[Antiganglioside autoantibody profiles in Guillain-Barré syndrome].
We established anti-ganglioside antibody profiles in GBS and studied the frequency, fine specificity and clinical correlate. IgG and IgM antibodies to 8 gangliosides were tested by immunodot-blot in 249 consecutive patients with Guillain-Barré syndrome with large variability in clinical expression, referred to our laboratory over a 8-year period. IgG and IgM anti-GM1 antibodies were measured by Elisa. Thin-layer chromatography overlayed by serum was used to control positivity. 89/249 GBS (36%) had characteristic anti-ganglioside antibody profile. Isotypes were, IgG (62%), IgG + IgM (26%) and IgM (12%). Antecedent infections were found in 62% of GBS included more frequently Campylobacter jejuni and cytomegalovirus. Various autoantibody profiles were described with an immunodominant ganglioside. We detected 6 characteristic anti-ganglioside profiles with fine specificity and immunodominant ganglioside corresponding to 6 immuno-clinical variants of GBS: 1) anti-GM1 and GD1b IgG and IgG > IgM in the acute motor axonal neuropathy after Campylobacter jejuni infection in 41 GBS; 2) anti-GD1a IgG in 6 severe motor axonal GBS after Campylobacter jejuni infection; 3) selectively anti-GQ1b IgG in 17 typical Miller Fisher syndrome with areflexia, ataxia and ophthalmoplegia; 4) anti- GT1b ganglioside and polysialogangliosides IgG (n = 9) in two separate cranial nerve variants, ophthalmoplegic SGB and lower cranial nerve variants depending upon the presenting deficit; 5) anti-GD1b IgG in 5 pure ataxic sensory GBS (4%); 6) anti-GM2 IgM in 11 severe GBS with antecedent CMV infection (8%). 34 GBS (14%) had low levels of anti-GM1 and GD1b IgM antibodies which are not disease specific and may simply represent part of the naturally occurring autoantibody population or a secondary response to disease. 126 GBS (50%) had no antibodies, predominantly in classical form. Associations between isotype, fine specificity and clinical presentation permit the definition of homogeneous immuno-clinical variants. Various autoantibody profiles with diagnostic and prognostic value are easy to perform by immunodot blot in acute peripheral neuropathies.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D002855:Chromatography, Thin Layer / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005677:G(M1) Ganglioside / Q000031:analogs & derivatives* / Q000737:chemistry / Q000276:immunology; D005732:Gangliosides / Q000737:chemistry / Q000276:immunology*; D020275:Guillain-Barre Syndrome / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D015151:Immunoblotting / Q000379:methods; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood*; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D001323:Autoantibodies; D005732:Gangliosides; D007074:Immunoglobulin G; D007075:Immunoglobulin M; C064020:ganglioside GD1alpha; C033851:ganglioside, GD1b; D005677:G(M1) Ganglioside; C016481:trisialoganglioside GT1; C039129:GQ1b ganglioside
Les profils autoanticoprs antigangliosides dans le syndrome de Guillain-Barré.