Mecanismes immunitaires et traitements du syndrome de Guillain-Barre et des polyradiculonevrites inflammatoires chroniques. [Immunopathology and treatments of Guillain-Barre syndrome and of chronic inflammatory demyelinating polyneuropathy]

Details

Serval ID
serval:BIB_95612B4D4F8C
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Mecanismes immunitaires et traitements du syndrome de Guillain-Barre et des polyradiculonevrites inflammatoires chroniques. [Immunopathology and treatments of Guillain-Barre syndrome and of chronic inflammatory demyelinating polyneuropathy]
Journal
Revue Neurologique
Author(s)
Radziwill  A. J., Kuntzer  T., Steck  A. J.
ISSN
0035-3787 (Print)
Publication state
Published
Issued date
03/2002
Peer-reviewed
Oui
Volume
158
Number
3
Pages
301-10
Notes
English Abstract Journal Article Review --- Old month value: Mar
Abstract
The concepts of Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) have changed over the last decade. The spectrum of GBS ranges from acute inflammatory demyelinating polyneuropathy to pure motor, sensory-motor or bulbar variants and the Miller Fisher syndrome. Also CIDP includes different variants in addition to the typical clinical picture with symmetrical proximal and distal weakness, such as a form with predominant distal weakness, a pure sensory form, an asymmetric form and a form with predominant cranial nerve involvement. Detailed immunopathologic features have been described in GBS and CIDP: most current investigations are centered on the hypothesis of molecular mimicry in GBS and together with the pathogenic role of cell-mediated immunity different antibodies have been discovered in GBS which interfere with nerve impulse conduction on neuromuscular transmission. The immunopathogenesis of CIDP remains fragmentary and insufficient for a unified hypothesis. Activated macrophages and T-cells with the participation of T-1 helper cell related cytokines seem to play a fundamental role in demyelination. The nature of antigen presenting cells, T-cell receptors, adhesion molecules and the proinflammatory cytokines need to be explored to design more specific immunotherapies. Established treatments in GBS include intravenous immunoglobulin and plasma exchange. Randomized trials have shown the efficacy of prednisone, intravenous immunoglobulin and plasma exchange in CIDP. New insight in the pathogenetic role of the cytokine-network in CIDP opens new therapeutical possibilities with the modification of the T-1 helper cell reaction with interferon.
Keywords
Adrenal Cortex Hormones/therapeutic use Antibody Specificity Autoantibodies/immunology Autoimmune Diseases/*immunology/therapy Cytokines/physiology Demyelinating Diseases/etiology/physiopathology Guillain-Barre Syndrome/classification/*immunology/therapy Humans Immunity, Cellular Immunoglobulins, Intravenous/therapeutic use Immunosuppressive Agents/therapeutic use Interferons/therapeutic use Lymphocyte Activation Macrophage Activation Models, Immunological Molecular Mimicry Neural Conduction Plasma Exchange Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/*immunology/mortality/therapy Synaptic Transmission T-Lymphocytes, Helper-Inducer/immunology/secretion
Pubmed
Web of science
Create date
25/01/2008 13:43
Last modification date
20/08/2019 15:57
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