BRAIN and NERVE－神経研究の進歩76巻10号

2024年10月発行

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大量免疫グロブリン—慢性炎症性脱髄性多発根ニューロパチー（CIDP）

著者： 清水文崇¹

所属機関： ¹山口大学大学院医学系研究科臨床神経学

ページ範囲：P.1109 - P.1118

文献概要

慢性炎症性脱髄性多発根ニューロパチーでの免疫グロブリン大量静注療法（intravenous immunoglobulin：IVIg）の作用機序として，①抗イディオタイプ抗体による病的自己抗体の中和，②FcRn阻害作用による病的自己抗体の減少，③サイトカイン・補体の中和，④T細胞・B細胞・マクロファージの活性調整，⑤血液神経関門修復が挙げられる。自己免疫性ノドパチーでIVIgが効きづらい理由としてIgG4自己抗体は抗原特異性が強いため，抗イディオタイプ抗体が結合しづらく中和作用が効きづらいなどが考えられる。

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