Deregulated Fcy receptor expression in patients with CIDP

Abstract

Objective: To evaluate the expression of activating and inhibitory Fc-gamma receptors (FcgRs) before and during clinically effective therapy with IV immunoglobulin (IVIg) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Methods: Peripheral blood leukocyte subsets, including classical CD14highCD162 and nonclassical inflammatory CD14lowCD161 monocytes as well as naive CD191CD272 and memory CD191CD271 B cells, were obtained at baseline and monitored at 2 and 4-8 weeks after initiation of IVIg therapy. Results: Compared with healthy donors matched by age and sex, patients with CIDP showed increased expression levels of the activating high-affinity FcγR1 on CD14highCD162 (p < 0.001) and CD14lowCD161 monocytes (p< 0.001). Expression of the activating low-affinity FcγRIIA was increased on CD14lowCD161 monocytes (p 5 0.023). Conversely, expression of the inhibitory FcγRIIB was reduced on naive (p 5 0.009) and memory (p 5 0.002) B cells as well as on CD14highCD162 monocytes (p 5 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 FcgR expression might provide a clinical benefit for patients with CIDP.