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  会員専用

• ホーム
• 49巻11号
• 臨床神経, 49：956−958, 2009
• 49巻11号目次

第50回日本神経学会総会

＜シンポジウム12―3＞末梢神経疾患研究の現在
免疫介在性ニューロパチー

楠　進

近畿大学神経内科〔〒589-8511　大阪府大阪狭山市大野東377-2〕

Such neuropathies as Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and IgM paraproteinemic neuropathy are caused by autoimmune mechanisms. IgM paraproteinemic neuropathies are known to be intractable. Rituximab has recently been reported to be effective for IgM paraproteinemic neuropathy with anti-MAG IgM M-protein in a placebo-controlled trial. The effect should be confirmed with a larger trial. The use of this drug also may be tried for other type of IgM paraproteinemic neuropathy and for intractable CIDP in future. Antiganglioside IgG antibodies are frequently present in the acute-phase sera from GBS patients. Recently, presence of the antibodies that recognize a conformational epitope formed by carbohydrate portions of two different gangliosides (ganglioside complex) has been reported. Antibodies against a complex formed by GD1a and GD1b (anti-GD1a/GD1b antibodies) are associated with severe GBS. Anti-GM1/GalNAc-GD1a antibodies are found to be associated with pure motor GBS with frequent conduction block. Anti-ganglioside complex antibodies may be useful diagnostic and prognostic markers of GBS. Future study is necessary to clarify the pathogenetic mechanisms in which those antibodies are specifically involved.
Full Text of this Article in Japanese PDF (235K)

(臨床神経, 49：956−958, 2009)
key words：IgMパラプロテイン血症をともなうニューロパチー, ギラン・バレー症候群, 慢性炎症性脱髄性多発ニューロパチー, 抗ガングリオシド抗体, ガングリオシド複合体

（受付日：2009年5月22日）