CLOSE ASSOCIATION OF GUILLAIN-BARRE-SYNDROME WITH ANTIBODIES TO MINORMONOSIALOGANGLIOSIDES GM1B AND GM1-ALPHA

Cumulative evidence supports the theory that anti-ganglioside antibodi es function in the development of Guillain-Barre syndrome (GBS). Some patients have developed GBS after the administration of monosialogangl ioside extracted from bovine brain. To clarify the pathogenesis of GBS associated with and without administration of the monosialogangliosid e fraction, we investigated serum antibodies to the minor monosialogan gliosides GM1b and GM1 alpha in patients with GBS and in control patie nts. GM1b and GM1 alpha were recognized specifically by the IgG antibo dy from the GBS patients. Twelve of 20 GBS patients who had high IgG a nti-GM1b antibody titers had a preceding gastrointestinal infection. T o evaluate the hypothesis that GM1b could be an immunogen, we determin ed whether a GM1b epitope was present in Campylobacter jejuni isolated from a patient with GBS associated with anti-GM1b antibody. Immunosta ining with the monoclonal anti-GM1b antibody indicated that the lipopo lysaccharide of the C. jejuni strain has the GM1b epitope. We speculat e that an injection of bovine GM1 fraction that contains GM1b, as well as infection by an agent that bears the GM1b epitope, induces product ion of the anti-GM1b antibody which functions in the development of GB S in some patients.