自身免疫性郎飞结病的研究进展
脱髓鞘,皮质激素,单抗
【摘要】 郎飞结是指在有髓神经纤维中每两个施万细胞之间没有髓鞘的部分。它包含四个区域:结区、结旁区、近结旁区和结间区。自身免疫性郎飞结病(AN)是由朗飞结中位于结区的神经束蛋白(NF)140/186和结旁区中位于髓鞘的NF155和位于轴索的接触蛋白1(CNTN1)、接触蛋白相关蛋白1(Caspr1)的相关抗体所介导的运动感觉受累的一种周围神经病,其结旁区抗体阳性在慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)的检测中多见。然而AN的临床表现与CIDP相似,但病理特征和治疗反应存在不同,故具有独特的诊断和治疗价值。目前针对AN患者治疗方式是以糖皮质激素、血浆置换和静脉注射用人免疫球蛋白(IVIg)治疗为主,但IgG4亚型的AN患者对免疫球蛋白治疗欠佳,另外利妥昔单抗、艾加莫德等靶向生物制剂也显示出了一定的疗效。本综述重点研究AN的临床表现及治疗进展。【关键词】 自身免疫性郎飞结病 神经束蛋白140/186 神经束蛋白155 接触蛋白1 接触蛋白相关蛋白1
Research Progress on Autoimmune Nodopathies/LU Lu, SONG Yan. //Medical Innovation of China, 2024, 21(33): -188
[Abstract] The node of Ranvier is the portion of a myelinated nerve fiber that is not myelinated between every two Schwann cells in a myelinated nerve fiber. It contains four regions: the junctional, parajunctional, subparajunctional, and interjunctional regions. Autoimmune nodopathy (AN) is a peripheral neuropathy with motor-sensory involvement mediated by antibodies related to neurofascin (NF) 140/186 in the junctional region of the node of Ranvier, NF155 located in the myelin sheath in the parajunctional region of the node, contactin-1 (CNTN1) and contactin-associated protein-1 (Caspr1) located in the axon. AN is similar to CIDP in clinical manifestations ......
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