Анналы клинической и экспериментальной неврологии (Feb 2017)

Pathogenetic and prognostic role of autoantibodies to gangliosides of the peripheral nerves in Guillain-Barre syndrome

  • N. A. Suponeva,
  • M. A. Piradov,
  • S. S. Nikitin,
  • O. L. Timchenko,
  • L. A. Gracheva,
  • L. P. Bykova,
  • S. V. Lapin,
  • J. A. Fedkina,
  • M. V. Kostyreva,
  • A. A. Shabalina,
  • D. A. Grishina

DOI
https://doi.org/10.17816/psaic250
Journal volume & issue
Vol. 7, no. 1
pp. 4 – 11

Abstract

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Testing for IgG+IgM autoantibodies to gangliosides of peripheralnerves (asialo-GM1, GM1, GM2, GD1a, GD1a, GD1b, GQ1b)was performed in 95 patients with GuillainBarr syndrome (GBS)in Moscow. In 70 patients (74%) acute inflammatory demyelinatingpolyneuropathy (AIDP) was diagnosed, and in 25 patients (26%) either acute motor axonal neuropathy (AMAN) or acute motorsensoryneuropathy (AMSAN). The role of antibodies to gangliosidesfor prognosis of the disease course and response to pathogenictreatment was assessed. Antibodies to gangliosides were found in55 patients (57.9%) more often in patients with AMAN/AMSAN(p0.05). The whole range of antibodies was found both in patientswith AIDP and AMAN/AMSAN. Anti-GM1 were found in bothsubtypes of GBS. Anti-GD1b were associated withAMAN/AMSAN (p0.05). There was a correlation between anti-GM1 and diarrhea (p0.05), anti-asialo-GM1 and campylobacteriosis(p0.05). There wasnt found significant correlation betweenanti-GD1 and axonal subtypes, diarrhea in anamnesis, and campylobacteriosis.Association of severe GBS and elderly age, camplylobacteriosisand axonal subtypes was confirmed. AMAN/AMSANsubtypes, severity of the disease, necessity in mechanical ventilationwere characterized by insufficient efficacy of pathogenic therapy.The same factors and elderly age were associated with unfavorableprognosis in terms of absence of unassisted walking in 6 and12months. Anti-GD1a were associated with sever course of the disease,including necessity in mechanical ventilation. Immunologicfactors are not sufficient in prognosis of the treatment efficacy.Antibodies to GM1 were associated with unfavorable prognosis withabsence of unassisted walking in 6 months. Clinical and neurophysiologicaldata is crucial for making diagnosis and prognosisof the GBS course. Testing for autoantibodies to gangliosidescould be helpful in diagnostics of GBS. It is possible to use thattest for revealing axonal type of the disease (anti-GD1b), prognosticationof severe course of GBS (anti-GD1a) and unfavorablerehabilitation of unassisted walking.

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