The Neuropathy Center at Weill Cornell Medicine is committed to translational and clinical research designed to improve our understanding of the underlying pathogenic mechanisms and develop more effective therapies for peripheral neuropathies.
A major focus of our research has been the autoimmune or inflammatory neuropathies. Dr. Latov’s laboratory is credited with the discovery of anti-MAG and GM1 antibodies, and the development of assays for detecting these antibodies for diagnosis. A current focus is the use to therapeutic anti-macrophage CD204 antibodies in inflammatory and other neuropathies. He has served as a member of the steering committees of the ICE trial of IVIG in CIDP which led to its FDA approval, and is currently a member of the steering committees of the multinational clinical trials of finglimod and HYQVIA in CIDP. Dr. Chin recently reported on his findings in CIDP demonstrating that electrodiagnostic studies can be useful in monitoring disease activity and predict the likelihood of relapse after cessation of therapy. Dr. Mary Vo has recently reported on her findings that more extensive EDX studies can increase the sensitivity of diagnosis, and that gait parameters are more sensitive than other outcome measures patients undergoing treatment for CIDP.
Another focus of research has been the neuropathies associated with nutritional anomalies. Dr. Chin has published widely on the neuropathy of celiac disease, and we recently reported on our findings that a significant number of neuropathy patients have highly elevated levels of mercury or vitamin B6, which can be toxic to nerves. These anomalies can be treated by dietary modifications. Another important finding was that patients can have more than one cause for neuropathy, supporting comprehensive testing for underlying causes.
At Weill Cornell
The Weill Cornell Neuropathy Center has been designated as the Central Reading Site for the International Phase III Efficacy, Safety and Tolerability of HYQVIA/HyQvia and Gammagard Liquid/KIOVIG in CIDP. Subject recruitment is planned to begin in the US in the spring of 2017.
Search Clinical Trial, go to https://clinicaltrials.gov
Genome Sequencing in Idiopathic Small Fiber Neuropathy
Idiopathic small fiber neuropathy is increasingly recognized as a cause of pain and autonomic dysfunction, including in fibromyalgia. We are collaborating with Dr. Elizabeth Ross at the Weill Cornell Brain and Mind Institute, (https://brainandmind.weill.cornell.edu/ross-laboratory) to sequence the genome of patients with small fiber neuropathy with the aim of identifying factors or pathways that predispose to the development of the neuropathy. This would lead to improved diagnosis and treatment of this condition.
Macrophage Targeting in Peripheral Neuropathies
Macrophages are resident immune cells that are involved in inflammatory and neurodegenerative diseases. They play a key role in in initiating and perpetuating autoimmunity, mediate inflammation, and release neurotoxins that damage nerves. They are also implicated in diabetic microvasculitis, as well as axonal and hereditary neuropathies.
We discovered that antibodies to a macrophage cell receptor, referred to as CD204, SR-A, or MSR1, prevents inflammatory neuropathy in experimental animals, and developed monoclonal antibodies specific to the receptor that are now being tested in Experimental Allergic Neuritis, an animal model for Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP). We plan to also test these antibodies in experimental models of other types of neuropathies including diabetic neuropathy and hereditary neuropathies, depending on the availability of funding. If successful, the antibodies could then be tested as potential therapeutic agents in clinical trials. The studies are being conducted through collaboration with contract research organizations. Cornell University was awarded a patent for the technology by the USPTO (US9375473).