GANGLIOSIDES AND BACTERIAL TOXINS IN GUILLAIN-BARRE-SYNDROME

Autoimmune factors are strongly favoured as mediating Guillain-Barre s yndrome (GBS); however, the precise mechanisms by which this occurs re main unknown. Microbial infections in a susceptible host resulting in an idiosyncratic immune response which cross-reacts with nerve constit uents still remains the most plausible working hypothesis on which muc h current research is based. Considerable recent evidence indicates th at this humoral immune response is at least in part directed to gangli osides. Interestingly, many bacterial toxins, including botulinum and tetanus neurotoxins, also bind to gangliosides and induce diseases wit h some similarities to GBS. This article discusses the evidence in fav our of a pathogenic role for anti-ganglioside antibodies in GBS in the context of our knowledge of the biology of gangliosides and the facto rs that determine their immunogenicity.