title: Anti-GM1, anti-central myelin proteins, and anti-cardiolipin autoantibodies during plasma-exchange in Guillain-Barré syndrome (GBS).
abstract: We measured the autoantibodies to GM1, central myelin proteins, and cardiolipin in 30 GBS patients using sensitive ELISA and Western blot techniques. The sequential modifications of titers during plasma-exchange (PE) and at follow-up were investigated in 15 patients. In pretreatment sera, we found significantly increased antibody titers to GM1 (37% of the patients), central myelin proteins (28%), and cardiolipin (21%). Seventeen patients out of 29 (58%) presented increased IgG or IgM antibody to at least one of the antigens considered as compared to 10 out of 70 controls (14%, P = 0.00001). By Western blot, IgG or IgM antibodies reactive with the triton insoluble fraction of central myelin were observed in 19 out of 28 GBS patients (67%). The follow-up measurements during and after PE showed a declining autoantibody titer in 10 out of 15 patients. However, in the remaining 5 GBS patients, we observed a persistently elevated titer or an increase from baseline values occurring during or after PE and reaching a peak. In 2 of the 5 patients, the titer peak preceded a clinical re-exacerbation. The presence of a persistently elevated or an increasing autoantibody titer during treatment with PE merits further investigation and may help to clarify the pathogenesis of GBS and improve its treatment.
authors.affiliation: Dipartimento di Scienze Neurologiche e Psichiatriche, University of Florence, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Matà
authors.forename: G
authors.initials: G
authors.lastname: Avanzi
authors.forename: R
authors.initials: R
authors.lastname: Lombardo
authors.forename: F
authors.initials: F
authors.lastname: Cepparone
authors.forename: F
authors.initials: F
authors.lastname: Pinto
authors.forename: F
authors.initials: F
authors.lastname: Lolli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D001323:Autoantibodies / Q000097:blood*; D015153:Blotting, Western; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005677:G(M1) Ganglioside / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008875:Middle Aged; D009185:Myelin Proteins / Q000276:immunology*; D010951:Plasma Exchange; D011129:Polyradiculoneuropathy / Q000276:immunology*; D012680:Sensitivity and Specificity; D017186:Titrimetry
chemical_list: D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D009185:Myelin Proteins; D005677:G(M1) Ganglioside