Serum anti‐GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain‐Barré syndrome
Serum anti‐GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain‐Barré syndrome
复制标题
血清抗 GQ1b IgG 抗体与 Miller Fisher 综合征和格林巴利综合征的眼肌麻痹相关
作者：
A. Chiba;S. Kusunoki;H. Obata;R. Machinami;I. Kanazawa
为了确定血清抗GQ 1b IgG抗体的意义，我们研究了与该抗体和GQ 1b表位相关的疾病谱。我们检测了19例典型米勒-费舍尔综合征（MFS）患者、5例急性感染后眼肌麻痹（不伴共济失调）患者（非典型MFS）、6例格林-巴利综合征（GBS）伴眼肌麻痹（GBS-OP[+]）患者和23例GBS不伴眼肌麻痹（GBS-OP[-]）患者的血清。我们还检查了84例其他神经系统或非神经系统疾病患者和16例正常对照组的血清。19例典型MFS患者中有18例、所有非典型MFS患者和6例GBS-OP（+）患者中有5例抗GQ 1b IgG活性升高，而其他组包括GBS-OP（-）患者均无升高，所有抗GQ 1b IgG抗体阳性患者血清均显示抗GT 1a IgG活性。吸收研究的结果表明，相同的抗体与GQ 1b和GT 1a反应。一种抗GQ 1b小鼠单克隆抗体免疫染色的paranodal区域的髓外部分的人眼神经，trophilar，外展神经。生化分析表明，人类眼神经比脊髓的前根和后根含有更大量的GQ 1b。我们的结论是，血清IgG抗体对GQ 1b是非常密切相关的急性感染后眼肌麻痹MFS和GBS。
To determine the significance of serum anti-GQ1b IgG antibody, we studied the disease spectrum associated with this antibody and GQ1b epitope in the human nervous system. We examined sera from 19 patients with typical Miller Fisher syndrome (MFS), five patients with acute postinfectious ophthalmoplegia without ataxia (atypical MFS), six patients with Guillain-Barré syndrome (GBS) with ophthalmoplegia (GBS-OP[+]), and 23 patients with GBS without ophthalmoplegia (GBS-OP[-]). We also examined sera from 84 patients with other neurologic or non-neurologic disorders and from 16 normal control subjects. Eighteen of the 19 patients with typical MFS, all the patients with atypical MFS, and five of the six patients with GBS-OP(+) had increased anti-GQ1b IgG activity in ELISA, but none of the patients in the other groups, including GBS-OP(-), had it. All the patients' sera that had anti-GQ1b IgG antibody showed anti-GT1a IgG activity. Results of absorption studies suggested that the same antibody reacted with GQ1b and GTla. An anti-GQ1b mouse monoclonal antibody immunostained the paranodal regions of the extramedullary portion of the human oculomotor, trochlear, and abducens nerves. Biochemical analysis showed that the human oculomotor nerve contained a larger amount of GQ1b than did the ventral and dorsal roots of the spinal cord. We conclude that serum IgG antibody against GQ1b is very closely associated with acute postinfectious ophthalmoplegia in MFS and GBS.