CEREBROSPINAL-FLUID AND SERUM FROM PATIENTS WITH INFLAMMATORY POLYRADICULONEUROPATHY HAVE OPPOSITE EFFECTS ON SODIUM-CHANNELS

The effects of cerebrospinal fluid (CSF) and serum from patients havin g Guillain-Barre syndrome (GBS) or chronic inflammatory demyelinating polyradicu loneuropathy (CIDP) on voltage-dependent Na+ channels were compared. Bathing human myoballs in CSF substantially reduced their Na + currents (by >40% with 8 of 10 patients) elicited at 1 Hz under whol e-cell recording conditions. This was because, at the resting potentia l, more Na+ channels were inactivated (left-shift of the h, curve), CS F from patients with other neurological diseases (OND) produces a simi lar, but smaller, effect, In contrast, serum samples from the same GBS and OND patients caused an increase of the Na+ currents by reducing t he number of Na+ channels inactivated at the resting potential. This r ight-shift of the h infinity curve is in part explained by the effect of serum albumin. We confirm that the CSF of most GBS and CIDP patient s contains factors inhibiting voltage-dependent Na+ currents, There is no indication that such factors are effective in the serum of these p atients. (C) 1995 John Wiley and Sons, Inc.