BRAIN and NERVE－神経研究の進歩75巻6号

2023年06月発行

特集 Antibody Update 2023　Part1 中枢編

視神経脊髄炎関連疾患

著者： 飯田紘太郎¹ 磯部紀子¹

所属機関： ¹九州大学大学院医学研究院神経内科学講座

ページ範囲：P.705 - P.710

文献概要

視神経脊髄炎関連疾患は主に視神経炎，脊髄炎をきたす中枢性自己免疫性疾患であり，その病態生理にアクアポリン4（aquaporin-4：AQP4）抗体が関わっている。AQP4抗体は補体や細胞性免疫の活性化によりアストロサイトの傷害や二次的な脱髄，神経障害をきたす。従来はステロイド中心の治療であったが，特に再発予防治療において有効性の高い生物学的製剤が登場した。ステロイド治療による副作用の軽減や患者QOLの向上が期待される。

参考文献

1)Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG: The spectrum of neuromyelitis optica. Lancet Neurol 6: 805-815, 2007

2)Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR: IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 202: 473-477, 2005

3)Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, et al; International Panel for NMO Diagnosis: International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 85: 177-189, 2015

4)Houzen H, Kondo K, Niino M, Horiuchi K, Takahashi T, et al: Prevalence and clinical features of neuromyelitis optica spectrum disorders in northern Japan. Neurology 89: 1995-2001, 2017

5)Kim HJ, Paul F, Lana-Peixoto MA, Tenembaum S, Asgari N, et al; Guthy-Jackson Charitable Foundation NMO International Clinical Consortium ＆ Biorepository: MRI characteristics of neuromyelitis optica spectrum disorder: an international update. Neurology 84: 1165-1173, 2015

6)Chihara N, Aranami T, Sato W, Miyazaki Y, Miyake S, et al: Interleukin 6 signaling promotes anti-aquaporin 4 autoantibody production from plasmablasts in neuromyelitis optica. Proc Natl Acad Sci U S A 108: 3701-3706, 2011

7)Crane JM, Lam C, Rossi A, Gupta T, Bennett JL, et al: Binding affinity and specificity of neuromyelitis optica autoantibodies to aquaporin-4 M1/M23 isoforms and orthogonal arrays. J Biol Chem 286: 16516-16524, 2011

8)Ratelade J, Asavapanumas N, Ritchie AM, Wemlinger S, Bennett JL, et al: Involvement of antibody-dependent cell-mediated cytotoxicity in inflammatory demyelination in a mouse model of neuromyelitis optica. Acta Neuropathol 126: 699-709, 2013

9)Takeshita Y, Obermeier B, Cotleur AC, Spampinato SF, Shimizu F, et al: Effects of neuromyelitis optica-IgG at the blood-brain barrier in vitro. Neurol Neuroimmunol Neuroinflamm 4: e311, 2016　［doi: 10.1212/NXI.0000000000000311］

10)Shimizu F, Schaller KL, Owens GP, Cotleur AC, Kellner D, et al: Glucose-regulated protein 78 autoantibody associates with blood-brain barrier disruption in neuromyelitis optica. Sci Transl Med 9: eaai9111, 2017　［doi: 101126/scitranslmed.aai9111］

11)高橋利幸, 狩野俊吾, 池本圭輔, 中島一郎: M23抗原を用いたAQP4Ab ELISA「コスミック」Ⅱキットの基礎的・臨床的検討. 医学と薬学73: 1297-1300, 2016

12)Kimbrough DJ, Fujihara K, Jacob A, Lana-Peixoto MA, Leite MI, et al; GJCF-CC＆BR: Treatment of neuromyelitis optica: review and recommendations. Mult Scler Relat Disord 1: 180-187, 2012

13)Mimura O, Ishikawa H, Kezuka T, Shikishima K, Suzuki T, et al: Intravenous immunoglobulin treatment for steroid-resistant optic neuritis: a multicenter, double-blind, randomized, controlled phase III study. Jpn J Ophthalmol 65: 122-132, 2021

14)Kakuta Y, Kawai Y, Okamoto D, Takagawa T, Ikeya K, et al; MENDEL study group: NUDT15 codon 139 is the best pharmacogenetic marker for predicting thiopurine-induced severe adverse events in Japanese patients with inflammatory bowel disease: a multicenter study. J Gastroenterol 53: 1065-1078, 2018

15)Pittock SJ, Berthele A, Fujihara K, Kim HJ, Levy M, et al: Eculizumab in aquaporin-4-positive neuromyelitis optica spectrum disorder. N Engl J Med 381: 614-625, 2019

16)Yamamura T, Kleiter I, Fujihara K, Palace J, Greenberg B, et al: Trial of satralizumab in neuromyelitis optica spectrum disorder. N Engl J Med 381: 2114-2124, 2019

17)Cree BAC, Bennett JL, Kim HJ, Weinshenker BG, Pittock SJ, et al; N-MOmentum study investigators: Inebilizumab for the treatment of neuromyelitis optica spectrum disorder (N-MOmentum): a double-blind, randomised placebo-controlled phase 2/3 trial. Lancet 394: 1352-1363, 2019

18)Tahara M, Oeda T, Okada K, Kiriyama T, Ochi K, et al: Safety and efficacy of rituximab in neuromyelitis optica spectrum disorders (RIN-1 study): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet Neurol 19: 298-306, 2020

19)Kitley J, Leite MI, Nakashima I, Waters P, McNeillis B, et al: Prognostic factors and disease course in aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder from the United Kingdom and Japan. Brain 135: 1834-1849, 2012

20)Akaishi T, Nakashima I, Takahashi T, Abe M, Ishii T, et al: Neuromyelitis optica spectrum disorders with unevenly clustered attack occurrence. Neurol Neuroimmunol Neuroinflamm 7: e640, 2020　［doi: 10.1212/NXI.0000000000000640］