronic inflammatory demyelinating polyneuropathy disease activity status: Recommendations for clinical research standards and use in clinical practice. J Peripher Nerv Syst 2010; 15: 326-333.
28 Hartung HP, Lehmann HC, Willison HJ. Peripheral neuropathies: Establishing common clinical research standards for cidp. Nat Rev Neurol 2011; 07: 250-251.
29 Cocito D. et al. A nationwide retrospective analysis on the effect of immune therapies in patients with chronic inflammatory demyelinating polyradiculoneuropathy. Eur J Neurol 2010; 17: 289-294.
30 Tackenberg B. et al. Classifications and treatment responses in chronic immune-mediated demyelinating polyneuropathy. Neurology 2007; 68: 1622-1629.
31 Chan Y, Allen D, Fialho D, Mills K, Hughes R. Predicting response to treatment in chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Neurosurg Psychiatry 2006; 77: 114-116.
32 Kuwabara S. et al. Long term prognosis of chronic inflammatory demyelinating polyneuropathy: A five year follow up of 38 cases. J Neurol Neurosurg Psychiatry 2006; 77: 66-70.
33 van Schaik IN. et al. Pulsed high-dose dexamethasone versus standard prednisolone treatment for chronic inflammatory demyelinating polyradiculoneuropathy (predict study): A doubleblind, randomised, controlled trial. Lancet Neurol 2010; 09: 245-253.