Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
Acta Neurol Scand. 2022 Nov;146(5):553-561. doi: 10.1111/ane.13678. Epub 2022 Aug 4.
Anti-neurofascin 155 (NF155) antibody has been discovered in chronic demyelinating conditions. However, the positive rate and clinical description were insufficient in acute demyelinating conditions, such as Guillain-Barré syndrome (GBS). This study aimed to explore the positive rate of anti-NF155 antibody in GBS patients and determine whether there were unique clinical characteristics in these patients.
MATERIALS & METHODS: Serum anti-NF155 antibody was detected from 94 GBS patients and 50 sex- and age-matched healthy controls using cell-based assay and tissue-based assay with immunostaining of mouse teased sciatic nerve fibers. Clinical characteristics, laboratory data, and electrophysiology examinations were retrospectively collected.
Seven of 94 (7.45%) GBS patients were positive for anti-NF155 antibody, and the main IgG subclass was IgG1. Compared with anti-NF155 antibody-negative GBS patients, anti-NF155 antibody-positive GBS patients had a higher GBS disability score at nadirs (p = .010), higher modified Erasmus GBS outcome score (p = .022), higher rate of abnormal compound motor action potential (CMAP) amplitude (p = .002), higher frequency of prolonged F-wave latency (p < .001), lower frequency of abnormal sensory conduction velocity (p < .001) and sensory nerve action potential amplitude (p < .001), more axonal type (p = .040), and poorer therapeutic effect (p = .017).
Anti-NF155 antibody exists in a small portion of GBS patients. Anti-NF155 antibody-positive GBS patients possibly have a more severe clinical course, less sensory nerves involved, higher proportion of axonal type, poorer therapeutic effect, and worse prognosis, but the pathogenicity of the anti-NF155 antibody in GBS needs further study.
抗神经束蛋白 155（NF155）抗体已在慢性脱髓鞘疾病中被发现。然而，在急性脱髓鞘疾病（如吉兰-巴雷综合征（GBS））中，其阳性率和临床描述尚不足。本研究旨在探讨 GBS 患者中抗 NF155 抗体的阳性率，并确定这些患者是否存在独特的临床特征。
采用基于细胞和基于组织的免疫染色法，检测了 94 例 GBS 患者和 50 名性别和年龄匹配的健康对照者血清中的抗 NF155 抗体。回顾性收集了临床特征、实验室数据和电生理学检查结果。
94 例 GBS 患者中有 7 例（7.45%）抗 NF155 抗体阳性，主要 IgG 亚类为 IgG1。与抗 NF155 抗体阴性的 GBS 患者相比，抗 NF155 抗体阳性的 GBS 患者在疾病高峰时的 GBS 残疾评分更高（p=0.010），改良 Erasmus GBS 结局评分更高（p=0.022），异常复合运动动作电位（CMAP）振幅的发生率更高（p=0.002），F 波潜伏期延长的发生率更高（p < 0.001），感觉传导速度异常和感觉神经动作电位振幅异常的发生率更低（p < 0.001），轴索性病变的发生率更高（p=0.040），治疗效果更差（p=0.017）。
抗 NF155 抗体存在于一小部分 GBS 患者中。抗 NF155 抗体阳性的 GBS 患者可能具有更严重的临床病程，感觉神经受累较少，轴索性病变比例较高，治疗效果较差，预后较差，但抗 NF155 抗体在 GBS 中的致病性仍需进一步研究。
