A cross-sectional study of sural nerve biopsies in chronic inflammatory demyelinating polyneuropathy (CIDP) showed extensive deposition of terminal complement complex (C5b-9) in ~94 % of patients, which was absent in non-inflammatory controls. Higher complement deposition correlated with more severe neuropathy and a progressive disease course, supporting a direct role of complement activation in nerve fibre injury. These findings highlight complement pathways as a key mechanism in CIDP and suggest that complement inhibitors could be a promising targeted therapeutic strategy for a subset of patients.
Key Points:
- Terminal complement complex (C5b-9) deposition was found in the large majority of sural nerve biopsies from CIDP patients, and was absent in non-inflammatory controls, confirming complement involvement in the pathology.
- Higher complement deposition correlated with greater neuropathy severity and a progressive disease course, supporting a direct role for complement activation in nerve fibre injury.
- These findings identify the complement pathway as a key mechanism in CIDP, suggesting complement inhibitors as a promising targeted therapeutic strategy for a subset of patients.
References:
Stascheit F, Roos A, Schroeter CB, Thomas JK, Hahn K, Preßler H, et al. Complement profiling of sural nerves in chronic-inflammatory demyelinating polyneuropathy. Acta Neuropathologica. 2025 Sep 19;150(1):32.
DOI: 10.1007/s00401-025-02936-w.
Publish on behalf of the Scientific Panel on Neuropathies.