Skip to main content
NCBI home page
Wiley - PMC COVID-19 Collection logoLink to Wiley - PMC COVID-19 Collection
. 2005 Dec 9;9(5):308–319. doi: 10.1002/jcla.1860090506

Myelin‐ and microbe‐specific antibodies in guillain‐barré syndrome

Jeff Terryberry 1, Made Sutjita 1, Yehuda Shoenfeld 2, Boris Gilburd 2, David Tanne 2, Margalit Lorber 3, Iyad Alosachie 1, Noori Barka 1, Hun‐Chi Lin 1, Pierre Youinou 4, James B Peter 1,✉
PMCID: PMC7167197  PMID: 8531012

Abstract

We surveyed the frequency of reported infections and target autoantigens in 56 Guillain Barré syndrome (GBS) patients by detecting antibodies to myelin and microbes. Sulfatide (43%), cardiolipin (48%), GD1a (15%), SGPG (11%), and GM3 (11%) antibodies were the most frequently detected heterogenous autoantibodies. A wide spectrum of antimicrobial IgG and IgM antibodies were also detected; mumps‐specific IgG (66%), adenovirus‐specific IgG (52%), varicella‐zoster virus‐specific IgG (46%), and S. pneumoniae serotype 7‐specific IgG (45%) were the most prevalent. Our results indicate that polyclonal expansion of physiologic and pathologic antibodies and/or molecular mimicry likely occurs following infection and is related to other autoimmune factors in the etiology of GBS. Although no single definitive myelin‐specific autoantibody was identified, our results suggest a unique pattern of reactivity against autoantigens.

