Evolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy

Yusuf A Rajabally,1,2 Shahram Attarian,3,4 Emilien Delmont3,4 1Inflammatory Neuropathy Clinic, University Hospitals Birmingham, Birmingham, UK; 2Aston Medical School, Aston University, Birmingham, UK; 3Reference Centre for Neuromuscular Diseases and ALS, Centre Hospitalier Universitaire La Timone, M...

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Autores principales:	Rajabally YA, Attarian S, Delmont E
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	chronic inflammatory demyelinating polyneuropathy dysimmune immunologic inflammatory nodal paranodal. Pathology RB1-214 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/161c9bf6d2914d018c7772711b9f69e7
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spelling	oai:doaj.org-article:161c9bf6d2914d018c7772711b9f69e72021-12-02T15:36:49ZEvolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy1178-7031https://doaj.org/article/161c9bf6d2914d018c7772711b9f69e72020-09-01T00:00:00Zhttps://www.dovepress.com/evolving-immunologic-perspectives-in-chronic-inflammatory-demyelinatin-peer-reviewed-article-JIRhttps://doaj.org/toc/1178-7031Yusuf A Rajabally,1,2 Shahram Attarian,3,4 Emilien Delmont3,4 1Inflammatory Neuropathy Clinic, University Hospitals Birmingham, Birmingham, UK; 2Aston Medical School, Aston University, Birmingham, UK; 3Reference Centre for Neuromuscular Diseases and ALS, Centre Hospitalier Universitaire La Timone, Marseille 13385, France; 4Aix-Marseille University, Inserm, GMGF, Marseille, FranceCorrespondence: Yusuf A RajaballyAston Medical School, Aston University, Aston Triangle, Birmingham B4 7ET, UKEmail y.rajabally@aston.ac.ukAbstract: Chronic inflammatory demyelinating polyneuropathy (CIDP) is the commonest chronic idiopathic dysimmune neuropathy. Pathophysiologic processes involve both cellular and humoral immunity. There are various known forms of CIDP, likely caused by varying mechanisms. CIDP in its different forms is a treatable disorder in the majority of patients. The diagnosis of CIDP is clinical, supported routinely by electrophysiology. Cerebrospinal fluid analysis may be helpful. Routine immunology currently rarely adds to the diagnostic process but may contribute to the identification of an associated monoclonal gammopathy with or without hematologic malignancy and the consideration of alternative diagnoses, such as POEMS syndrome, anti-myelin associated glycoprotein (MAG) neuropathy or chronic ataxic neuropathy, with ophthalmoplegia, M-protein, cold aglutinins and disialosyl antibodies (CANOMAD). The search for antibodies specific to CIDP has been unsuccessful for many years. Recently, antibodies to paranodal proteins have been identified in a minority of patients with severe CIDP phenotypes, often unresponsive to first-line therapies. In conjunction with reports of high rates of antibody responses to neural structures in CIDP, this entertains the hope that more discoveries are to come. Although still arguably for only a small minority of patients, in view of current knowledge, such progress will enable earlier accurate diagnosis with direct management implications but only if the important, unfortunately and infrequently discussed issues of immunologic technique, test reliability and reproducibility are adequately tackled.Keywords: chronic inflammatory demyelinating polyneuropathy, dysimmune, immunologic, inflammatory, nodal, paranodalRajabally YAAttarian SDelmont EDove Medical Pressarticlechronic inflammatory demyelinating polyneuropathydysimmuneimmunologicinflammatorynodalparanodal.PathologyRB1-214Therapeutics. PharmacologyRM1-950ENJournal of Inflammation Research, Vol Volume 13, Pp 543-549 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic inflammatory demyelinating polyneuropathy dysimmune immunologic inflammatory nodal paranodal. Pathology RB1-214 Therapeutics. Pharmacology RM1-950
spellingShingle	chronic inflammatory demyelinating polyneuropathy dysimmune immunologic inflammatory nodal paranodal. Pathology RB1-214 Therapeutics. Pharmacology RM1-950 Rajabally YA Attarian S Delmont E Evolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy
description	Yusuf A Rajabally,1,2 Shahram Attarian,3,4 Emilien Delmont3,4 1Inflammatory Neuropathy Clinic, University Hospitals Birmingham, Birmingham, UK; 2Aston Medical School, Aston University, Birmingham, UK; 3Reference Centre for Neuromuscular Diseases and ALS, Centre Hospitalier Universitaire La Timone, Marseille 13385, France; 4Aix-Marseille University, Inserm, GMGF, Marseille, FranceCorrespondence: Yusuf A RajaballyAston Medical School, Aston University, Aston Triangle, Birmingham B4 7ET, UKEmail y.rajabally@aston.ac.ukAbstract: Chronic inflammatory demyelinating polyneuropathy (CIDP) is the commonest chronic idiopathic dysimmune neuropathy. Pathophysiologic processes involve both cellular and humoral immunity. There are various known forms of CIDP, likely caused by varying mechanisms. CIDP in its different forms is a treatable disorder in the majority of patients. The diagnosis of CIDP is clinical, supported routinely by electrophysiology. Cerebrospinal fluid analysis may be helpful. Routine immunology currently rarely adds to the diagnostic process but may contribute to the identification of an associated monoclonal gammopathy with or without hematologic malignancy and the consideration of alternative diagnoses, such as POEMS syndrome, anti-myelin associated glycoprotein (MAG) neuropathy or chronic ataxic neuropathy, with ophthalmoplegia, M-protein, cold aglutinins and disialosyl antibodies (CANOMAD). The search for antibodies specific to CIDP has been unsuccessful for many years. Recently, antibodies to paranodal proteins have been identified in a minority of patients with severe CIDP phenotypes, often unresponsive to first-line therapies. In conjunction with reports of high rates of antibody responses to neural structures in CIDP, this entertains the hope that more discoveries are to come. Although still arguably for only a small minority of patients, in view of current knowledge, such progress will enable earlier accurate diagnosis with direct management implications but only if the important, unfortunately and infrequently discussed issues of immunologic technique, test reliability and reproducibility are adequately tackled.Keywords: chronic inflammatory demyelinating polyneuropathy, dysimmune, immunologic, inflammatory, nodal, paranodal
format	article
author	Rajabally YA Attarian S Delmont E
author_facet	Rajabally YA Attarian S Delmont E
author_sort	Rajabally YA
title	Evolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy
title_short	Evolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy
title_full	Evolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy
title_fullStr	Evolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy
title_full_unstemmed	Evolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy
title_sort	evolving immunologic perspectives in chronic inflammatory demyelinating polyneuropathy
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/161c9bf6d2914d018c7772711b9f69e7
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Evolving Immunologic Perspectives in Chronic Inflammatory Demyelinating Polyneuropathy

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