ANTIBODIES TO GANGLIOSIDES AND GALACTOCEREBROSIDE IN PATIENTS WITH GUILLAIN-BARRE-SYNDROME WITH PRECEDING CAMPYLOBACTER-JEJUNI AND OTHER IDENTIFIED INFECTIONS

The relationship between preceding infections and antibodies to glycol ipids was investigated in 205 Japanese patients with Guillain-Barre sy ndrome (GBS). Serological evidence of recent Campylobacter jejuni (C. jejuni) infection was found in 45% of the patients, compared with 1% i n healthy controls. In contrast, recent infection of cytomegalovirus ( CMV), Mycoplasma pneumoniae (M. pneumoniae) and Epstein-Barr virus (EB V) was detected in only 5%, 2% and none of the patients, respectively, C. jejuni-associated GBS was more frequent in early spline than in ot her seasons. All stool specimens positive for C. jejuni isolation were obtained within 10 days after the onset of GBS symptoms. Of 13 C. jej uni isolates from GBS patients, 10 (77%) belonged to Penner serotype 1 9 (heat-stable, HS-19). Elevated titers of anti-GM1 antibody were foun d in 8 (80%) of 10 GBS patients whose C. jejuni isolates belonged to H S-19 and in none of those infected with non-HS-19 C. jejuni (P = 0.04) , and in 49% of 92 patients with C. jejuni infection and 25% of patien ts without infection of C. jejuni, CMV, EBV, or M. pneumoniae (P = 0.0 007). The frequencies of elevated antibody titers to GD1a, GD1b and GQ 1b were also significantly higher in GBS patients associated with C. j ejuni than those not associated with C. jejuni, CMV, EBV, and M. pneum oniae. GBS in Japan seems to be associated more frequently with C. jej uni and less frequently with CMV than in Europe and North America. (C) 1998 Elsevier Science B.V.