TY - GEN
T1 - Current and future immunotherapy targets in autoimmune neurology
AU - Hu, Melody Y.
AU - Stathopoulos, Panos
AU - O'connor, Kevin C.
AU - Pittock, Sean J.
AU - Nowak, Richard J.
N1 - Funding Information:
K.C.O. is the recipient of the Grant for Multiple Sclerosis Research Innovation provided by EMD/Merck/Serono, and is supported, in part by the Myasthenia Gravis Foundation of America. R.J.N. is the recipient of grant number U01NS084495-01A1 from the National Institute of Neurological Disorders and Stroke (NINDS) at the National Institutes of Health (NIH). The authors thank Dr. Kimberly R. Robeson for critical reading of this manuscript.
PY - 2016
Y1 - 2016
N2 - Randomized controlled treatment trials of autoimmune neurologic disorders are generally lacking and data pertaining to treatment are mostly derived from expert opinion, large case series, and anecdotal reports. The treatment of autoimmune neurologic disorders comprises oncologic therapy (where appropriate) and immunotherapy. In this chapter, we first describe the standard acute and chronic immunotherapies and provide a practical overview of their use in the clinic (mechanisms of action, dosing, monitoring, and side effects). Novel approaches to treatment of autoimmune neurologic disorders, through new drug discovery or repurposing, are dependent on improved mechanistic understanding of immunopathology. Such approaches, with emphasis on monoclonal antibodies, are discussed using the paradigm of three autoimmune neurologic disorders whose immunopathogenesis is better understood, specifically myasthenia gravis, neuromyelitis optica, and chronic inflammatory demyelinating polyradiculoneuropathy. It is important to realize that the treatment strategy and management plan must be individualized for each patient. In general these are influenced by the following: clinical severity, antibody type, presence or absence of cancer, and prior treatment response, if known.
AB - Randomized controlled treatment trials of autoimmune neurologic disorders are generally lacking and data pertaining to treatment are mostly derived from expert opinion, large case series, and anecdotal reports. The treatment of autoimmune neurologic disorders comprises oncologic therapy (where appropriate) and immunotherapy. In this chapter, we first describe the standard acute and chronic immunotherapies and provide a practical overview of their use in the clinic (mechanisms of action, dosing, monitoring, and side effects). Novel approaches to treatment of autoimmune neurologic disorders, through new drug discovery or repurposing, are dependent on improved mechanistic understanding of immunopathology. Such approaches, with emphasis on monoclonal antibodies, are discussed using the paradigm of three autoimmune neurologic disorders whose immunopathogenesis is better understood, specifically myasthenia gravis, neuromyelitis optica, and chronic inflammatory demyelinating polyradiculoneuropathy. It is important to realize that the treatment strategy and management plan must be individualized for each patient. In general these are influenced by the following: clinical severity, antibody type, presence or absence of cancer, and prior treatment response, if known.
KW - Autoimmunity
KW - Chronic inflammatory demyelinating polyradiculoneuropathy
KW - Immunopathology
KW - Immunosuppressive therapy
KW - Immunotherapy
KW - Myasthenia gravis
KW - Neuroimmunology
KW - Neurologic disorders
KW - Neuromyelitis optica
UR - http://www.scopus.com/inward/record.url?scp=84978417776&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84978417776&partnerID=8YFLogxK
U2 - 10.1016/B978-0-444-63432-0.00027-X
DO - 10.1016/B978-0-444-63432-0.00027-X
M3 - Conference contribution
C2 - 27112694
AN - SCOPUS:84978417776
SN - 9780444634320
T3 - Handbook of Clinical Neurology
SP - 511
EP - 536
BT - Autoimmune Neurology, 2016
A2 - Pittock, Sean J.
A2 - Vincent, Angela
PB - Elsevier
ER -