Abstract
Elevated levels of serum autoantibodies directed against gangliosides are closely associated with acute and chronic autoimmune neuropathies. An agglutination immunoassay using polystyrene microparticles coated with a total extract of brain gangliosides was used to test patient sera for the presence of anti‐ganglioside antibodies. Results were compared with those obtained by ELISA for anti‐GM1 and anti‐GQ1b ganglioside antibodies. Eight of the twelve sera from patients with multifocal motor neuropathy and seven of the thirteen sera from patients with Guillain‐Barré syndrome were positive for the presence of anti‐ganglioside antibodies by the ganglioside agglutination immunoassay. The assay compared favorably with the ELISA system in sensitivity and specificity, while requiring a fraction of the time and cost to perform. The new assay can serve as a rapid and effective method for detecting or screening for anti‐ganglioside antibodies in patients with acute or chronic immune‐mediated neuropathies. It would be particularly useful for detecting antibodies that react with multiple gangliosides, or with minor or as yet uncharacterized gangliosides. J. Clin. Lab. Anal. 15:96–99, 2001. © 2001 Wiley‐Liss, Inc.
Keywords: autoantibodies, gangliosides, peripheral neuropathies, immunoassays, Guillain‐Barré syndrome
references
- 1. Asbury AK. 2000. New concepts of Guillain‐Barré syndrome. J Child Neurol 15:183–191. [DOI] [PubMed] [Google Scholar]
- 2. Hughes RAC, Hadden RDM, Gregson NA, Smith KJ. 1999. Pathogenesis of Guillain‐Barré syndrome. J Neuroimmunol 100:74–97. [DOI] [PubMed] [Google Scholar]
- 3. Latov N. 1995. Pathogenesis and therapy of neuropathies associated with monoclonal gammopathies. Ann Neurol 37(S1):S32–S42. [DOI] [PubMed] [Google Scholar]
- 4. Nobile‐Orazio E, Carpo M, Legname G, Meucci N, Sonnino S, Scarlato G. 1990. Anti‐GM1 IgM antibodies in motor neuron disease and neuropathy. Neurology 40:1747–1750. [DOI] [PubMed] [Google Scholar]
- 5. Ilyas AA, Quarles RH, Dalakas MC, Fishman PH, Brady RO. 1985. Monoclonal IgM in a patient with paraproteinemic polyneuropathy binds to gangliosides containing disialosyl groups. Ann Neurol 18:655–659. [DOI] [PubMed] [Google Scholar]
- 6. Willison HJ, Almemar A, Veitch J, Thrush D. 1994. Acute ataxic neuropathy with cross‐reactive antibodies to GD1b and GD3 gangliosides. Neurology 44:2395–2397. [DOI] [PubMed] [Google Scholar]
- 7. Oga T, Kusunoki S, Fujimura H, Kuboki T, Yoshida T, Takai T. 1998. Severe motor‐dominant neuropathy with IgM M‐protein binding to the NeuAc&agr;2‐3Gal&bgr;‐ moiety. J Neurol Sci 154:4–7. [DOI] [PubMed] [Google Scholar]
- 8. Carpo M, Pedotti R, Lolli F, et al. 1998. Clinical correlate and fine specificity of anti‐GQ1b antibodies in peripheral neuropathy. J Neurol Sci 155:186–191. [DOI] [PubMed] [Google Scholar]
- 9. Pestronk A. 1991. Motor neuropathies, motor neuron disorders, and antiglycolipid antibodies. Muscle Nerve 14:927–936. [DOI] [PubMed] [Google Scholar]
- 10. Alaedini A, Latov N. 2000. Agglutination immunoassay for rapid detection of anti‐GM1 antibodies in patients with neuropathy. Ann Neurol 48:439. [DOI] [PubMed] [Google Scholar]
- 11. Kinsella LJ, Lange DJ, Trojaborg W, Sadiq SA, Younger DS, Latov N. 1994. Clinical and electrophysiologic correlates of elevated anti‐GM1 antibody titers. Neurology 44:1278–1282. [DOI] [PubMed] [Google Scholar]
- 12. Briani C, Brannagan TH 3rd, Trojaborg W, Latov N. 1996. Chronic inflammatory demyelinating polyneuropathy. Neuromuscul Disord 6:311–325. [DOI] [PubMed] [Google Scholar]
- 13. Van den Berg L, Hays AP, Nobile‐Orazio E, et al. 1996. Anti‐MAG and anti‐SGPG antibodies in neuropathy. Muscle Nerve 19:637–643. [DOI] [PubMed] [Google Scholar]
- 14. Asbury AK, Cornblath DR. 1990. Assessment of current diagnostic criteria for Guillain‐Barré syndrome. Ann Neurol 27:S21–S24. [DOI] [PubMed] [Google Scholar]
- 15. Sadiq SA, Thomas FP, Kilidireas K, et al. 1990. The spectrum of neurologic disease associated with anti‐GM1 antibodies. Neurology 40:1067–1072. [DOI] [PubMed] [Google Scholar]
- 16. Marcus DM, Latov N, Hsi BP, Gillard BK. 1989. Measurement and significance of antibodies against GM1 ganglioside. Report of a workshop, 18 April 1989, Chicago, IL, USA. J Neuroimmunol 25:255–259. [DOI] [PubMed] [Google Scholar]
- 17. Pestronk A. 2000. Testing for serum IgM binding to GM1 ganglioside in clinical practice. Neurology 54:2353–2354. [DOI] [PubMed] [Google Scholar]
- 18. Zielasek J, Ritter G, Magi S, Hartung HP, Toyka KV. 1994. A comparative trial of anti‐glycoconjugate antibody assays: IgM antibodies to GM1. J Neurol 241:475–480. [DOI] [PubMed] [Google Scholar]
- 19. Ho TW, Willison HJ, Nachamkin I, et al. 1999. Anti‐GD1a antibody is associated with axonal but not demyelinating forms of Guillain‐Barré syndrome. Ann Neurol 45:168–173. [DOI] [PubMed] [Google Scholar]
- 20. O’Leary CP, Veitch J, Durward WF, Thomas AM, Rees JH, Willison HJ. 1996. Acute oropharyngeal palsy is associated with antibodies to GQ1b and GT1a gangliosides. J Neurol Neurosurg Psychiatry 61:649–651. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21. Vriesendorp FJ, Triggs WJ, Mayer RF, Koski CL. 1995. Electrophysiological studies in Guillain‐Barrésyndrome: correlation with antibodies to GM1, GD1b and Campylobacter jejuni . J Neurol 242:460–465. [DOI] [PubMed] [Google Scholar]
- 22. Koga M, Yuki N, Takahashi M, Saito K, Hirata K. 1998. Close association of IgA anti‐ganglioside antibodies with antecedent Campylobacter jejuni infection in Guillain‐Barré and Fisher’s syndromes. J Neuroimmunol 81:138–143. [DOI] [PubMed] [Google Scholar]