title: Immunomodulation of inflammatory leukocyte markers during intravenous immunoglobulin treatment associated with clinical efficacy in chronic inflammatory demyelinating polyradiculoneuropathy.
abstract: The objective of the study was to profile leukocyte markers modulated during intravenous immunoglobulin (IVIg) treatment, and to identify markers and immune pathways associated with clinical efficacy of IVIg for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with potential for monitoring treatment efficacy.
  
  
  
  Response to IVIg treatment in newly diagnosed IVIg-naïve and established IVIg-experienced patients was assessed by changes in expression of inflammatory leukocyte markers by flow cytometry. The adjusted INCAT disability and Medical Research Council sum scores defined clinical response.
  
  
  
  Intravenous immunoglobulin modulated immunopathogenic pathways associated with inflammatory disease in CIDP. Leukocyte markers of clinical efficacy included reduced CD185+follicular helper T cells, increased regulatory markers (CD23 and CD72) on B cells, and reduction in the circulating inflammatory CD16+myeloid dendritic cell (mDC) population and concomitant increase in CD62L and CD195 defining a less inflammatory lymphoid homing mDC phenotype. A decline in inflammatory CD16+dendritic cells was associated with clinical improvement or stability, and correlated with magnitude of improvement in neurological assessment scores, but did not predict relapse. IVIg also induced a nonspecific improvement in regulatory and reduced inflammatory markers not associated with clinical response.
  
  
  
  Clinically effective IVIg modulated inflammatory and regulatory pathways associated with ongoing control or resolution of CIDP disease. Some of these markers have potential for monitoring outcome.
authors: Australian Red Cross Blood Service Alexandria NSW Australia; Sydney Medical School University of Sydney Camperdown NSW Australia.
authors: Wayne B
authors: WB
authors: Dyer
authors: Australian Red Cross Blood Service Alexandria NSW Australia; Sydney Medical School University of Sydney Camperdown NSW Australia.
authors: Joanne C G
authors: JC
authors: Tan
authors: Cabrini Medical Centre Cabrini Hospital Malvern Vic. Australia; Department of Neurophysiology Royal Melbourne Hospital Parkville Vic. Australia.
authors: Timothy
authors: T
authors: Day
authors: Department of Neurophysiology Royal Melbourne Hospital Parkville Vic. Australia.
authors: Lynette
authors: L
authors: Kiers
authors: Sydney Medical School University of Sydney Camperdown NSW Australia; Brain and Mind Centre University of Sydney Camperdown NSW Australia.
authors: Matthew C
authors: MC
authors: Kiernan
authors: Burwest Neurophysiology Burwood NSW Australia.
authors: Con
authors: C
authors: Yiannikas
authors: Sydney Medical School University of Sydney Camperdown NSW Australia; Department of Neurology Concord Repatriation and General Hospital Concord NSW Australia.
authors: Stephen
authors: S
authors: Reddel
authors: Sydney Medical School University of Sydney Camperdown NSW Australia; Department of Neurophysiology Royal North Shore Hospital St Leonards NSW Australia.
authors: Karl
authors: K
authors: Ng
authors: Australian Red Cross Blood Service Alexandria NSW Australia.
authors: Phillip
authors: P
authors: Mondy
authors: Australian Red Cross Blood Service Alexandria NSW Australia.
authors: Peta M
authors: PM
authors: Dennington
authors: Australian Red Cross Blood Service Kelvin Grove Qld Australia.
authors: Melinda M
authors: MM
authors: Dean
authors: Burnet Institute Prahran Vic. Australia.
authors: Halina M
authors: HM
authors: Trist
authors: Sydney Medical School University of Sydney Camperdown NSW Australia.
authors: Cristobal
authors: C
authors: Dos Remedios
authors: Burnet Institute Prahran Vic. Australia.
authors: P Mark
authors: PM
authors: Hogarth
authors: Sydney Medical School University of Sydney Camperdown NSW Australia; Department of Neurology Westmead Hospital Westmead NSW Australia.
authors: Steve
authors: S
authors: Vucic
authors: Australian Red Cross Blood Service Alexandria NSW Australia; University of Technology Sydney NSW Australia.
authors: David O
authors: DO
authors: Irving
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D000944:Antigens, Differentiation, B-Lymphocyte / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D005260:Female; D058851:GPI-Linked Proteins / Q000378:metabolism; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D019041:L-Selectin / Q000378:metabolism; D007962:Leukocytes / Q000187:drug effects* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects / Q000378:metabolism; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D019713:Receptors, CCR5 / Q000378:metabolism; D054380:Receptors, CXCR5 / Q000378:metabolism; D017455:Receptors, IgE / Q000378:metabolism; D017452:Receptors, IgG / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD; D000944:Antigens, Differentiation, B-Lymphocyte; D015415:Biomarkers; C584933:CCR5 protein, human; C064228:CD72 protein, human; C428200:FCGR3B protein, human; D058851:GPI-Linked Proteins; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D019713:Receptors, CCR5; D054380:Receptors, CXCR5; D017455:Receptors, IgE; D017452:Receptors, IgG; D019041:L-Selectin
keywords: Fc‐gamma receptors; autoimmune neuropathies; chronic inflammatory demyelinating polyradiculoneuropathy; dendritic cells; disease pathways; immunophenotyping; intravenous immunoglobulin G