Identification and localization of minor glycolipid antigens recognized by serum antibody in Guillain-Barre' syndrome

由于血浆置换术的有效性，包括自身抗体在内的体液因素可能在格林-巴利综合征（GBS）的发病过程中发挥作用。据报道，GBS急性期患者血清中存在针对多种糖脂的血清抗体，其滴度随着临床改善而降低。由于少量未鉴定的糖脂也可能是 GBS 血清中抗体的靶标，因此我们使用薄层色谱 (TLC) 免疫染色测定了针对粗神经节苷脂级分的血清抗体。在接受测试的 50 名 GBS 患者中，有 6 名检测到了针对迁移至 GD1a 下方的条带的抗体活性。通过 DEAE-Sephadex A-25 柱色谱、唾液酸酶处理和 Iatrobeads 柱色谱分离未鉴定的糖脂。快原子轰击质谱表明其为GalNAc-GD1a。所有 6 名患者在 GBS 神经系统发病前均患有胃肠道感染，并且复合肌肉动作电位波幅较低，神经传导速度正常或仅略有下降。因此，这种抗体可能在周围神经最远端部位发生轴突损伤或脱髓鞘改变的 GBS 中产生。未来的研究对于确定 GalNAc-GD1a 的定位是必要的。肺炎支原体是GBS前期感染的病原体之一。82名GBS患者中，有4人在GBS发病前曾受过支原体感染。所有4名患者均检测到半乳糖脑苷脂(Gal-C)抗体。 78 名不伴支原体感染的 GBS 患者中，有 2 名患者存在抗 Gal-C 抗体，但患者或正常对照者均未检测到该抗体。因此，支原体感染后，GBS 中可能会典型地产生抗 Gal-C 抗体。 Gal-C 已知是髓磷脂中的重要抗原，据报道对 Gal-C 过敏可导致兔抗体介导的脱髓鞘性神经病。抗Gal-C抗体可能在支原体感染后GBS患者脱髓鞘性神经病变的病理生理机制中发挥作用。较少的

Because of the effectiveness of plasmapheresis, humoral factors including autoantibodies may function in the pathogenetic process of Guillain-Barre' syndrome (GBS). Serum antibodies against several glycolipids have been reported in patients in the acute phase sera of GBS,their titers decreasing with clinical improvement. Because minor unidentified glycolipids also may be targets of antibodies in GBS sera, we assayd serum antibody against a crude ganglioside fraction using thin-layr chromatogram (TLC) immunostaining. Antibody activity was detected against a band that migrated just below GD1a in 6 of the 50 patients with GBS tested. The unidentified glycolipid was isolated by DEAE-Sephadex A-25 column chromatography, sialidase treatment, and Iatrobeads column chromatography. Fast atom bombardment-mass spectra showed it to be GalNAc-GD1a. All 6 patients had suffered gastrointestinal infection before the neurological onset of GBS and showed low amplitudes for the compound muscle action pot … More entials and normal or only slightly decreased nerve conduction velocities. Therefore, this antibody may be raised in GBS with axonal damage or demyelinative change in the most distal sites of the peripheral nerve. Future study is necessary for determining localization of GalNAc-GD1a. Mycoplasma pneumoniae is one agent of the infections preceding GBS.Four of 82 patients with GBS suffered from mycoplasma infection before onset of GBS.All four patients had antibody against galactocerebroside (Gal-C). Two of 78 patients with GBS without mycoplasma infection had anti-Gal-C antibody but none of the disease or normal controls had it. Thus anti-Gal-C antibody may be characteristically raised in GBS subsequent to mycoplasma infection. Gal-C is known to be an important antigen in myelin, and sensitization to Gal-C has been reported to cause antibody-mediated demyelinative neuropathy in rabbit. The anti-Gal-C antibodies may function in the pathophysiologic mechanism of demyelinative neuropathy in patients with GBS subsequent to mycoplasma infection. Less