Axonal Loss

Marinos C. Dalakas, M.D., Principal Author

A concomitant axonal loss has been attributed to the primary demyelinating process in patients with CIDP. It is not fully known whether or not the release of neurotoxic cytokines (e.g., TNFα) and noxious mediators, such as nitric oxide and metalloproteinases, enhance axonal loss. (Bouchard, 1999; Dalakas, 1999) However, since the long-term prognosis of CIDP depends on the magnitude of axonal loss rather than on the degree of demyelination, this finding is very important. (Köller, 2005)

Axonal degeneration and loss has a greater long-term prognostic impact of CIDP than active demyelination, inflammatory infiltrates, or onion-bulb formations. (Rezania, 2004)