Tagawa Y, Matsumoto Y, Yuki N
Department of Biochemistry, Faculty of Medicine, Tokyo Medical and Dental University.
No To Shinkei. 1998 Sep;50(9):849-53.
Gangliosides, important constituents of the plasma membrane, are particularly abundant in the nervous system. Some patients develop Guillain-Barré syndrome after the administration of bovine brain gangliosides. We previously showed existence of molecular mimicry between GM1 ganglioside and lipopolysaccharide of Campylobacter jejuni isolated from the patients with Guillain-Barré syndrome, and that between GQ1b and C. jejuni isolated from Fisher's syndrome patients. Moreover, the anti-ganglioside antibody can cause motor nerve dysfunction in vitro. These support the pathogenic significance of anti-ganglioside antibodies. To clarify clinical utility of measurement for anti-GM1 and anti-GQ1b antibodies, we investigated sera from 429 patients with immunoneurological diseases included Fisher's syndrome, Bickerstaff's brainstem encephalitis, acute ophthalmoparesis, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy, and controls by enzyme-linked immunosorbent assay. We found very high titers of IgM anti-GM1 antibody in serum from a patient who had been diagnosed as having motor neuron disease. By further electrophysiological study, the patient was diagnosed as having multifocal motor neuropathy. Presence of high IgG anti-GM1 antibody titers was useful for supporting diagnosis of Guillain-Barré syndrome, IgG anti-GQ1b antibody was detected in patients who had paresis of extraocular muscles in Fisher's syndrome, Guillain-Barré syndrome, Bickerstaff's brainstem encephalitis, and acute ophthalmoparesis. This study showed that the measurement for anti-GM1 and anti-GQ1b antibodies are very useful.
神经节苷脂是质膜的重要组成成分,在神经系统中尤其丰富。一些患者在注射牛脑神经节苷脂后会患上吉兰 - 巴雷综合征。我们之前发现,吉兰 - 巴雷综合征患者分离出的空肠弯曲菌的脂多糖与GM1神经节苷脂之间存在分子模拟,以及费舍尔综合征患者分离出的空肠弯曲菌与GQ1b之间存在分子模拟。此外,抗神经节苷脂抗体在体外可导致运动神经功能障碍。这些都支持了抗神经节苷脂抗体的致病意义。为了阐明检测抗GM1和抗GQ1b抗体的临床效用,我们通过酶联免疫吸附测定法研究了429例免疫性神经疾病患者(包括费舍尔综合征、比克斯特法夫脑干脑炎、急性眼肌麻痹、吉兰 - 巴雷综合征、慢性炎症性脱髓鞘性多发性神经病、多灶性运动神经病)以及对照组患者的血清。我们在一名被诊断为运动神经元病的患者血清中发现了非常高滴度的IgM抗GM1抗体。通过进一步的电生理研究,该患者被诊断为多灶性运动神经病。高滴度的IgG抗GM1抗体有助于支持吉兰 - 巴雷综合征的诊断,在费舍尔综合征、吉兰 - 巴雷综合征、比克斯特法夫脑干脑炎和急性眼肌麻痹的眼外肌麻痹患者中检测到了IgG抗GQ1b抗体。这项研究表明,检测抗GM1和抗GQ1b抗体非常有用。