Antibodies to GM1(NeuGc) in Guillain-Barre syndrome after ganglioside therapy

N-Glycolyneuraminic acid-containing GM1 [GM1(Gc)] is a molecule for serum a ntibodies in patients with Guillain-Barre syndrome (GBS). To clarify the pa thogenesis of GBS after treatment with bovine brain ganglioside, we investi gated the presence of anti-GM 1(Gc) antibody in patients who developed GBS after ganglioside injection. Serum samples were taken from nine Italian pat ients with GBS after ganglioside therapy as well as from untreated Italian (n = 30) and Japanese (n = 131) GBS patients. Bovine brain gangliosides fra ctionated in a column were used as antigens, and binding of serum IgG or Ig M was examined. An absorption study of IgG anti-GM1(Gc) antibody was made w ith CMI, asialo-GM1, GM2, CD1a, and GD1b. Four of the nine patients who dev eloped GBS after being administered gangliosides had IgG anti-GM1(Gc) antib odies. Anti-GM1(Gc) IgG antibody frequencies were higher in patients with G BS after ganglioside therapy than in those who were untreated. Rates of abs orption of IgG anti-GM1(Gc) antibodies by GM1 were significantly higher (ex cept for asialo-GM1 and GD1b) than by GM2 and GD1a. The presence of GM 1(Gc ) was confirmed in bovine brain immunochemically using cholera toxin and Ha nganutziu-Deicher antibody. Secondary ion mass spectra showed that the stru cture of the ganglioside was consistent with that of GM1(Gc). GM1(Gc) was r ecognized more frequently in sera from patients who developed GBS after gan glioside therapy than in sera from untreated GBS patients. Because N-glycol ylneuraminic acid-containing gangliosides seem to be highly immunogenic in humans, GM1(Gc) may act as an immunogen in some patients who develop GBS fo llowing ganglioside therapy. (C) 2000 Elsevier Science B.V. All rights rese rved.