Keywords: autoantibodies, autoimmunity, gangliosides, myelin, neuropathy

References

  • 1. Ropper AH: The Guillain‐Barré syndrome. N Engl J Med 326: 1130–1136, 1992. [DOI] [PubMed] [Google Scholar]
  • 2. Ropper AH, Wijdicks EFM, Truax BT, eds: Guillain‐Barré syndrome. FA Davis, Philadelphia, 1991, p 18–24. [Google Scholar]
  • 3. Rostami AM: Pathogenesis of immune mediated neuropathies. Pediatr Res 33: 590–594, 1993. [DOI] [PubMed] [Google Scholar]
  • 4. Lampert PW: Autoimmune and virus‐induced demyelinating diseases:A review. Am J Pathol 91: 176–208, 1978. [PMC free article] [PubMed] [Google Scholar]
  • 5. Svennerholm L, Fredman P: Antibody detection in Guillain‐Barré syndrome. Ann Neurol 27 (suppl): S35–S40, 1990. [DOI] [PubMed] [Google Scholar]
  • 6. Fredman P, Vedeler CA, Hyland H, et al.: Antibodies in sera from patients with inflammatory demyelinating polyradiculoneuropathy react with ganglioside LM1 and sulfatide of peripheral nerve myelin. J Neurol 238: 75–79, 1991. [DOI] [PubMed] [Google Scholar]
  • 7. Koski CL: Characterization of complement‐fixing antibodies to peripheral nerve myelin in Guillain‐Barré syndrome. Ann Neurol 27 (suppl): 544–547, 1990. [DOI] [PubMed] [Google Scholar]
  • 8. Yu R, Ariga T, Kohriyama T, Kusunoki S, Maeda Y, Miyatani N: Autoimmune mechanisms in peripheral neuropathies. Ann Neurol 27 (suppl): S30–S35, 1990. [DOI] [PubMed] [Google Scholar]
  • 9. van Doorn PA, Brand A, Vermeulen N: Anti‐neuroblastoma cell line antibodies in inflammatory demyelinating polyneuropathy:Inhibition in vitro and in vivo by IV immunoglobulin. Neurology 38: 1592–1595, 1988. [DOI] [PubMed] [Google Scholar]
  • 10. The Guillain‐Barré Syndrome Study Group : Plasmapheresis and acute Guillain‐Barré syndrome. Neurology 335: 1096–1104, 1985. [PubMed] [Google Scholar]
  • 11. Gerken G, Trautmann F, Kohler H, et al.: Rare association of herpes simplex virus IgM specific antibodies and Guillain‐Barré syndrome treated with plasma exchange and immunosuppression. Klin Wochenschr 63: 468–474, 1985. [DOI] [PubMed] [Google Scholar]
  • 12. Melnick SC: Role of infection in the Guillain‐Barré syndrome. J Neurol Neurosurg Psychiatry 27: 395–407, 1964. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13. Pepose JS: A theory of virus‐induced demyelination in the Landry‐Guillain‐Barré syndrome. J Neurol 227: 93–97, 1982. [DOI] [PubMed] [Google Scholar]
  • 14. Dowling PC, Cook SD: Role of infection in Guillain‐Barré syndrome: Laboratory confirmation of herpesviruses in 41 cases. Ann Neurol 9 (suppl): 44–55, 1981. [DOI] [PubMed] [Google Scholar]
  • 15. Menonna J, Goldschmidt B, Haidri N, et al.: Herpes simplex virus IgM‐specific antibodies in Guillain‐Barré syndrome and encephalitis. Acta Neurol Scand 56: 223–231, 1977. [DOI] [PubMed] [Google Scholar]
  • 16. Smith MS, Laguna JF: Neurologic complications of infectious mononucleosis. Pediatr Clin North Am 26: 315–326, 1979. [PubMed] [Google Scholar]
  • 17. Wahren B, Link H: Antibodies to Epstein‐Barr virus and cytomegalovirus in Guillain Barré syndrome. J Neurol Sci 28: 129–138, 1976. [DOI] [PubMed] [Google Scholar]
  • 18. Schmitz H, Enders G: Cytomegalovirus as a frequent causeof Guillain‐Barré syndrome. J Med Virol 1: 21–27, 1977. [DOI] [PubMed] [Google Scholar]
  • 19. Harada T, Kohriyama T, Ishizaki F, et al.: Guillain‐Barré syndrome and disturbance in multiple organs associated with cytomegalovirus infection. No To ShinKei 42: 245–251, 1990. [PubMed] [Google Scholar]
  • 20. Merelli E, Sola P, Faglioni P, et al.: Newest human herpesvirus (HHV‐6) in the Guillain‐Barré syndrome and other neurological diseases. Acta Neurol Scand 85: 334–336, 1992. [DOI] [PubMed] [Google Scholar]
  • 21. Welch RG: Chicken‐pox and the Guillain‐Barré syndrome. Arch Dis Child 37: 557–559, 1962. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22. Leeming RD: Varicella‐zoster virus and facial palsy. J Laryngol Otol 90: 365–371, 1976. [DOI] [PubMed] [Google Scholar]
  • 23. Lolli F, Fredrikson S, Kam‐Hansen S, Link H: Increased reactivity to HTLV‐I in inflammatory nervous system diseases. Ann Neurol 22: 67–71, 1987. [DOI] [PubMed] [Google Scholar]
  • 24. Cornblath DR, McArthur JC, Kennedy PG, et al.: Inflammatory de myelinating peripheral neuropathies associated with human T‐cell lymphotropic virus III infection. Ann Neurol 21: 32–40, 1987. [DOI] [PubMed] [Google Scholar]
  • 25. Gross FJ, Mindel JS: Pseudotumor cerebri and Guillain‐Barré Syndrome associated with human immunodeficiency virus infection. Neurology 41: 1845–1846, 1991. [DOI] [PubMed] [Google Scholar]
  • 26. Dalakas MC, Pezeshkpour GH: Neuromuscular diseases associated with human immunodeficiency virus infection. Ann Neurol 23 (suppl): S 38–48, 1988. [DOI] [PubMed] [Google Scholar]
  • 27. Drueke TB, Pujade‐Lauraine E, Persson M, et al.: Measles virus and Guillain‐Barré syndrome during long‐term hemodialysis. Am J Med 60: 444–446, 1976. [DOI] [PubMed] [Google Scholar]
  • 28. Grose C, Spigland I: Guillain Barré syndrome following administration of live measles vaccine. Am J Med 60: 441–443, 1976. [DOI] [PubMed] [Google Scholar]
  • 29. Usui T, Hamada Y, Arita M: A case of Guillain‐Barré syndrome associated with Coxsackie B‐5 virus infection. Tokushima J Exp Med 21: 17–19, 1974. [PubMed] [Google Scholar]
