R. Press et al., Temporal profile of anti-ganglioside antibodies and their relation to clinical parameters and treatment in Guillain-Barre syndrome, J NEUR SCI, 190(1-2), 2001, pp. 41-47
Elevated anti-ganglioside antibody levels mainly of anti-GM1 and anti-GD1a
specificities have been reported in THE serum of patients with Guillain-Bar
re syndrome (GBS). The relevance of anti-ganglio side antibodies other than
anti-GM1 and anti-GD1a IgG antibodies and the temporal profile of anti-gan
glioside antibodies in GBS is less clear. We studied serum antibodies to GM
1, GD1a, GD1b, GQ1b, sulfatide and cardiolipin of the Ig, I-G and IgA class
es over the course of GBS in patients who were untreated or treated with hi
ghdose intravenous immunoglobulin (Mg). Antibodies to GD1b, GQ1b, sulfatide
and cardiolipin were not detected in the sera of the GBS patients examined
in this study. Anti-GM1 I-G titers peaked around 40 days and anti-GD1a lam
around 90 days after GBS onset. Titers of anti-GM1 IgG antibodies decrease
d following Mg treatment. Patients with antibody peaks, defined as fivefold
or higher increase in antibody titer compared to the lowest antibody titer
over the course of GBS, had higher disability scores during the first two
weeks of GBS and a worse clinical outcome (anti-GM1 IgG and anti-GD1a IgM a
ntibody peaks) and axonal damage (anti-GD1a I-M antibody peaks), compared t
o patients without peak antibody titers. Anti-GM1 IgG and anti-GD1a I.-M an
tibodies are thus strongly associated with more severe- and predominantly a
xonal cases of GBS. The appearance of anti-GM1 IgG and anti-GD1a antibody p
eaks in the serum after the termination of the acute phase of GBS suggests
that these antibodies are produced secondary to nerve damage in GBS. The da
ta does not exclude the possibility that secondarily secreted anti-GM1 IgG
and anti-GD1a IgM antibodies may themselves be biologically active and play
a role in disease propagation and/or recovery from disease in some patient
s with GBS. (C) 2001 Elsevier Science B.V. All rights reserved.