Pharmacokinetics of intravenous immunoglobulin in multifocal motor neuropathy
| Autor: | Elisabeth A. Cats, Eline A.J. Willemse, Leonard H. van den Berg, Jan H. Veldink, Sanne Piepers, Jelena Medic, W-Ludo van der Pol, Lotte Vlam, Hessel Franssen |
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| Přispěvatelé: | Clinical chemistry, NCA - neurodegeneration |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male DNA Copy Number Variations Mismatch negativity Minisatellite Repeats Receptors Fc Polyneuropathies Young Adult Pharmacokinetics hemic and lymphatic diseases Humans Medicine Muscle Strength Dosing Motor Neuron Disease biology business.industry Cumulative dose Histocompatibility Antigens Class I Immunoglobulins Intravenous Middle Aged medicine.disease Psychiatry and Mental health Variable number tandem repeat Treatment Outcome Immunoglobulin G Immunology biology.protein Biomarker (medicine) Female Surgery Neurology (clinical) Antibody business Multifocal motor neuropathy |
| Zdroj: | Vlam, L, Cats, E A, Willemse, E, Franssen, H, Medic, J, Piepers, S, Veldink, J H, van den Berg, L H & van der Pol, W L 2014, ' Pharmacokinetics of intravenous immunoglobulin in multifocal motor neuropathy. ', Journal of neurology, neurosurgery, and psychiatry, vol. 85, no. 10, pp. 1145-1148 . https://doi.org/10.1136/jnnp-2013-306227 Journal of neurology, neurosurgery, and psychiatry, 85(10), 1145-1148. BMJ Publishing Group |
| ISSN: | 0022-3050 |
| DOI: | 10.1136/jnnp-2013-306227 |
| Popis: | Multifocal motor neuropathy (MMN) is often responsive to treatment with intravenous immunoglobulin (IVIg), but the optimal dose and intervals of IVIg maintenance treatment have not been established. Increase in IgG concentration (ΔIgG) after IVIg infusion has recently been identified as determinant of outcome in Guillain-Barré syndrome. ΔIgG may therefore represent a potentially useful biomarker to optimise IVIg dosing in patients with MMN. The aims of this study were to determine variability of IVIg pharmacokinetics in patients with MMN in relation to treatment response, and to establish whether interindividual differences in IVIg pharmacokinetics were associated with genetic polymorphisms of the endothelial IgG receptor (FcRn) which determines IgG half-life. Twenty-three patients with MMN receiving their first IVIg treatment at a cumulative dose of 2.0 g/kg in 5 days were included. A good treatment response was defined as an increase in muscle strength of at least one Medical Research Council point in minimally two muscle groups. IgG concentrations in serum were determined at baseline, at day 1 and day 5 of the IVIg course, and 3 weeks after treatment. FcRn copy number variation and differences in repeat length of the variable number of tandem repeats in the FcRn gene were determined by quantitative PCR and Sanger sequencing. Seventeen patients (74%) had a good response to treatment. Total IgG and ΔIgG levels showed large variation between patients. Mean ΔIgG was higher in IVIg responders than in non-responders, with the largest difference on day 1 (11.1 g/L vs 4.5 g/L, p=0.06), but our study lacked power to show statistically significant differences. Genetic variation in the FcRn gene was not associated with ΔIgG levels or response to treatment. IVIg pharmacokinetics varies in patients with MMN and may be associated with clinical response. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. |
| Databáze: | OpenAIRE |
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