N. Yuki, TRYPTOPHAN-IMMOBILIZED COLUMN ADSORBS IMMUNOGLOBULIN-G ANTI-GQ1B ANTIBODY FROM FISHERS SYNDROME - A NEW APPROACH TO TREATMENT, Neurology, 46(6), 1996, pp. 1644-1651
Sera from patients with Fisher's syndrome in the acute phase contain i
mmunoglobulin (Ig)G anti-GQ1b ganglioside antibody. Removal of the aut
oantibody should lead to earlier recovery with less residual neurologi
c involvement. A tryptophan- or phenylalanin-immobilized polyvinyl alc
ohol gel column (IM-TR 350 or IM-PH 350) semi-selectively adsorbs such
adsorbs antibodies as rheumatoid factor, anti-DNA antibody, or anti-a
cetylcholine receptor antibody. A batchwise adsorption test showed tha
t an IM-TR gel adsorbed a larger amount of the IgG anti-GQ1b antibody
than did an IM-PH column. Several patients with Fisher's syndrome ther
efore were given immunoadsorbent therapy using the IM-TR column withou
t adverse reactions. An ex vivo plasma perfusion study done with the I
M-TR column confirmed that it effectively adsorbs the IgG anti-GQ1b an
tibody. Results of adsorption tests done with various amino acid-immob
ilized gels suggest that both the hydrophobic for ce of the side chain
and the anionic charge of the carboxylic acid in tryptophan are impor
tant in the adsorption of the autoantibody by the IM-TR gel. Immunoads
orption using the IM-TR column, which does not need replacement fluids
, offers an alternative type of plasmapheresis for Fisher's syndrome.