Interferon alpha and neuromuscular disorders.
Interferon-alpha (IFNalpha) is a potent extracellular protein mediator of host defense and homeostasis. IFNalpha has well-established direct antiviral, antiproliferative and immunomodulatory properties. The worldwide, increasing and long-term use of IFNalpha, particularly for the treatment of chronic hepatitis C virus infection, has drawn attention to the development or exacerbation of numerous autoimmune phenomena, including a variety of neuropathy syndromes, neuromuscular junction disorders and myopathies. Management entailed withdrawal of IFNalpha therapy with supportive, immunomodulatory, and symptomatic treatment as clinically indicated. The mechanisms of IFNalpha-induced autoimmunity are incompletely understood, and likely vary depending on the inherent differences in the pathogenesis of the immune disorder on a background of patient genetic susceptibility. In addition, there is preliminary evidence from case reports and open-label studies that the immunomodulatory effects of IFNalpha may have potential as a treatment option for a spectrum of immune-mediated neuromuscular diseases, but further studies are needed.
Stübgen
Joerg-Patrick
JP
Department of Neurology and Neuroscience, Weill Medical College of Cornell University/New York Presbyterian Hospital, USA. pstuebge@med.cornell.edu
D000818:Animals; D015551:Autoimmunity; D003449:Cryoglobulinemia / Q000150:complications; D005260:Female; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008954:Models, Biological; D009135:Muscular Diseases / Q000139:chemically induced; D009157:Myasthenia Gravis / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology; D009468:Neuromuscular Diseases / Q000145:classification / Q000188:drug therapy*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology
D007155:Immunologic Factors; D016898:Interferon-alpha