Koga Michiaki
Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine.
Brain Nerve. 2018 Apr;70(4):395-403. doi: 10.11477/mf.1416201012.
Recent reserch has successfully identified several autoantibodies in chronic inflammatory demyelinating polyneuropathy (CIDP). Most of those identified were IgG4 antibodies targeting cell adhesion molecules around the node of Ranvier of myelinated fibers. In particular, much has been learned concerning the pathogenic roles of antibodies against neurofascin 155. Growing evidence has revealed that patients with CIDP with these antibodies are characterized by IVIg-resistance and lack typical demyelinating findings on biopsied nerve fibers, both of which could make diagnosis and treatment difficult without autoantibody measurement. Clinicians should recognize that it is now essential to measure autoantibodies in CIDP and utilize antibody testing.
最近的研究已成功在慢性炎性脱髓鞘性多发性神经病（CIDP）中鉴定出几种自身抗体。其中大多数鉴定出的是针对有髓纤维郎飞结周围细胞粘附分子的IgG4抗体。特别是，关于抗神经束蛋白155抗体的致病作用已有很多了解。越来越多的证据表明，患有这些抗体的CIDP患者具有静脉注射免疫球蛋白抵抗性，并且在活检的神经纤维上缺乏典型的脱髓鞘表现，若不进行自身抗体检测，这两者都会使诊断和治疗变得困难。临床医生应认识到，现在对CIDP患者进行自身抗体检测并利用抗体检测至关重要。
