BRAIN and NERVE－神経研究の進歩75巻7号

2023年07月発行

特集 Antibody Update 2023　Part2 末梢編

自己免疫性自律神経節障害—「10の課題」を解くために

著者： 中根俊成¹

所属機関： ¹富山大学学術研究部医学系脳神経内科

ページ範囲：P.821 - P.829

文献概要

自己免疫性自律神経節障害（autoimmune autonomic ganglionopathy：AAG）患者血清からはニコチン性自律神経節アセチルコリン受容体（ganglionic acetylcholine receptor：gAChR）に対する自己抗体が検出される。gAChR抗体は病原性を有し，自律神経節におけるシナプス伝達を障害することから自律神経障害を引き起こすことが知られている。近年，AAGの臨床像に関する報告のほか，1）新しいgAChR抗体測定法，2）免疫治療の有用性，3）新規動物モデル，4）新型コロナウイルス感染症とそのワクチン接種と自律神経障害の関連，5）がん治療における免疫チェックポイント阻害薬の免疫関連副作用として自律神経障害，などが注目されている。筆者らは以前にAAGの病態や実際の診療上の問題を理解していくための臨床と研究における「10の課題」を設定した。本論では最近5年間の研究の動向を織り込みつつ，「10の課題」の1つひとつに関する研究の現況を解説する。

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