TRYPTOPHAN-IMMOBILIZED COLUMN ADSORBS IMMUNOGLOBULIN-G ANTI-GQ1B ANTIBODY FROM FISHERS SYNDROME - A NEW APPROACH TO TREATMENT

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.