An evaluation of anti-VacA antibody and its target molecules in the cerebrospinal fluid of patients with demyelinating form of Guillain-Barre syndrome.

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Immunological studyIn order to detect antibodies against recombinant vacuolating cytotoxin (r-VacA) of Helicobacter pylori (H.pylori) in the cerebrospinal fluid (CSF) from patients with Guillain-Barre syndrome (GBS). The CSF samples from 13 patients with GBS (electrophysiologically classified as 8 acute inflammatory demyelinating polyradiculoneuropathy (AIDP), 4 acute motor axonal neuropathy (AMAN), and 1 unexcitable) and 8 disease control patients were studied. The r-VacA protein was separated by SDS-PAGE and Western blot analysis was carried out. Six of the 13 GBS patients had a specific IgG antibody against VacA of H.pylori, which was confirmed by absorption experiments using r-VacA. Every patient with positive CSF anti-r-VacA antibody had AIDP. The sequence homology between VacA and human (Na^++K^+)-ATPase α subunit has been outlined. Our findings lead to the possible hypothesis that anti-VacA antibodies involve ion channels in abaxonal Schwann cell plasmalemma resulting in demyeli … More nation in some patients with GBS.Histochemical evaluationTo identify the target molecules of anti-VacA-antibody (A-VacA-Ab) in the human ventral nerve roots, the immunohistochemical examination was carried out. A-VacA-Ab obtained from rabbits was prepared by immunization of the native VacA purified by the culture media of H.pylori. Cervical ventral nerve roots were obtained from patients with no known neurologic disorders within two hours after death. Both DAB and FITC procedures were employed. Disseminated spotty stainings were observed in cross sections. In longitudinal sections, string-like immunostainings were also seen both by DAB and FITC procedures. These were localized within the nerve fibers. Consequently, the target epitopes of A-VacA-Ab were thought to be present in the myelin components of the nerve roots. These results indicate that the target molecules of A-VacA-Ab in the cerebrospinal fluid obtained from patients with GBS are probably associated with some components of the peripheral nerve myelin. A-VacA-Ab may play an important role in the immune responses of patients with the demyelinating form of GBS. Less