ギラン・バレー症候群に対するアフェレシス療法

概要

論文の詳細を見る
Guillain-Barre syndrome (GBS) is an autoimmune peripheral neuropathy in which serum IgG autoantibodies against gangliosides are often detected. Therapies with plasma exchange and intravenous immunoglobulin have both recently been considered as the first-line treatment for patients with GBS, but the latter is more often chosen as the first mainly due to ease of administration. Experimental studies demonstrated the pathogenic role of anti-ganglioside IgG antibodies, indicating a possible approach to autoantigen-specific immunoadsorption treatment in GBS. However, there are several problems which should be resolved before clinical usage of this treatment: the biggest problem is the diverse autoantibody reactivity in GBS. This indicates that various types of immunoadsorption columns should be prepared and, more importantly, that we cannot initiate the therapy until the result of the anti-ganglioside antibody testing is obtained. Several studies evaluated the efficacy of the combined treatment of plasmapheresis and intravenous immunoglobulin, but failed to show the superiority of the combined treatment compared to plasmapheresis or intravenous immunoglobulin alone. Because of the broad variety of neurological and immunological aspects in GBS patients, it should be clarified which types of GBS patients respond to plasmapheresis better than to intravenous immunoglobulin treatment.
2013-10-31