title: Binding of immunoglobulin G antibodies in Guillain-Barré syndrome sera to a mixture of GM1 and a phospholipid: possible clinical implications.
abstract: Anti-GM1 immunoglobulin G (IgG) antibodies are frequently present in sera from patients with Guillain-Barré syndrome (GBS). A previous report on a patient who had a neuropathy with immunoglobulin M (IgM) M-protein binding to a conformational epitope formed by phosphatidic acid (PA) and gangliosides prompted us to investigate the binding of IgG antibodies in GBS sera to a mixture of GM1 and PA (GM1/PA). Of 121 GBS patients, 32 had anti-GM1 IgG antibodies. All 32 also had antibody activity against GM1/PA. Twenty-five (78%) of 32 patients had greater activity against GM1/PA than against GM1 alone. Twelve patients who had no anti-GM1 IgG antibodies had IgG antibody activity against GM1/PA. No GBS patient had IgG antibody against PA alone. In contrast, two rabbit anti-GM1 antisera had greater activity against GM1 alone than against GM1/PA. IgG antibody with greater binding activity against a mixture of GM1 and a phospholipid than against GM1 alone may have an important role in the pathogenesis of GBS and has implications for diagnosis.
authors.affiliation: Department of Neurology, School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. kusunoki-tky@umin.ac.jp
authors.forename: Susumu
authors.initials: S
authors.lastname: Kusunoki
authors.forename: Daiji
authors.initials: D
authors.lastname: Morita
authors.forename: Shinya
authors.initials: S
authors.lastname: Ohminami
authors.forename: Seiji
authors.initials: S
authors.lastname: Hitoshi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kanazawa
mesh_terms: D000208:Acute Disease; D000918:Antibody Specificity; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers; D004797:Enzyme-Linked Immunosorbent Assay; D005677:G(M1) Ganglioside / Q000276:immunology*; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D010743:Phospholipids / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D007074:Immunoglobulin G; D010743:Phospholipids; D005677:G(M1) Ganglioside