Anti-GM1IgG antibodies in Guillain–Barré syndrome: fine specificity is associated with disease severity

Ricardo D Lardone
June 2010
Journal of Neurology, Neurosurgery & Psychiatry;Jun2010, Vol. 81 Issue 6, p629
Academic Journal
BACKGROUND: Clinical severity of Guillain–Barré syndrome (GBS) is highly variable, but the immunopathological reason is unknown. OBJECTIVE: The study was designed to show which antibody parameters are associated with disease severity in GBS patients with serum anti-GM1 IgG antibodies. METHODS: Thirty-four GBS patients with anti-GM1IgG antibodies were grouped into two categories according to disease severity at nadir: mild (grades 1–3 by Hughes functional scale, n=13) and severe (grades 4 and 5, n=21). Titre, affinity, fine specificity and cell binding of anti-GM1antibodies were obtained and compared between the two groups. RESULTS: No differences in antibody titre (GM1-ELISA) or affinity were found between the two patient groups. In contrast, the severe group showed a significantly higher frequency (95%, vs 46% in the mild group, p=0.002) of specific (not cross-reacting with GD1b) anti-GM1antibodies. In addition, the severe group also exhibited a higher antibody binding titre to cellular GM1. CONCLUSIONS: Differences in fine specificity of antibodies are strong indications that different regions of the GM1-oligosaccharide are involved in antibody binding. High titres of specific anti-GM1antibody binding to cellular GM1can be explained by antigen exposure, that is, GM1exposes or forms mainly epitopes recognised by specific antibodies, and ‘hides’ those involved in binding of cross-reacting antibodies. Thus, the fine specificity of anti-GM1antibodies may influence disease severity by affecting antibody binding to cellular targets. Additionally, since antibody specificity studies are relatively easy to implement, fine specificity could be considered a useful predictor of disease severity.


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