An antibody to the GM1/GalNAc-GD1a complex correlates with development of pure motor Guillain-Barre syndrome with reversible conduction failure

作者：Ogawa Go; Kaida Ken ichi^*; Kuwahara Motoi; Kimura Fumihiko; Kamakura Keiko; Kusunoki Susumu

来源：Journal of Neuroimmunology, 2013, 254(1-2): 141-145.

DOI：10.1016/j.jneuroim.2012.09.005

• Guillain-Barre syndrome
• GM1
• GalNAc-GD1a
• Ganglioside complex
• Conduction block

Antibodies to a ganglioside complex consisting of GM1 and GalNAc-GDla (GM1/GalNAc-GD1a) are found in sera from patients with Guillain-Barre syndrome (CBS). To elucidate the clinical significance of anti-GM1/GalNAc-GD1a antibodies in GBS, clinical features of 58 CBS patients with IgG anti-GM1/GalNAc-GD1a antibodies confirmed by enzyme-linked immunosorbent assay and thin layer chromatography immunostaining were analyzed. Compared to CBS patients without anti-GM1/GalNAc-GD1a antibodies, anti-GM1/GaINAc-GD1a-positive patients more frequently had a preceding respiratory infection (n=38, 66%, p<0.01) and were characterized by infrequency of cranial nerve deficits (n=9, 16%, p<0.01) and sensory disturbances (n=26, 45%, p<0.01). Of the 28 anti-GM1/GaINAc-GD1a-positive patients for whom electrophysiological data were available, 14 had conduction blocks (CBs) at intermediate segments of motor nerves, which were not followed by evident remyelination. Eight of 10 bedridden cases were able to walk independently within one month after the nadir. These results show that the presence of anti-GM1/GalNAc-GD1a antibodies correlated with pure motor CBS characterized by antecedent respiratory infection, fewer cranial nerve deficits, and CBs at intermediate sites of motor nerves. The CB may be generated through alteration of the regulatory function of sodium channels in the nodal axolemma.

• 出版日期2013-1-15