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

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Abstract

Testing for IgG+IgM autoantibodies to gangliosides of peripheral nerves (asialo-GM1, GM1, GM2, GD1a, GD1a, GD1b, GQ1b) was performed in 95 patients with Guillain–Barré syndrome (GBS) in Moscow. In 70 patients (74%) acute inflammatory demyelinating polyneuropathy (AIDP) was diagnosed, and in 25 patients (26%) – either acute motor axonal neuropathy (AMAN) or acute motorsensory neuropathy (AMSAN). The role of antibodies to gangliosides for prognosis of the disease course and response to pathogenic treatment was assessed. Antibodies to gangliosides were found in 55 patients (57.9%) – more often in patients with AMAN/AMSAN (p<0.05). The whole range of antibodies was found both in patients with AIDP and AMAN/AMSAN. Anti-GM1 were found in both subtypes of GBS. Anti-GD1b were associated with AMAN/AMSAN (p<0.05). There was a correlation between anti-GM1 and diarrhea (p<0.05), anti-asialo-GM1 and campylobacteriosis (p<0.05). There wasn’t found significant correlation between anti-GD1 and axonal subtypes, diarrhea in anamnesis, and campylobacteriosis. Association of severe GBS and elderly age, camplylobacteriosis and axonal subtypes was confirmed. AMAN/AMSAN subtypes, severity of the disease, necessity in mechanical ventilation were characterized by insufficient efficacy of pathogenic therapy. The same factors and elderly age were associated with unfavorable prognosis in terms of absence of unassisted walking in 6 and 12months. Anti-GD1a were associated with sever course of the disease, including necessity in mechanical ventilation. Immunologic factors are not sufficient in prognosis of the treatment efficacy. Antibodies to GM1 were associated with unfavorable prognosis with absence of unassisted walking in 6 months. Clinical and neurophysiological data is crucial for making diagnosis and prognosis of the GBS course. Testing for autoantibodies to gangliosides could be helpful in diagnostics of GBS. It is possible to use that test for revealing axonal type of the disease (anti-GD1b), prognostication of severe course of GBS (anti-GD1a) and unfavorable rehabilitation of unassisted walking.

 

About the authors

N. A. Suponeva

Research Center of Neurology, Russian Academy of Medical Sciences

Author for correspondence.
Email: platonova@neurology.ru
Russian Federation

M. A. Piradov

Research Center of Neurology, Russian Academy of Medical Sciences

Email: platonova@neurology.ru
Russian Federation

S. S. Nikitin

The Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences

Email: platonova@neurology.ru
Russian Federation

O. L. Timchenko

Moscow State University of Medicine and Dentistry

Email: platonova@neurology.ru
Russian Federation

L. A. Gracheva

Russian Children’s Clinical Hospital (Moscow)

Email: platonova@neurology.ru
Russian Federation

L. P. Bykova

Russian Children’s Clinical Hospital (Moscow)

Email: platonova@neurology.ru
Russian Federation

S. V. Lapin

St. Petersburg State Medical University

Email: platonova@neurology.ru
Russian Federation

J. A. Fedkina

Moscow State University of Medicine and Dentistry

Email: platonova@neurology.ru
Russian Federation

M. V. Kostyreva

Research Center of Neurology, Russian Academy of Medical Sciences

Email: platonova@neurology.ru
Russian Federation

A. A. Shabalina

Research Center of Neurology, Russian Academy of Medical Sciences

Email: platonova@neurology.ru
Russian Federation

D. A. Grishina

Research Center of Neurology, Russian Academy of Medical Sciences

Email: platonova@neurology.ru
Russian Federation

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Copyright (c) 2017 Suponeva N.A., Piradov M.A., Nikitin S.S., Timchenko O.L., Gracheva L.A., Bykova L.P., Lapin S.V., Fedkina J.A., Kostyreva M.V., Shabalina A.A., Grishina D.A.

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