ANTIBODIES TO GT1A GANGLIOSIDE IN PATIENTS WITH GUILLAIN-BARRE-SYNDROME

Serum antibodies from 8 (13%) of 62 patients with the acute Guillain-B arre syndrome (GBS) and 1 of 3 patients with the Miller Fisher syndrom e (MFS) recognized a minor ganglioside in bovine and human brain trisi aloganglioside fractions. The ganglioside antigen migrated between GD1 a and GD1b on thin-layer chromatograms. The structure of this ganglios ide was established to be GT1a by thin-layer chromatography blotting a nd mass spectrometry. GT1a ganglioside was also detected in human and bovine peripheral nerves by thin-layer chromatogram immunostaining. Se rum from the GBS patients had IgM. IgG. or IgA antibodies against GT1a detectable by enzyme-linked immunosorbent assay (ELISA). Serum from t he MFS patient also had elevated levels of IgG against GT1a. None of t he sera from 43 patients with other neurological diseases or from 24 h ealthy controls reacted with GT1a. Sera from 6 of 8 GBS patients with anti-GT1a antibodies also reacted with GQ1b. There was no difference i n the incidence of anti-GT1a immunoglobulins in acute GBS patients wit h or without oculomotor abnormalities. Levels of anti-GT1a antibodies correlated temporally with clinical symptoms in GBS patients. Although the incidence of dysphagia was slightly higher in GBS patients with a nti-GT1a antibodies than in those without, the number of patients stud ied may have been too small to detect an association between anti-GT1a antibodies and a specific clinical variant of GBS. Our data demonstra te that a proportion of CBS patients have antibodies against GT1a gang lioside and suggest that these antibodies may play a role in the patho genesis of neuropathy in GBS. (C) 1998 Elsevier Science B.V.