Odaka Masaaki, Koga Michiaki, Yuki Nobuhiro, Susuki Keiichiro, Hirata Koichi
Department of Neurology, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
J Neurol Sci. 2003 Jun 15;210(1-2):99-103. doi: 10.1016/s0022-510x(03)00029-7.
Anti-ganglioside antibodies frequently are present in sera from patients with Guillain-Barré syndrome (GBS) during the acute phase, but no patients in whom anti-ganglioside antibodies were tested before the onset of the syndrome have been reported. We describe the first case of GBS subsequent to Campylobacter jejuni infection, in which longitudinal changes in anti-ganglioside antibody titers were measured before and after the onset of limb weakness. Serum antibody titers against GM1 (IgM/IgG), GM1b (IgM/IgG), GalNAc-GD1a (IgM/IgG), and GD1b (IgG) were highest on the day of onset, but negative before onset. Anti-C. jejuni IgG and IgA antibody titers paralleled those of the anti-ganglioside antibodies, indicative that C. jejuni infection triggered anti-ganglioside antibody production. Press et al. [J. Neurol. Sci. 190 (2001) 41] reported that anti-ganglioside antibody titers peaked during the recovery phase, but our findings are counter to theirs. We speculate that anti-ganglioside antibodies are the primary effectors of nerve damage in GBS.
抗神经节苷脂抗体在吉兰-巴雷综合征（GBS）患者急性期的血清中常可检测到，但此前尚未有在该综合征发病前检测抗神经节苷脂抗体的患者报道。我们描述了首例空肠弯曲菌感染后发生的GBS病例，其中在肢体无力发作前后测量了抗神经节苷脂抗体滴度的纵向变化。抗GM1（IgM/IgG）、GM1b（IgM/IgG）、GalNAc-GD1a（IgM/IgG）和GD1b（IgG）的血清抗体滴度在发病当天最高，但发病前为阴性。抗空肠弯曲菌IgG和IgA抗体滴度与抗神经节苷脂抗体滴度平行，表明空肠弯曲菌感染触发了抗神经节苷脂抗体的产生。Press等人[《神经科学杂志》190（2001）41]报道抗神经节苷脂抗体滴度在恢复阶段达到峰值，但我们的研究结果与他们相反。我们推测抗神经节苷脂抗体是GBS中神经损伤的主要效应因子。
