title: Effective treatment with intravenous immunoglobulins reduces autoreactive T-cell response in patients with CIDP.
abstract: OBJECTIVE
  To investigate changes in autoreactive T-cell responses against PMP-22 and P2 antigen as well as a T-cell memory repertoire in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) induced by repeated intravenous immunoglobulin (IVIg) treatment.
  
  
  METHODS
  In an observational trial, we prepared cryopreserved human peripheral blood monocytes from blood from 34 patients with CIDP (18 treatment naïve and 16 maintenance IVIg treatment) and from 14 healthy controls (non-immune neuropathy and healthy control). Treatment response was defined by clinical evaluation. The autoantigen-specific T-cell response was analysed by enzyme linked immunosorbent spot (ELISPOT) assay before IVIg start (baseline) and at follow-up. The T-cell memory subsets were analysed by using flow cytometric analysis.
  
  
  RESULTS
  Myelin-derived P2-specific and PMP-22-specific IFN-γ producers were increased in IVIg responders compared with non-responders before treatment, which decreased by repeated IVIg infusion cycles. Treatment responders but not non-responders showed higher frequencies of CD4 T effector memory (TEM) and T central memory frequencies at baseline compared with maintenance IVIg treatment patients and controls. In addition, IVIg treatment was associated with a significant reduction in CD8 TEM at follow-up.
  
  
  CONCLUSIONS
  Our data demonstrate that immunomodulatory treatment with IVIgs on a long-term basis reduces the autoreactive T-cell response against PMP-22 and P2-antigens, which may be influenced by the altered maintenance of CD8 and CD4 effector/memory T-cell subsets towards a more anti-inflammatory immune status. Elevated PMP-22 and P2-specific T-cell responses may serve as predictors for treatment responsiveness to IVIgs warranting validation in larger studies.
authors: Department of Neurology, University Hospital Charité, Berlin, Germany.
authors: Juliane
authors: J
authors: Klehmet
authors: Department of Neurology, University Hospital Charité, Berlin, Germany.
authors: Jos
authors: J
authors: Goehler
authors: Department of Neurology, University Hospital Charité, Berlin, Germany.
authors: Lena
authors: L
authors: Ulm
authors: Department of Neurology, University Hospital Charité, Berlin, Germany.
authors: Siegfried
authors: S
authors: Kohler
authors: Institute of Medical Immunology, Charité, Berlin Department of Immunology, Labor Berlin Charité
authors: Christian
authors: C
authors: Meisel
authors: Department of Neurology, University Hospital Charité, Berlin, Germany.
authors: Andreas
authors: A
authors: Meisel
authors: Department of Neurology, St. Josefs Krankenhaus Potsdam, Potsdam, Germany.
authors: Hendrik
authors: H
authors: Harms
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001324:Autoantigens / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007156:Immunologic Memory; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D009186:Myelin Sheath / Q000276:immunology; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000276:immunology* / Q000628:therapy*; D016176:T-Lymphocyte Subsets / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001324:Autoantigens; D016756:Immunoglobulins, Intravenous
keywords: Neuropathy