Department of Translational Medicine, Milan University, Milan, Italy; 2nd Neurology, IRCCS Humanitas Clinical Institute, Rozzano, Milan, Italy.
J Neuroimmunol. 2010 Feb 26;219(1-2):119-22. doi: 10.1016/j.jneuroim.2009.11.012. Epub 2009 Dec 16.
Anti-ganglioside complexes (GSCs) IgG antibodies have been reported in patients with Guillain-Barré (GBS) or Fisher syndrome but little is known on their presence in multifocal motor neuropathy (MMN) or other chronic immune-mediated neuropathies. We examined 24 patients with MMN, 34 with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), 23 with neuropathy associated with IgM monoclonal gammopathy (PN+IgM), 13 with GBS, 34 with motor neuron disease (MND), 24 with other neuropathies and 20 normal subjects. Patients' sera were tested by ELISA for IgM reactivity to GM1, GM2, GD1a, GD1b and GT1b and with GSCs made by any combination of two of these gangliosides. In all GM1 positive patients with MMN (11), PN+IgM (1), CIDP (1) and POEMS (1), binding to GM1 was abolished or consistently reduced when tested in GSCs also containing GD1a or other gangliosides. This only occurred in one of the three GM1 positive MND patients. In a patient with PN-IgM and anti-GM2 and GD1a IgM, both reactivities were reduced when tested in GSCs also containing GM1. New reactivities were found in a patient with CIDP and anti-GD1b IgM who presented an additional reactivity to GT1b/GM1 and GT1b/GM2 GSCs, and in one with PN-IgM who had reactivity to GM2/GD1b but not to individual gangliosides. Testing for IgM antibodies to GSCs rarely permitted to identify new reactivities in chronic immune neuropathies. IgM binding to gangliosides was however often modified in GSCs suggesting that these reactivities may be affected by contiguous gangliosides possibly influencing their pathogenicity.
抗神经节苷脂复合物（GSCs）IgG 抗体已在吉兰-巴雷（GBS）或 Fisher 综合征患者中报告，但在多发性运动神经病（MMN）或其他慢性免疫介导性神经病中其存在情况知之甚少。我们检查了 24 例 MMN 患者、34 例慢性炎症性脱髓鞘性多发性神经病（CIDP）患者、23 例与 IgM 单克隆丙种球蛋白血症相关的神经病（PN+IgM）患者、13 例 GBS 患者、34 例运动神经元病（MND）患者、24 例其他神经病患者和 20 例正常对照者。通过 ELISA 检测患者血清中 IgM 对 GM1、GM2、GD1a、GD1b 和 GT1b 的反应性，并用这些神经节苷脂中任意两种组合制成的 GSCs 进行检测。在所有 11 例 GM1 阳性 MMN 患者（11）、1 例 PN+IgM（1）、1 例 CIDP（1）和 1 例 POEMS（1）患者中，当在包含 GD1a 或其他神经节苷脂的 GSCs 中进行测试时，GM1 的结合被消除或一致减少。这仅在三名 GM1 阳性 MND 患者中的一名中发生。在一名具有 PN-IgM 和抗-GM2 和 GD1a IgM 的患者中，当在包含 GM1 的 GSCs 中进行测试时，两种反应性均降低。在一名患有 CIDP 和抗-GD1b IgM 的患者中发现了新的反应性，该患者对 GT1b/GM1 和 GT1b/GM2 GSCs 具有另外的反应性，而在一名具有 PN-IgM 的患者中具有对 GM2/GD1b 的反应性，但对单个神经节苷脂无反应性。检测 GSCs 中的 IgM 抗体很少能够在慢性免疫神经病变中确定新的反应性。然而，IgM 与神经节苷脂的结合在 GSCs 中经常发生改变，这表明这些反应性可能受相邻神经节苷脂的影响，从而可能影响其致病性。
