Recent advance in neuroimmunology

: Many important reports have been published during these several years in Japan in the field of neuroimmunology. Serum vascular endothelial factor (VEGF) levels in Crow-Fukase (POEMS) syndrome were about 15 to 30 times than those in the control subjects and other neurological disorders. The overproduction of VEGF may be relevant to the pathogenesis of most of the manifestations including neuropathy. We speculate that VEGF may affect the blood nerve barrier by increasing microvascular hyperpermeability and thereby increasing endoneural pressure subsequent to edema. In Isaacs' syndrome, voltage-gated potassium channel (VGKC) were suppressed by anti-VGKC antibodies. The patch clamp study indicate that the pathophysiology of the suppression of VGKC seems to be due to the increased degradation of VGKC. By the recent nationwide survey, the total number of HTLV-I-associated myelopathy (HAM) patients in Japan is now estimated as 1,432. A most likely pathological mechanism of HAM is that cytotoxic T lymphocytes attack the HTLV-I infected lymphocytes infiltrating the central nervous system, resulting a surrounding nervous tissue damage by bystander mechanism.