BRAIN and NERVE－神経研究の進歩67巻11号

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増大特集 ギラン・バレー症候群のすべて—100年の軌跡

ギラン・バレー症候群の新規治療の現状と展望

著者： 三澤園子¹

所属機関： ¹千葉大学大学院医学研究院神経内科学

ページ範囲：P.1421 - P.1428

ギラン・バレー症候群（GBS）の標準治療として，免疫グロブリン大量静注療法，血漿交換療法の有効性が示されている。GBSの大半の症例は，無治療もしくは上記標準治療により改善する。しかし，一部の症例においては，長期にわたる人工呼吸器管理や日常生活に支障をきたす神経学的後遺障害を生じる。GBSは若年者の罹患も多く，これらの予後不良例においては，現状の治療は不十分であると言わざるを得ない。これまで，インターフェロンβ，脳由来神経栄養因子（BDNF）などの新規治療の試みが複数なされてきた。しかし，残念ながら，有効性の確立された新規治療は現時点ではない。現在，重症例を対象とした免疫グロブリンの反復投与の臨床試験，補体阻害薬であるエクリズマブの臨床試験が進行中であり，その結果が待たれる。免疫グロブリン大量静注療法，血漿交換療法の作用機序は非特異的であり，不明の点も多い。GBSの病態解明が進むとともに，より病態に即した治療法の開発が待たれる。

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