Invited Review: Chronic Inflammatory Demyelinating Polyneuropathy: How Pathophysiology Can Guide Treatment-Article

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The review titled "Chronic Inflammatory Demyelinating Polyneuropathy: How Pathophysiology Can Guide Treatment" by Karissa L. Gable and Yingkai Li explores the pathophysiology of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and its implications for treatment strategies. CIDP is an autoimmune neuropathy characterized by progressive muscle weakness, sensory loss, and reduced reflexes, affecting both limbs within at least eight weeks.<br /><br />The authors emphasize the complexity of CIDP's pathophysiology, which involves both innate and adaptive immune systems. They discuss the potential targets for treatment arising from recent advancements in understanding these mechanisms. Key findings include the discovery of antibodies targeting paranodal and nodal regions, prompting a reclassification of related diseases as demyelinating nodopathies. Though first-line therapies, like immunoglobulins and corticosteroids, remain non-specific, efforts are being made towards more targeted treatments that address specific immunologic dysfunctions.<br /><br />The review highlights targeted treatment strategies, including B-cell depletion, complement inhibition, and FcRn-mediated IgG reduction. Specifically noteworthy is the potential of monoclonal antibodies that aim at novel therapeutic targets. The paper also discusses current clinical trials exploring FcRn antagonists and complement inhibitors, which indicate promising results for CIDP patients.<br /><br />Finally, the authors point out the genetic and aging-related factors contributing to the variability in disease severity and treatment response among patients. They suggest future directions might see the development of diagnostic biomarkers and more individualized therapies aimed at achieving disease remission or minimal manifestation.<br /><br />This comprehensive review underscores the importance of advancing our understanding of CIDP's pathophysiology to enhance treatment efficacy and patient outcomes, by moving towards therapies targeting underlying immunological pathways.

Keywords

Chronic Inflammatory Demyelinating Polyneuropathy

cidp

autoimmune neuropathy

pathophysiology

treatment strategies

immunologic dysfunction

monoclonal antibodies

FcRn antagonists

complement inhibitors

biomarkers