Overview of the pathogenesis and treatment of chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulins

Mahdi-Rogers, Mohamed; Rajabally, Yusuf A.

doi:10.2147/btt.s4881

Cited by 8 publications

(5 citation statements)

References 67 publications

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“…Furthermore, IVIg could modulate macrophage functions, interfering with the production of the macrophage pro-inflammatory factor involved in peripheral nerve degeneration and exerting their immunomodulatory effects acting on several components of the immune system, as observed in chronic inflammatory demyelinating polyneuropathy [ 40 ]. However, these hypotheses are, so far, supported by indirect evidence, and deserve to be further investigated to explain the higher capacity of IVIg to limit macrophages infiltration induced by bortezomib [ 36 ] respect to PTX.…”

Section: Discussionmentioning

confidence: 99%

Human Intravenous Immunoglobulin Alleviates Neuropathic Symptoms in a Rat Model of Paclitaxel-Induced Peripheral Neurotoxicity

Meregalli

Monza

Chiorazzi

et al. 2021

IJMS

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The onset of chemotherapy-induced peripheral neurotoxicity (CIPN) is a leading cause of the dose reduction or discontinuation of cancer treatment due to sensory symptoms. Paclitaxel (PTX) can cause painful peripheral neuropathy, with a negative impact on cancer survivors’ quality of life. While recent studies have shown that neuroinflammation is involved in PTX-induced peripheral neurotoxicity (PIPN), the pathophysiology of this disabling side effect remains largely unclear and no effective therapies are available. Therefore, here we investigated the effects of human intravenous immunoglobulin (IVIg) on a PIPN rat model. PTX-treated rats showed mechanical allodynia and neurophysiological alterations consistent with a severe sensory axonal polyneuropathy. In addition, morphological evaluation showed a reduction of intra-epidermal nerve fiber (IENF) density and evidenced axonopathy with macrophage infiltration, which was more prominent in the distal segment of caudal nerves. Three weeks after the last PTX injection, mechanical allodynia was still present in PTX-treated rats, while the full recovery in the group of animals co-treated with IVIg was observed. At the pathological level, this behavioral result was paralleled by prevention of the reduction in IENF density induced by PTX in IVIg co-treated rats. These results suggest that the immunomodulating effect of IVIg co-treatment can alleviate PIPN neurotoxic manifestations, probably through a partial reduction of neuroinflammation.

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Section: Discussionmentioning

confidence: 99%

Human Intravenous Immunoglobulin Alleviates Neuropathic Symptoms in a Rat Model of Paclitaxel-Induced Peripheral Neurotoxicity

Meregalli

Monza

Chiorazzi

et al. 2021

IJMS

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“…We examined expression of SOCS genes in the samples of peripheral blood cells obtained from AIDP and CIDP patients versus healthy individuals. These two autoimmune conditions have common clinical symptoms, histologic signs and similar therapeutic options (immunosuppressive therapy) (21). The role of aberrant immune responses in these types of neuropathies has been vastly investigated.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Expression of SOCS Genes in Acquired Immune-Mediated Polyneuropathies

et al. 2021

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Acquired immune-mediated polyneuropathies are classified to some subtypes among them are acute and chronic inflammatory demyelinating polyradiculoneuropathies (AIDP and CIDP). These two conditions share some common signs and underlying mechanisms. Based on the roles of Suppressor of cytokine signaling (SOCS) genes in the modulation of immune system reactions, these genes might be involved in the pathogenesis of these conditions. We evaluated expression of SOCS1-3 and SOCS5 genes in the leukocytes of 32 cases of CIDP, 19 cases of AIDP and 40 age- and sex-matched controls using real time PCR method. The Bayesian regression model was used to estimate differences in mean values of genes expressions between cases and control group. Expression levels of SOCS1 and SOCS2 were significantly lower in male patients compared with controls. This sex-specific pattern was also observed for SOCS3 down-regulation. Based on the area under curve values in Receiver Operating Characteristics (ROC) curve, diagnostic powers of SOCS1, SOCS2, SOCS3 and SOCS5 genes in the mentioned disorder were 0.61, 0.73, 0.68 and 0.58, respectively. Expression of none of genes was correlated with age of enrolled cases. The current study shows evidences for participation of SOCS genes in the pathophysiology of acquired immune-mediated polyneuropathies.

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“…The three treatments with scientific evidence deriving from randomized controlled trials are: corticosteroids, plasmapheresis and Ig. ( 53 ) A metaanalysis of the Cochrane Library demonstrated significant improvement in strength with short term Ig use, while the benefits of this drug's long-term use have been confirmed by recent randomized studies. ( 53 - 55 ) Despite the demonstrated benefits of Ig in CIPD and good tolerability of this drug, corticosteroids and plasmapheresis are also options for treatment, especially in cases unresponsive to Ig.…”

Section: "Off-label" Indications For Ig Usementioning

confidence: 99%

“…Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired disorder secondary to a demyelinating process, leading to sensory loss and dysesthesia as well as muscle weakness. ( 53 )…”

Section: "Off-label" Indications For Ig Usementioning

confidence: 99%

Clinical applications of immunoglobulin

Novaretti

Dinardo

2011

Rev. Bras. Hematol. Hemoter.

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Human immunoglobulin is the most used blood product in the clinical practice. Immunoglobulin applications have increased quickly since the elucidation of its immunomodulatory and antiinflammatory properties which turned this blood product into a precious tool in the treatment of numerous diseases that present with humoral immune deficiency or that cause immune system dysfunction. Currently, the approved indications for Ig are: primary immunodeficiencies, secondary immunodeficiencies (multiple myeloma or chronic lymphoid leukemia), Kawasaki syndrome, immune thrombocytopenic purpura, Guillain Barré syndrome, graft-versus-host disease following bone marrow transplantation and repeat infections in HIV children. On the other hand, there are numerous "off-label" indications of immunoglobulin, which represent 20-60% of all clinical applications of this drug. It is important to study all these indications and, above all, the scientific evidence for its use, in order to provide patients with a new therapeutic option without burdening the health system. This review results from a wide selection of papers identified in the Pubmed and Lilacs scientific electronic databases. A group of descriptors were used from human immunoglobulin to the names of each disease that immunoglobulin is clinically applied. Our main objective is to list the numerous indications of immunoglobulin, both authorized and "off-label" and to analyze these indications in the light of the most recent scientific evidence.

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Overview of the pathogenesis and treatment of chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulins

Cited by 8 publications

References 67 publications

Human Intravenous Immunoglobulin Alleviates Neuropathic Symptoms in a Rat Model of Paclitaxel-Induced Peripheral Neurotoxicity

Human Intravenous Immunoglobulin Alleviates Neuropathic Symptoms in a Rat Model of Paclitaxel-Induced Peripheral Neurotoxicity

Assessment of Expression of SOCS Genes in Acquired Immune-Mediated Polyneuropathies

Clinical applications of immunoglobulin

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