Anti-ganglioside antibodies and elevated CSF IgG levels in Guillain-Barré syndrome

Eur J Neurol. 2006 Feb;13(2):153-60. doi: 10.1111/j.1468-1331.2006.01161.x.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Action Potentials / physiology
  • Action Potentials / radiation effects
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Anti-Idiotypic / metabolism*
  • Central Nervous System Diseases / cerebrospinal fluid
  • Central Nervous System Diseases / immunology
  • Central Nervous System Diseases / physiopathology
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • Gangliosides / immunology*
  • Guillain-Barre Syndrome / cerebrospinal fluid*
  • Guillain-Barre Syndrome / immunology*
  • Guillain-Barre Syndrome / physiopathology
  • Humans
  • Immunoglobulin G / cerebrospinal fluid*
  • Linear Models
  • Male
  • Middle Aged
  • Neural Conduction / physiology
  • Neural Conduction / radiation effects
  • Statistics, Nonparametric

Substances

  • Antibodies, Anti-Idiotypic
  • Gangliosides
  • Immunoglobulin G