Anti-GM1 antibody IgG subclass: a clinical recovery predictor in Guillain-Barré syndrome.
OBJECTIVE
To determine whether the anti-GM1 antibody IgG subclass (IgG1 to 4) is associated with clinical profiles and patterns of recovery in Guillain-Barré syndrome (GBS).


METHODS
The IgG subclassification of anti-GM1 antibody was examined and compared with clinical data on 42 GBS patients positive for the antibody.


RESULTS
Frequent anti-GM1 antibody subclasses were IgG1 (76%) and IgG3 (31%). IgG1 antibody was associated with preceding gastroenteritis and Campylobacter jejuni serology, whereas IgG3 antibody was associated with preceding respiratory infection. Although the severity at nadir was similar for IgG1- and IgG3-positive patients, the percentage of patients who could not walk independently was greater for the IgG1-positive group 1 month (42 vs 0%; p = 0.02), 3 months (28 vs 0%), and 6 months (25 vs 0%) after onset. Rapid recovery within 1 month occurred frequently in the patients with the IgG3 antibody but rarely in those with the IgG1 antibody (67 vs 11%; p = 0.003).


CONCLUSIONS
The IgG1 subclass of anti-GM1 antibody is a major subtype indicative of slow recovery, whereas isolated elevation of IgG3 subclass antibody titer suggests rapid recovery. Variation in subclass patterns may depend on which pathogen precipitates GBS.
Department of Neurology, Dokkyo University School of Medicine, Shimotsuga, Tochigi, Japan. kogamrk@dokkyomed.ac.jp
M
M
Koga
N
N
Yuki
K
K
Hirata
M
M
Morimatsu
M
M
Mori
S
S
Kuwabara
D000328:Adult; D001323:Autoantibodies / Q000145:classification / Q000276:immunology*; D002169:Campylobacter Infections / Q000150:complications; D016123:Campylobacter jejuni; D003289:Convalescence; D005260:Female; D005677:G(M1) Ganglioside / Q000276:immunology*; D005759:Gastroenteritis / Q000150:complications; D020275:Guillain-Barre Syndrome / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D006192:Haemophilus Infections / Q000150:complications; D006193:Haemophilus influenzae; D006801:Humans; D007074:Immunoglobulin G / Q000145:classification / Q000276:immunology*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D016896:Treatment Outcome
D001323:Autoantibodies; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D005677:G(M1) Ganglioside