RT Journal Article
SR Electronic
T1 Serum levels of tumor necrosis factor–α in chronic inflammatory demyelinating polyneuropathy
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 666
OP 669
DO 10.1212/WNL.56.5.666
VO 56
IS 5
A1 S. Misawa
A1 S. Kuwabara
A1 M. Mori
A1 N. Kawaguchi
A1 Y. Yoshiyama
A1 T. Hattori
YR 2001
UL http://n.neurology.org/content/56/5/666.abstract
AB Background: Activated macrophages and T lymphocytes may play a role in the pathogenesis of chronic inflammatory demyelinating polyneuropathy (CIDP). Both cell types secrete tumor necrosis factor-α (TNFα), which has toxic effects on myelin and endothelial cells. Methods: The serum concentration of TNFα was measured by ELISA and compared with clinical and electrophysiological profiles in 20 patients with CIDP. Results: An increased serum level of TNFα was detected in 5 (25%) patients and was associated with subacute progression, severe neurologic disabilities, and symmetric weakness involving proximal as well as distal muscles. TNFα levels increased during the active phase in this subgroup of patients. The levels of TNFα correlated with the severity of demyelinating conduction abnormalities in the intermediate as well as distal nerve segments, suggesting demyelination diffusely distributed along the nerves. Conclusion: Circulating TNFα increases during the active phase in a subgroup of CIDP patients and may play a role in the pathogenesis of demyelination and the breakdown of the blood–nerve barrier in CIDP.