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.
Koga
M
M
Department of Neurology, Dokkyo University School of Medicine, Shimotsuga, Tochigi, Japan. kogamrk@dokkyomed.ac.jp
Yuki
N
N
Hirata
K
K
Morimatsu
M
M
Mori
M
M
Kuwabara
S
S
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