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7 th International Immunoglobulin Conference: Neurology
Author(s) -
NobileOrazio E.,
Lewis R. A.
Publication year - 2014
Publication title -
clinical & experimental immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 135
eISSN - 1365-2249
pISSN - 0009-9104
DOI - 10.1111/cei.12498
Subject(s) - medicine , immunology , antibody , disease , immune system , neurology , multiple sclerosis , intravenous immunoglobulin therapy , autoimmune encephalitis , immunotherapy , immunoglobulin g , neuroimmunology , autoantibody , psychiatry
Summary Immunoglobulin ( I g) therapy has been used and studied as a treatment for a variety of neurological conditions for decades. In some of these disorders I g therapy has a significant role as a first‐line treatment. This session explores the use of I g therapy in immune‐mediated peripheral neuropathies and various central nervous system ( CNS ) diseases. Informative practice points relating to the management and treatment of these diseases are discussed. Potential future neurological indications for I g therapy, as well as data on efficacy and possible mechanisms of action, are also presented. In peripheral immune‐mediated neuropathies, data show good response rates to I g therapy and it is often used as a first‐line treatment. Intravenous immunoglobulin ( IVIg ) and subcutaneous immunoglobulin ( SCIg ) are both well tolerated, but dose and dosing frequency should be based on individual clinical responses. In A lzheimer's disease, although clinical data show no significant differences between IVIg and placebo, biomarker studies indicate that plasma‐derived antibodies may be involved in clearance of amyloid aggregates from the brain. Data suggest that the use of high IVIg doses in early‐stage A lzheimer's treatment may warrant further investigation. Ig therapy is considered a valuable option for autoimmune encephalitis, an antibody‐mediated CNS disease. Combination treatment with IVIg and corticosteroids shows promising results and is proposed as a first‐line treatment in these disorders. Until recently, very little was understood about the pathogenesis of chronic pain disorders. Data now indicate that perpetuation of the pain response may be underpinned by central immune activation. Some data suggest that I g therapy may mitigate this effect, with good response rates in a number of studies, but these data need confirmation.

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