title: Ganglionic acetylcholine receptor autoantibodies in patients with Guillain-Barré syndrome.
abstract: Although standardized autonomic tests are useful for diagnosing autonomic failure in patients with Guillain-Barré syndrome (GBS), they cannot be used as predictive markers. Thus, serological markers may correctly identify patients with GBS who are at risk for autonomic dysfunction.
  
  
  
  We validated a luciferase immunoprecipitation system that detects IgG antibodies in patient serum that specifically bind to the α3 or β4 subunits of ganglionic neuronal nicotinic acetylcholine receptors (gAChR). We then used luciferase-conjugated ligands specific to antibodies against two gAChR subunits to test 79 sera samples from patients with GBS, 34 from subjects with other neurological diseases (OND), and 73 from healthy controls (HC). 1) In the first analysis, patients were classified into two groups according to the presence or absence of autonomic symptoms (AS). We compared the frequency of the anti-gAChR antibodies between these two groups (AS+ and AS-). 2) In the second analysis, furthermore, patients were classified depending on the presence or absence of anti-glycolipid antibodies (AGA). We compared the frequency of the anti-gAChR antibodies between the four categories of GBS (AS+/AGA+, AS+/AGA-, AS-/AGA+, and AS-/AGA-), OND, and HC.
  
  
  
  Eight subjects with GBS were positive for α3 subunits, while one was positive for β4 subunits. Anti-α3 and -β4 gAChR antibodies were also detected in 13.6% of AS+ GBS group in the first analysis. Two of 35 patients in AS-GBS group were seropositive for the anti-gAChR antibodies and AGA in the second analysis. Patients with GBS that were positive for serum antibodies to the α3 and/or β4 subunits of gAChRs showed a range of clinical features including AS and AGA.
  
  
  
  Patients with GBS may have circulating antibodies against gAChR, which may contribute to the autonomic dysfunction associated with this disease.
authors.affiliation: Department of Clinical Research, Nagasaki Kawatana Medical Center, Nagasaki, Japan; Department of Neurology, Nagasaki Kawatana Medical Center, Nagasaki, Japan. Electronic address: nakaneshunya@gmail.com.
authors.forename: Shunya
authors.initials: S
authors.lastname: Nakane
authors.affiliation: Department of Clinical Research, Nagasaki Kawatana Medical Center, Nagasaki, Japan. Electronic address: osmhgc@gmail.com.
authors.forename: Osamu
authors.initials: O
authors.lastname: Higuchi
authors.affiliation: Department of Neurology, Kinki University Faculty of Medicine, Osaka, Japan. Electronic address: hamashi1207@yahoo.co.jp.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Hamada
authors.affiliation: Department of Clinical Research, Nagasaki Kawatana Medical Center, Nagasaki, Japan; Department of Neurology, Nagasaki Kawatana Medical Center, Nagasaki, Japan; Department of Neuroimmunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. Electronic address: yas.maeda@hotmail.co.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Maeda
authors.affiliation: Department of Neuroimmunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Neurology and Strokology, Nagasaki University Hospital, Nagasaki, Japan. Electronic address: a.mukaino@gmail.com.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Mukaino
authors.affiliation: Department of Neurology, Nagasaki Kawatana Medical Center, Nagasaki, Japan. Electronic address: wakasakai@gmail.com.
authors.forename: Waka
authors.initials: W
authors.lastname: Sakai
authors.affiliation: Department of Neurology, Kinki University Faculty of Medicine, Osaka, Japan. Electronic address: kusunoki-tky@umin.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kusunoki
authors.affiliation: Department of Neurology, Nagasaki Kawatana Medical Center, Nagasaki, Japan. Electronic address: hidenori@hosp.go.jp.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Matsuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D005260:Female; D020275:Guillain-Barre Syndrome / Q000097:blood* / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011950:Receptors, Cholinergic / Q000276:immunology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D011950:Receptors, Cholinergic
keywords: Anti-ganglionic acetylcholine receptor autoantibodies; Anti-glycolipid antibodies; Autonomic dysfunction; Guillain-Barré syndrome