Abstract
To study clinical and paraclinical effects of natalizumab in a patient with chronic inflammatory demyelinating polyneuropathy (CIDP). Case report. Department of Neurology, Heinrich-Heine University, Düsseldorf, Germany. Patient A patient with highly active CIDP who did not respond to standard therapies. Intervention Standard therapy then treatment with natalizumab (300 mg). Clinical disability, magnetic resonance imaging, and saturation of the alpha(4) integrin on T lymphocytes. T cells expressing the alpha(4) integrin were found in the inflamed peripheral nerve. Natalizumab bound with high affinity to the alpha(4) integrin on T lymphocytes in our patient. However, the patient's clinical condition deteriorated and as seen on magnetic resonance imaging without any measurable effect after treatment with this antibody. Although experimental evidence suggests that natalizumab could theoretically be effective in immune-mediated disorders of the peripheral nervous system, our patient with CIDP did not benefit from this therapeutic approach. Natalizumab cannot be recommended in CIDP at present and should only be explored in controlled clinical trials.
Citations
Aug 9, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Fumitaka ShimizuTakashi Kanda
Jun 30, 2011·Journal of Neurology·P Lozeron, D Adams
Jul 31, 2013·Journal of Neurology·Chiara BrianiRoberto Gasparotti
Mar 24, 2016·Journal of the Neurological Sciences·A CorteseE Marchioni
Jan 26, 2016·Immunotherapy·Stéphane MathisLaurent Magy
May 7, 2013·La Presse médicale·Marinos C Dalakas
Jan 23, 2013·Journal of the Neurological Sciences·Joerg-Patrick Stübgen
May 31, 2011·Autoimmunity Reviews·Bernd C KieseierGerd Meyer Zu Hörste
Jun 23, 2011·Journal of the Peripheral Nervous System : JPNS·Hans-Peter HartungRichard A C Hughes
May 11, 2012·Journal of the Peripheral Nervous System : JPNS·Marinos C Dalakas
Sep 17, 2013·Clinical and Experimental Immunology·N Melzer, S G Meuth
May 27, 2015·Current Neurology and Neuroscience Reports·Inna Kleyman, Thomas H Brannagan
Nov 23, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·R PressH Hägglund
Jun 21, 2014·Biochimica Et Biophysica Acta·Marinos C Dalakas
Mar 24, 2016·Expert Review of Neurotherapeutics·Olivier Outteryck
Jun 10, 2017·Expert Review of Neurotherapeutics·Eduardo Nobile-OrazioMariangela Bianco
Nov 10, 2012·Therapeutic Advances in Neurological Disorders·Kenneth C Gorson
May 28, 2017·Journal of Neurology, Neurosurgery, and Psychiatry·Christian SchneiderHelmar Christoph Lehmann
Oct 19, 2017·Neurodegenerative Disease Management·Yusuf A Rajabally
Aug 17, 2011·Nature Reviews. Neurology·Marinos C Dalakas, UNKNOWN Medscape
May 10, 2017·The Cochrane Database of Systematic Reviews·Mohamed Mahdi-RogersRichard Ac Hughes
Jul 24, 2015·Current Opinion in Neurology·Eduardo Nobile-Orazio, Francesca Gallia
Oct 13, 2018·Nature Reviews. Disease Primers·Bernd C KieseierHans-Peter Hartung