Sheikh Kazim A, Zhang Gang, Gong Yanpin, Schnaar Ronald L, Griffin John W
Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.
Ann Neurol. 2004 Aug;56(2):228-39. doi: 10.1002/ana.20173.
Immune responses against gangliosides are strongly implicated in the pathogenesis of some variants of Guillain-Barré syndrome (GBS). For example, IgG antibodies against GM1, GD1a, and related gangliosides are frequently present in patients with post-Campylobacter acute motor axonal neuropathy (AMAN) variant of GBS, and immunization of rabbits with GM1 has produced a model of AMAN. However, the role of anti-ganglioside antibodies in GBS continues to be debated because of lack of a passive transfer model. We recently have raised several monoclonal IgG anti-ganglioside antibodies. We passively transfer these antibodies by intraperitoneal hybridoma implantation and by systemic administration of purified anti-ganglioside antibodies in mice. Approximately half the animals implanted with an intraperitoneal clone of anti-ganglioside antibody-secreting hybridoma developed a patchy, predominantly axonal neuropathy affecting a small proportion of nerve fibers. In contrast to hybridoma implantation, passive transfer with systemically administered anti-ganglioside antibodies did not cause nerve fiber degeneration despite high titre circulating antibodies. Blood-nerve barrier studies indicate that animals implanted with hybridoma had leaky blood-nerve barrier compared to mice that received systemically administered anti-ganglioside antibodies. Our findings suggest that in addition to circulating antibodies, factors such as antibody accessibility and nerve fiber resistance to antibody-mediated injury play a role in the development of neuropathy.
针对神经节苷脂的免疫反应与吉兰-巴雷综合征(GBS)某些变异型的发病机制密切相关。例如,抗GM1、GD1a及相关神经节苷脂的IgG抗体在GBS的空肠弯曲菌感染后急性运动轴索性神经病(AMAN)变异型患者中经常出现,用GM1免疫兔子可建立AMAN模型。然而,由于缺乏被动转移模型,抗神经节苷脂抗体在GBS中的作用仍存在争议。我们最近制备了几种单克隆IgG抗神经节苷脂抗体。我们通过腹腔内植入杂交瘤以及向小鼠全身注射纯化的抗神经节苷脂抗体来被动转移这些抗体。大约一半腹腔内植入分泌抗神经节苷脂抗体杂交瘤克隆的动物出现了斑片状、主要为轴索性的神经病变,影响一小部分神经纤维。与杂交瘤植入不同,尽管循环抗体滴度很高,但全身注射抗神经节苷脂抗体进行被动转移并未导致神经纤维变性。血-神经屏障研究表明,与接受全身注射抗神经节苷脂抗体的小鼠相比,植入杂交瘤的动物血-神经屏障存在渗漏。我们的研究结果表明,除了循环抗体外,抗体可及性和神经纤维对抗体介导损伤的抵抗力等因素在神经病变的发生中也起作用。