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Wahatule R, Dutta D, Debnath M, Nagappa M, Mahadevan A, Sinha S, Sundaravadivel P, Rao U, Periyavan S, Binu VS, Rao S, Taly AB. Ganglioside complex antibodies in an Indian cohort of Guillain‐Barré syndrome. Muscle Nerve 2020; 62:728-734. [DOI: 10.1002/mus.27071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/06/2020] [Accepted: 09/11/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Rahul Wahatule
- Department of Neurology National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Debprasad Dutta
- Department of Human Genetics National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Monojit Debnath
- Department of Human Genetics National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Madhu Nagappa
- Department of Neurology National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Anita Mahadevan
- Department of Neuropathology National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Sanjib Sinha
- Department of Neurology National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Pandarisamy Sundaravadivel
- Department of Human Genetics National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Umamaheswara Rao
- Department of Neuroanesthesia and Neurocritical Care National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Sundar Periyavan
- Department of Transfusion Medicine and Hematology National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - VS Binu
- Department of Biostatistics National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Shivaji Rao
- Department of Biostatistics National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
| | - Arun B Taly
- Department of Neurology National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore India
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Pathogenic mechanisms in inflammatory and paraproteinaemic peripheral neuropathies. Curr Opin Neurol 2014; 27:541-51. [DOI: 10.1097/wco.0000000000000137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Kaida K. [Guillain-Barré and Fisher syndromes: update on the pathophysiological role of antiganglioside antibodies]. Rinsho Shinkeigaku 2014. [PMID: 23196466 DOI: 10.5692/clinicalneurol.52.914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There are growing experimental and clinical data on the pathophysiological roles of antiganglioside antibodies in Guillain-Barré syndrome (GBS) and Fisher syndrome (FS). Antibodies to a ganglioside complex (GSC) consisting of two different gangliosides are detected in some GBS and FS sera. Recently, anti-GM1/GalNAc-GD1a complex antibodies, anti-GA1/GQ1b antibodies with no reaction against GM1/GQ1b, and anti-GM1/LM1 antibodies have been detected in GBS or FS sera. The anti-GM1/GalNAc-GD1a antibodies correlated with pure motor GBS characterized by antecedent respiratory infection and early CBs at intermediate sites of motor nerves. Complement activation is considered to be a key process causing nerve damage in GBS and FS with antiganglioside antibodies. A recent ex vivo study indicates that antibodies to GM1/GD1a or GM1/GQ1b can induce complement-mediated functional and morphological injury at mouse motor nerve terminals. Complement-independent pathophysiology such as blockade of voltage-gated Ca channels, the apoptotic mechanism of neurons, and alteration of microdomains in the nerve cell membrane should also be considered. Complex glycolipid environments in the cell membrane may govern the accessibility and avidity of antiganglioside antibodies for target gangliosides. Thus, the pathogenic effect of antiganglioside antibodies may depend on the local glycolipid environment in the nerve membrane, as well as on the antibody specificity.
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Affiliation(s)
- Kenichi Kaida
- Division of Neurology, Department of Internal Medicine 3, National Defense Medical College
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Abstract
Understanding of Guillain-Barré syndrome (GBS) has progressed substantially since the seminal 1916 report by Guillain et al. Although Guillain, Barré, and Strohl summarised the syndrome based on observations of two French infantrymen, 2012 saw the beginning of an ambitious collaborative study designed to collect detailed data from at least 1,000 patients worldwide (IGOS, www.gbsstudies.org/about-igos). Progress has been made in many areas even since GBS was last reviewed in this journal in 2009. GBS subsequently received prominent attention in light of concerns regarding H1N1 influenza vaccinations, and several large-scale surveillance studies resulted. Despite these developments, and promising pre-clinical studies, disease-modifying therapies for GBS have not substantially altered since intravenous immunoglobulin was introduced over 20 years ago. In other areas, management has improved. Antibiotic prophylaxis in ventilated patients reduces respiratory tract infection, thromboprophylaxis has reduced the risk of venous thromboembolism, and there is increasing awareness of the benefit of high-intensity rehabilitation. This article highlights some of the interesting and thought-provoking developments of the last 3 years, and is based on a plenary lecture given at the 2012 Peripheral Nerve Society (PNS) meeting.
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Affiliation(s)
- Simon Rinaldi
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.
