Conclusions
The FcγR regulatory system is disturbed in patients with CIDP. Balancing activating vs inhibitory FcγR expression might provide a clinical benefit for patients with CIDP.
Methods
Peripheral blood leukocyte subsets, including classical CD14(high)CD16(-) and nonclassical inflammatory CD14(low)CD16(+) monocytes as well as naive CD19(+)CD27(-) and memory CD19(+)CD27(+) B cells, were obtained at baseline and monitored at 2 and 4-8 weeks after initiation of IVIg therapy.
Objective
To evaluate the expression of activating and inhibitory Fc-gamma receptors (FcγRs) before and during clinically effective therapy with IV immunoglobulin (IVIg) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP).
Results
Compared with healthy donors matched by age and sex, patients with CIDP showed increased expression levels of the activating high-affinity FcγR1 on CD14(high)CD16(-) (p < 0.001) and CD14(low)CD16(+) monocytes (p < 0.001). Expression of the activating low-affinity FcγRIIA was increased on CD14(low)CD16(+) monocytes (p = 0.023). Conversely, expression of the inhibitory FcγRIIB was reduced on naive (p = 0.009) and memory (p = 0.002) B cells as well as on CD14(high)CD16(-) monocytes (p = 0.046). Clinically effective IVIg therapy partially restored deregulated FcγR expression on B cell subsets and monocytes. Conclusions: The FcγR regulatory system is disturbed in patients with CIDP. Balancing activating vs inhibitory FcγR expression might provide a clinical benefit for patients with CIDP.