Susuki K, Yuki N, Hirata K
Department of Neurology, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
J Neurol Sci. 2001 Mar 15;185(1):5-9. doi: 10.1016/s0022-510x(01)00464-6.
Anti-GQ1b IgG frequently is present in sera of patients with Miller Fisher syndrome (MFS), Guillain-Barré syndrome (GBS) with ophthalmoplegia, Bickerstaff's brainstem encephalitis (BBE), and acute ophthalmoparesis (AO) in the acute phase. Why various clinical signs develop under these conditions, however, has yet to be clarified. We investigated the fine specificity of anti-GQ1b IgG and its clinical correlation in sera from 82 patients: 56 with MFS, 11 with GBS, 13 with BBE, and 2 with AO. Anti-GQ1b IgG antibodies were absorbed by GT1a in 80 (98%) of the 82 sera, by GD1b in 11 (13%), and by the other b-series gangliosides GD3, GD2, or GT1b in 24 (29%). The most frequent pattern of fine specificity was the cross-reaction with GT1a alone, seen in 56 (68%) samples. Of the 11 patients with anti-GQ1b IgG, cross-reacting with GD1b, 6 (55%) had impaired deep sense, and the association was significant (p=0.02). This is the first study to show that the fine specificity of anti-GQ1b IgG is heterogeneous and that the difference is correlated with the presence of a particular clinical sign.
抗GQ1b IgG在急性米勒费雪综合征（MFS）、伴有眼肌麻痹的吉兰-巴雷综合征（GBS）、比克斯特法夫脑干脑炎（BBE）及急性眼肌麻痹（AO）患者的血清中常呈阳性。然而，在这些情况下为何会出现各种临床症状仍有待阐明。我们研究了82例患者血清中抗GQ1b IgG的精细特异性及其临床相关性，其中56例为MFS患者，11例为GBS患者，13例为BBE患者，2例为AO患者。82份血清中的80份（98%）抗GQ1b IgG抗体可被GT1a吸收，11份（13%）可被GD1b吸收，24份（29%）可被其他b系列神经节苷脂GD3、GD2或GT1b吸收。最常见的精细特异性模式是仅与GT1a发生交叉反应，见于56份（68%）样本。在11例抗GQ1b IgG与GD1b发生交叉反应的患者中，6例（55%）存在深感觉障碍，且这种关联具有显著性（p = 0.02）。这是第一项表明抗GQ1b IgG的精细特异性具有异质性且这种差异与特定临床症状的存在相关的研究。