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Rinaldi S, Brennan KM, Kalna G, Walgaard C, van Doorn P, Jacobs BC, Yu RK, Mansson JE, Goodyear CS, Willison HJ. Antibodies to heteromeric glycolipid complexes in Guillain-Barré syndrome. PLoS One 2013; 8:e82337. [PMID: 24358172 PMCID: PMC3864991 DOI: 10.1371/journal.pone.0082337] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 10/09/2013] [Indexed: 12/29/2022] Open
Abstract
Autoantibodies are infrequently detected in the sera of patients with the demyelinating form of Guillain-Barré syndrome most commonly encountered in the Western world, despite abundant circumstantial evidence suggesting their existence. We hypothesised that antibody specificities reliant on the cis interactions of neighbouring membrane glycolipids could explain this discrepancy, and would not have been detected by traditional serological assays using highly purified preparations of single gangliosides. To assess the frequency of glycolipid complex antibodies in a Western European cohort of patients GBS we used a newly developed combinatorial glycoarray methodology to screen against large range of antigens (11 gangliosides, 8 other single glycolipids and 162 heterodimeric glycolipid complexes). Serum samples of 181 patients from a geographically defined, Western European cohort of GBS cases were analysed, along with 161 control sera. Serum IgG binding to single gangliosides was observed in 80.0% of axonal GBS cases, but in only 11.8% of cases with demyelinating electrophysiology. The inclusion of glycolipid complexes increased the positivity rate in demyelinating disease to 62.4%. There were 40 antigens with statistically significantly increased binding intensities in GBS as compared to healthy control sera. Of these, 7 complex antigens and 1 single ganglioside also produced statistically significantly increased binding intensities in GBS versus neurological disease controls. The detection of antibodies against specific complexes was associated with particular clinical features including disease severity, requirement for mechanical ventilation, and axonal electrophysiology. This study demonstrates that while antibodies against single gangliosides are often found in cases with axonal-type electrophysiology, antibodies against glycolipid complexes predominate in cases with demyelinating electrophysiology, providing a more robust serum biomarker than has ever been previously available for such cases. This work confirms the activation of the humoral immune system in the dysimmune disease process in GBS, and correlates patterns of antigen recognition with different clinical features.
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Affiliation(s)
- Simon Rinaldi
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
| | - Kathryn M. Brennan
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Gabriela Kalna
- Bioinformatics, Beatson Institute for Cancer Research, Glasgow, United Kingdom
| | - Christa Walgaard
- Department of Neurology, Erasmus Medical Centre, University Medical Center, Rotterdam, The Netherlands
| | - Pieter van Doorn
- Department of Neurology, Erasmus Medical Centre, University Medical Center, Rotterdam, The Netherlands
| | - Bart C. Jacobs
- Department of Neurology, Erasmus Medical Centre, University Medical Center, Rotterdam, The Netherlands
- Department of Immunology, Erasmus Medical Centre, University Medical Center, Rotterdam, The Netherlands
| | - Robert K. Yu
- Institute of Molecular Medicine and Genetics, Medical College of Georgia, Georgia Health Sciences University, Augusta, Georgia, United States of America
| | - Jan-Eric Mansson
- Laboratory Medicine/Clinical Chemistry, Sahlgren's University Hospital, Molndal, Sweden
| | - Carl S. Goodyear
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Hugh J. Willison
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
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Glycolipid antigens and autoantibodies in autoimmune neuropathies. Trends Immunol 2013; 34:453-9. [DOI: 10.1016/j.it.2013.05.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/17/2013] [Accepted: 05/01/2013] [Indexed: 11/24/2022]
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Kaida K. Pathogenic roles of antiganglioside antibodies in immune-mediated neuropathies. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/cen3.12007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kenichi Kaida
- Division of Neurology; Department of Internal Medicine 3; National Defense Medical College; Saitama; Japan
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Abstract
PURPOSE OF REVIEW Over the past 25 years, many autoantibodies directed against peripheral nerve glycan and protein antigens have been described. Principally through this area of research, significant advances have been achieved in the understanding of the pathophysiology of inflammatory neuropathies. More evidence constantly continues to emerge supporting the role of antibodies in pathogenesis. This review reports the recent studies highlighting the complex association between autoantibodies directed against various peripheral nerve antigens and immune polyneuropathies. RECENT FINDINGS The discovery of serum antibodies directed against ganglioside and glycolipid complexes has generated huge interest in this area of research. The expectation that nodal proteins are important targets continues to be pursued in line with the improvements in detection methodology. Basic studies continue to support a direct role for autoantibodies in neuropathy pathogenesis. SUMMARY Discovery of new target epitopes has not only raised hopes for further improvement in our understanding of pathophysiology and availability of new diagnostic markers, but also for future targeted therapies. Further studies are required to elucidate the precise pathological and clinical significance of these new antibodies.
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Yamada MH, Ueda M, Tsuji S, Kusunoki S. Effects of acidic phospholipids on antiganglioside antibodies in Guillain-Barré syndrome: Role of the disialosyl residue. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/cen3.12002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Masami Ueda
- Department of Neurology; Kinki University School of Medicine; Osaka; Japan
| | - Shoji Tsuji
- Department of Neurology; School of Medicine; University of Tokyo; Tokyo; Japan
| | - Susumu Kusunoki
- Department of Neurology; Kinki University School of Medicine; Osaka; Japan
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