The neuroimmune hypothesis in Parkinson's disease.

The role of immune mechanisms in the pathogenesis of Parkinson's disease is still a matter of controversy. Immunological abnormalities have been reported in various brain areas and in peripheral immune parameters. Beside antigen specific findings which might indicate an autoimmune process directed against dopaminergic neurons, non-antigen specific abnormalities have been found, which could be caused either by a disease specific process and/or by immunological properties of various anti-parkinsonian drugs, e.g. bromocriptine. Immune reactions may imitate or maintain the degenerative process. In this case possible neuroprotective strategies interfering with immune functions could be developed. Further investigations are necessary to elucidate the impact of immune mechanisms on the degenerative process in Parkinson's disease.

[Mechanisms of action of intravenous immunoglobulins]. / Wirkmechanismen intravenöser Immunglobuline.

Intravenous immunoglobulins (IVIG) are now used to treat various diseases, including autoimmune diseases, systemic inflammatory diseases, allografts and for replacement therapy in the case of IgG deficiency. Only in some of the indications has the efficacy of this treatment been confirmed in large-scale studies. Also, in many cases the modes of action remain unclear. Principally, the following therapeutic strategies can be differentiated: Replacement treatment, blocking of the effector molecules, influencing of the cellular and humoral limbs of the immune defence system and interaction with cytokines. In certain CNS diseases, displacement of pathological immunoglobulins may be involved. It would be desirable to acquire more detailed knowledge about modes of action with the aim of using IVIG with greater specificity in the future.