Anti-ganglioside antibodies and elevated CSF IgG levels in Guillain-Barré syndrome.
Anti-ganglioside antibody production and dysfunction of blood-cerebrospinal fluid (CSF) barrier (BCB) are frequent findings in dysimmune neuropathy patients, whereas intrathecal synthesis of immunoglobulins is still a matter of debate. We examined the CSF, immunological and electrophysiological characteristics from a cohort of patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP), and from patients with other neurological diseases as control. Thirty-eight percent of GBS patients and 28% of CIDP patients had detectable serum titers of anti-ganglioside antibodies, which were associated with a high incidence of motor conduction block and increased F wave latencies. In GBS patients, but not in CIDP or control patients, there was an association between anti-ganglioside antibodies and increased CSF immunoglobulin-G (IgG) levels as determined by the IgG index. However, none of the GBS patients had CSF oligoclonal bands (OBs) or indications of intrathecal anti-ganglioside antibody synthesis. The possibility of an abnormal CSF concentration of immunoglobulins from serum through dysfunctional BCB or damaged nerve roots, and the role of serum anti-ganglioside reactivity in this process are discussed.
Department of Neurological and Psychiatric Science, University of Firenze, Firenze, Italy. masa@unifi.it
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Matà
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Amantini
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Lolli
D000200:Action Potentials / Q000502:physiology / Q000528:radiation effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000888:Antibodies, Anti-Idiotypic / Q000378:metabolism*; D002493:Central Nervous System Diseases / Q000134:cerebrospinal fluid / Q000276:immunology / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005732:Gangliosides / Q000276:immunology*; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid* / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology / Q000528:radiation effects; D018709:Statistics, Nonparametric
D000888:Antibodies, Anti-Idiotypic; D005732:Gangliosides; D007074:Immunoglobulin G