NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany, Phone: +0049 30 450 639807.
Charité - Universitätsmedizin Berlin, Department of Neurology, Berlin, Germany.
Clin Chem Lab Med. 2018 May 24;56(6):919-926. doi: 10.1515/cclm-2017-0792.
Unlike for acute immune-mediated neuropathies (IN), anti-ganglioside autoantibody (aGAAb) testing has been recommended for only a minority of chronic IN yet. Thus, we used a multiplex semi-quantitative line immunoassay (LIA) to search for aGAAb in chronic-inflammatory demyelinating polyneuropathy (CIDP) and its clinical variants.
Anti-GAAb to 11 gangliosides and sulfatide (SF) were investigated by LIA in 61 patients with IN (27 typical CIDP, 12 distal-acquired demyelinating polyneuropathy, 6 multifocal-acquired demyelinating sensory/motor polyneuropathy, 10 sensory CIDP, 1 focal CIDP and 5 multifocal-motoric neuropathy), 40 with other neuromuscular disorders (OND) (15 non-immune polyneuropathies, 25 myasthenia gravis), 29 with multiple sclerosis (MS) and 54 healthy controls (HC).
In contrast to IgG, positive anti-GAAB IgM against at least one ganglioside/SF was found in 17/61 (27.9%) IN compared to 2/40 (5%) in OND, 2/29 MS (6.9%) and 4/54 (7.4%) in HC (p=0.001). There was a statistically higher prevalence of anti-sulfatide (aSF) IgM in IN compared to OND (p=0.008). Further, aGM1 IgM was more prevalent in IN compared to OND and HC (p=0.009) as well as GD1b in IN compared to HC (p<0.04). The prevalence of aGM1 IgM in CIDP was lower compared to in multifocal motor neuropathy (MMN) (12% vs. 60%, p=0.027). Patients showing aSF, aGM1 and aGM2 IgM were younger compared to aGAAb negatives (p<0.05). Patients with aSF IgM positivity presented more frequently typical CIDP and MMN phenotypes (p<0.05, respectively).
The aGAAb LIA revealed an elevated frequency of at least one aGAAb IgM in CIDP/MMN patients. Anti-SF, aGM1 and aGM2 IgM were associated with younger age and anti-SF with IN phenotypes.
与急性免疫介导性神经病（IN）不同，抗神经节苷脂自身抗体（aGAAb）检测仅推荐用于少数慢性 IN。因此，我们使用多重半定量线免疫分析（LIA）来检测慢性炎症性脱髓鞘性多发性神经病（CIDP）及其临床变异中的 aGAAb。
通过 LIA 检测 61 例 IN 患者（27 例典型 CIDP、12 例远端获得性脱髓鞘性多发性神经病、6 例多灶获得性脱髓鞘感觉/运动多发性神经病、10 例感觉 CIDP、1 例局灶性 CIDP 和 5 例多灶运动神经病）、40 例其他神经肌肉疾病（OND）（15 例非免疫性多发性神经病、25 例重症肌无力）、29 例多发性硬化症（MS）和 54 例健康对照组（HC）中 11 种神经节苷脂和硫酸脑苷脂（SF）的 aGAAb。
与 IgG 相比，61 例 IN 中有 17/61（27.9%）患者至少有一种神经节苷脂/SF 的阳性抗-GAAB IgM，而 40 例 OND 中有 2/40（5%）、29 例 MS 中有 2/29（6.9%）和 54 例 HC 中有 4/54（7.4%）（p=0.001）。与 OND 相比，IN 中抗硫酸脑苷脂（aSF）IgM 的患病率更高（p=0.008）。此外，与 OND 和 HC 相比，IN 中 aGM1 IgM 更为常见（p=0.009），而 IN 中 GD1b 与 HC 相比也更为常见（p<0.04）。CIDP 中 aGM1 IgM 的患病率低于多灶性运动神经病（MMN）（12%比 60%，p=0.027）。显示 aSF、aGM1 和 aGM2 IgM 的患者比 aGAAb 阴性患者年轻（p<0.05）。aSF IgM 阳性患者更常出现典型 CIDP 和 MMN 表型（p<0.05，分别）。
aGAAb LIA 显示 CIDP/MMN 患者中至少有一种 aGAAb IgM 的频率升高。抗 SF、aGM1 和 aGM2 IgM 与年龄较小有关，抗 SF 与 IN 表型有关。
