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伴有 LM1 相关抗体的 CIDP 的临床特征。

Clinical features of CIDP with LM1-associated antibodies.

机构信息

Department of Neurology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.

出版信息

J Neurol Neurosurg Psychiatry. 2013 May;84(5):573-5. doi: 10.1136/jnnp-2012-303440. Epub 2012 Nov 8.

Abstract

BACKGROUND

LM1 is the predominant glycolipid in human peripheral nerve myelin and antibodies to LM1 and LM1-containing ganglioside complexes are detected in some patients with chronic inflammatory demyelinating polyneuropathy (CIDP). The clinical features of patients with such antibodies have not yet been investigated.

METHODS

Serum antibodies to LM1, a mixture of GM1 and LM1 (GM1/LM1), and that of GD1b and LM1 (GD1b/LM1) were examined in 75 consecutive patients with CIDP. The clinical features of the CIDP patients with such antibodies in the present series and those in the previous reports were investigated and compared with those of antibody-negative patients.

RESULTS

Of the 75 patients with CIDP, two had antibodies to LM1, three had anti-GM1/LM1 complex antibody, one had anti-GD1b/LM1 complex antibody and two had antibodies to both the GM1/LM1 and GD1b/LM1 complexes. Patients with the LM1-associated antibodies did not have cranial nerve deficits (p<0.05) and exhibited ataxia more frequently than the antibody-negative patients (p<0.01).

CONCLUSION

In humans, LM1 is contained more in the dorsal root than in the cranial nerves. The clinical features of CIDP patients with antibodies to LM1 and LM1-containing complexes may be associated with the distribution of the LM1 antigen. LM1-associated antibodies are possible markers for a subclass of CIDP.

摘要

背景

LM1 是人类周围神经髓鞘中的主要糖脂,在一些慢性炎症性脱髓鞘性多发性神经病(CIDP)患者中检测到针对 LM1 和包含 LM1 的神经节苷脂复合物的抗体。这些具有抗体的患者的临床特征尚未得到研究。

方法

在 75 例连续的 CIDP 患者中检查了针对 LM1、GM1 和 LM1(GM1/LM1)混合物以及 GD1b 和 LM1(GD1b/LM1)的血清抗体。研究并比较了本系列和以前报告中具有此类抗体的 CIDP 患者的临床特征与抗体阴性患者的临床特征。

结果

在 75 例 CIDP 患者中,有 2 例存在针对 LM1 的抗体,3 例存在抗 GM1/LM1 复合物抗体,1 例存在抗 GD1b/LM1 复合物抗体,2 例同时存在抗 GM1/LM1 和 GD1b/LM1 复合物抗体。具有 LM1 相关抗体的患者没有颅神经缺损(p<0.05),并且比抗体阴性患者更频繁地出现共济失调(p<0.01)。

结论

在人类中,LM1 在背根中比在颅神经中含量更高。具有针对 LM1 和包含 LM1 的复合物的抗体的 CIDP 患者的临床特征可能与 LM1 抗原的分布有关。LM1 相关抗体可能是 CIDP 亚类的标志物。

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