Multifaceted features of immunoglobulin G anti‐GM1 antibodies in Guillain-Barre syndrome
Multifaceted features of immunoglobulin G anti‐GM1 antibodies in Guillain-Barre syndrome
复制标题
吉兰-巴利综合征免疫球蛋白 G 抗 GM1 抗体的多方面特征
DOI：
10.1111/cen3.12653
复制
发表时间：
2021
影响因子：
--
通讯作者：
Koga Michiaki
中科院分区：
文献类型：
--
作者：
Koga Michiaki
免疫球蛋白G（IgG）抗GM 1抗体是格林-巴利综合征（GBS）中最常见的自身抗体，具有IgG亚类、补体激活、亲和力和良好特异性等多种特征。在这篇综述中，提供了IgG抗GM 1抗体多方面的最新信息，强调了它们在创建GBS的不同临床表现和在前驱感染后发展为纯运动神经病中的作用。IgG亚类和交叉反应性的多样性，两者都与先前感染的类型密切相关，似乎导致疾病的临床特征和严重程度的变化。神经组织中GM 1表达周围的环境被认为通过调节免疫反应性表位干扰抗GM 1抗体的结合，仅允许具有特定精细特异性的抗GM 1抗体与GM 1神经节苷脂结合。这可能会在抗GM 1阳性GBS中产生纯运动神经病的特征性临床表现，尽管GM 1在运动神经和感觉神经中同样存在。空肠弯曲菌上GM 1表位周围的环境是GBS前期感染中最常见的病原体，在抗GM 1抗体的精细特异性中产生多样性也可能很重要，可能会阻止大多数肠炎患者中携带GM 1表位的空肠弯曲菌发生GBS。由于没有直接证据表明抗GM 1抗体的多样性与GBS的发生有关，因此需要进一步研究。
Immunoglobulin G (IgG) anti‐GM1 antibodies, the most common autoantibodies in Guillain–Barré syndrome (GBS), have diverse characteristics regarding IgG subclass, complement activation, affinity and fine specificity. In this review, an update on multifaceted aspects of IgG anti‐GM1 antibodies is provided, emphasizing their roles in creating a varying clinical picture of GBS and in developing pure motor neuropathy after antecedent infection. Diversity in IgG subclass and cross‐reactivity, both of which are closely related to the type of antecedent infection, appears to cause the variation in clinical features and severity of the disease. The environment around GM1 expression in neural tissue is thought to interfere with the binding of anti‐GM1 antibodies by modulating the immunoreactive epitope, allowing only anti‐GM1 antibodies with specific fine specificity to bind to the GM1 ganglioside. This might create the characteristic clinical picture of pure motor neuropathy in anti‐GM1‐positive GBS, although GM1 is present equally in motor and sensory nerves. The environment around the GM1 epitope onCampylobacter jejuni, the most frequently identified agent in antecedent infections of GBS, might also be important in creating diversity in the fine specificity of anti‐GM1 antibodies, possibly preventing the development of GBS in most patients with enteritis by the GM1 epitope‐bearingC.jejuni. Because there remains no direct evidence indicative that diversity of anti‐GM1 antibodies is involved in the development of GBS, further study is required.