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Volume 31, Issue 2, June 2020




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Mediterr J Rheumatol 2020;31(1):10-8
Autoimmune Peripheral Neuropathies and Contribution of Antiganglioside/Sulphatide Autoantibody Testing
Authors Information
1. Faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology  Cottbus – Senftenberg, the Brandenburg Medical School Theodor Fontane and the  University of Potsdam, Germany
2. Institute of Biotechnology, Faculty Environment and Natural Sciences, Brandenburg University of Technology Cottbus Senftenberg, Senftenberg, Germany
3. Referral Center for Neuromuscular Diseases and ALS, La Timone Hospital, AP-HM, Marseille, France
4. Institute of Molecular and Clinical Immunology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
5. Institute of Immunology, Medical Faculty of the Technical University Dresden, Dresden, Germany
6. Aix Marseille Université, Institut de Neurosciences de la Timone, Medicine Faculty, Marseille, France
7. Immunology laboratory, Conception Hospital, AP-HM, Marseille, France
Abstract

Peripheral immune-mediated polyneuropathies (IMPN) are a diverse group of rare neurological illnesses characterized by nerve damage. Leading morphological features are mostly nerve fibre demyelination or combination of axonal damage and demyelination.

There has been remarkable progress in the clinical and electrophysiological categorization of acute (fulminant, life-threatening) and chronic (progressive/remitting-relapsing) immune-mediated neuropathies recently. Besides electrophysiological and morphological makers, autoantibodies against glycolipids or paranodal/nodal molecules have been recommended as candidate markers for IMPN. The progress in testing for autoantibodies (autoAbs) to glycolipids such as gangliosides and sulfatide may have significant implications on the stratification of patients and their treatment response. Thus, this topic was reviewed in a presentation held during the 1st Panhellenic Congress of Autoimmune Diseases, Rheumatology and Clinical Immunology in Portaria, Pelion, Greece.

For acute IMPN, often referred to as Guillain-Barré syndrome and its variants, several serological markers including autoAbs to gangliosides and sulphatide have been employed successfully in clinical routine. However, the evolution of serological diagnosis of chronic variants, such as chronic inflammatory demyelinating polyneuropathy or multifocal motor neuropathy, is less satisfactory. Serological diagnostic markers could, therefore, help in the differential diagnosis due to their assumed pathogenic role. Additionally, stratification of patients to improve their response to treatment may be possible. In general, a majority of patients respond well to causal therapy that includes intravenous immunoglobulins and plasmapheresis. As second line therapy options, biologicals (e.g., rituximab) and immunosuppressant or immunomodulatory drugs may be considered when patients do not respond adequately.

https://doi.org/10.31138/mjr.31.1.10

Article Submitted: 15 Dec 2019; Article Accepted: 4 Feb 2020; Published: 31 Mar 2020

This work is licensed under a Creative Commons Attribution 4.0 International License (CC-BY).

©Roggenbuck D, Delmont E, Reinhold D, Schierack P, Conrad K, Boucraut J.