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

Abstract
Antibodies to a ganglioside complex consisting of GM1 and GalNAc-GD1a (GM1/GalNAc-GD1a) are found in sera from patients with Guillain-Barré syndrome (GBS). To elucidate the clinical significance of anti-GM1/GalNAc-GD1a antibodies in GBS, clinical features of 58 GBS patients with IgG anti-GM1/GalNAc-GD1a antibodies confirmed by enzyme-linked immunosorbent assay and thin layer chromatography immunostaining were analyzed. Compared to GBS patients without anti-GM1/GalNAc-GD1a antibodies, anti-GM1/GalNAc-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/GalNAc-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 GBS 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.
AuthorsGo Ogawa, Ken-ichi Kaida, Motoi Kuwahara, Fumihiko Kimura, Keiko Kamakura, Susumu Kusunoki
JournalJournal of neuroimmunology (J Neuroimmunol) Vol. 254 Issue 1-2 Pg. 141-5 (Jan 15 2013) ISSN: 1872-8421 [Electronic] Netherlands
PMID23000056 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2012 Elsevier B.V. All rights reserved.
Chemical References
  • Antibodies
  • Gangliosides
  • ganglioside, GD1a
  • G(M1) Ganglioside
Topics
  • Action Potentials (physiology)
  • Adult
  • Aged
  • Antibodies (blood)
  • Cranial Nerves (physiopathology)
  • Electric Stimulation
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • G(M1) Ganglioside (immunology)
  • Gangliosides (immunology)
  • Guillain-Barre Syndrome (blood, pathology, physiopathology)
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction (physiology)
  • Retrospective Studies
  • Young Adult

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