Anti-GM1, anti-central myelin proteins, and anti-cardiolipin autoantibodies during plasma-exchange in Guillain-Barré syndrome (GBS).
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.
Matà
S
S
Dipartimento di Scienze Neurologiche e Psichiatriche, University of Florence, Italy.
Avanzi
G
G
Lombardo
R
R
Cepparone
F
F
Pinto
F
F
Lolli
F
F
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
D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D009185:Myelin Proteins; D005677:G(M1) Ganglioside