  • 30. Estrada Gonzalez Mas P: Virological studies in acute polyradiculoneuritis‐LGBS type. Various findings in relation to Coxsackie A4 virus. Neurol Neurocir Psiquiatr 18 (suppl 2) [PubMed] [Google Scholar]; Neurol Neurocir Psiquiatr 3: 527–531, 1977. [PubMed] [Google Scholar]
  • 31. Gear JH: Nonpolio causes of polio‐like paralytic syndromes. Rev In fect Dis 6 (suppl 2): S379–S384, 1984. [DOI] [PubMed] [Google Scholar]
  • 32. Saeed AA, Lange LS: Guillain‐Barré syndrome after rubella. Postgrad Med J 54: 333–334, 1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33. Atkins MC, Esmonde TF: Guillain‐Barré syndrome associated with rubella. Postgrad Med J 67: 375–376, 1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34. Dussaix E, Lebon P, Ponsot G, et al.: Intrathecal synthesis of different alpha‐interferons in patients with various neurologic diseases. Acta Neurol Scand 71: 504–509, 1985. [DOI] [PubMed] [Google Scholar]
  • 35. Seneca H: Influenza:Epidemiology, etiology, immunization and management. J Am Geriatr Sac 28: 241–250, 1980. [DOI] [PubMed] [Google Scholar]
  • 36. Stevens D, Burman D, Clarke SKR, et al.: Temporary paralysis in childhood after influenza B. Lancet 2: 1354–1355, 1974. [DOI] [PubMed] [Google Scholar]
  • 37. Lin SM, Ryu SJ, Liaw YF: Guillain‐Barré syndrome associated with acute delta hepatitis virus superinfection. J Med Virol 22: 144–145, 1989. [DOI] [PubMed] [Google Scholar]
  • 38. Tabor E: Guillain‐Barré syndrome and other neurologic syndromes in hepatitis A, B, and non‐A, and non‐B. J Med Virol 21: 207–216, 1987. [DOI] [PubMed] [Google Scholar]
  • 39. Goldschmidt B, Menonna J, Fortunato J, et al.: Mycoplasma antibody in Guillain‐Barré syndrome and other neurological disorders. Ann Neurol 7: 108–112, 1980. [DOI] [PubMed] [Google Scholar]
  • 40. Dowling PC, Bosch VV, Cook SD, Chmel H: Serum immunoglobulins in Guillain‐Barré syndrome. J Neurol Sci 57: 435–440, 1982. [DOI] [PubMed] [Google Scholar]
  • 41. Garcia‐Arenzana JM: Antibodies to Borrelia burgdorferi in Guillain‐Barré syndrome. Lancet 335: 1168, 1990. [DOI] [PubMed] [Google Scholar]
  • 42. Boucquey D, Sindic CJ, Lamy M, et al.: Clinical and serological studies in a series of 45 patients with Guillain‐Barré syndrome. J Neurol Sci 104: 56–63, 1991. [DOI] [PubMed] [Google Scholar]
  • 43. Gruenewald R, Ropper AH, Lior H, et al.: Serological evidence of Camphylobacter jejuni and E. coli enteritis in patients with Guillain‐Barré syndrome. Arch Neurol 48: 1080–1082, 1991. [DOI] [PubMed] [Google Scholar]
  • 44. Kuroki S, Saida T, Nukina M, et al.: Camphylobacter jejuni strains from patients with Guillain‐Barré syndrome belong mostly to Penner serogroup 19 and contain b̃‐N‐Acetylglucosamine residues. Ann Neurol 33: 243–247, 1993. [DOI] [PubMed] [Google Scholar]
  • 45. Samantray SK, Johnson SC, Mathai KV, et al.: Landry‐Guillain‐Barré‐Strohl syndrome:A study of 302 cases. Med J Aust 2: 84–91, 1977. [DOI] [PubMed] [Google Scholar]
  • 46. Zimprich F, Winter J, Wege H, Lassmann H: Coronavirus induced primary demyelination:Indications for the involvement of a humoral immune response. Neuropathol Appl Neurobiol 17: 469–484, 1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47. Roman G, Phillips CA, Poser CM: Parainfluenza virus type 3: isolation from CSF in a patient with Guillain Barré‐syndrome. JAMA 240: 1613–1615, 1978. [PubMed] [Google Scholar]
  • 48. Bronze MS, Dale JB: Epitopes of streptococcal M proteins that evoke antibodies that cross‐react with human brain. J Immunol 151: 2820–2828, 1993. [PubMed] [Google Scholar]
  • 49. Chopra A, Rana PV, Narayanaswamy AS, et al.: Neurological complications following acute viral conjunctivitis:A new profile. Trop Geogr Med 38: 197–202, 1986. [PubMed] [Google Scholar]
  • 50. Winer JB, Hughes RA, Anderson MJ, et al.: A prospective study of acute idiopathic neuropathy. II Antecedent Events. J Neurol Neurosurg Psychiatry 51: 616–618, 1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 51. Serratrice G: Polyneuritis, polyradiculoneuritis, polyneuro‐pathies:Development of a concept. Rev Prat 42: 9–17, 1992. [PubMed] [Google Scholar]
  • 52. Weise MF, Canegie RR: An approach to search protein sequences for superfamily relationships or chance similarities relevant to the molecular mimicry hypothesis:Application to the basic proteins of myelin. J Neurochem 51: 1267–1273, 1988. [DOI] [PubMed] [Google Scholar]
  • 53. Plotz PH: Autoantibodies are anti‐idiotype antibodies to antiviral antibodies. Lancet 2: 824–826, 1983. [DOI] [PubMed] [Google Scholar]
  • 54. Rose NR, Bona C: Defining criteria for autoimmune diseases (Witebsky's postulates revisited). Immunol Today 14: 426–430, 1993. [DOI] [PubMed] [Google Scholar]
  • 55. Ternynck T, Avrameas S: Murine natural monoclonal autoantibodies:A study of their polyspecificities and their affinities. Immunol Rev 94: 99–112, 1986. [DOI] [PubMed] [Google Scholar]
  • 56. Nina Y, Sakane T, Kanoh T, et al.: Transient autoantibodies with elevated complement levels in common viral diseases. J Clin Lab Immunol 13: 183–188, 1984. [PubMed] [Google Scholar]
  • 57. Mithen FA, Ilyas AA, Birchem R, Cook SD: Effects of Guillain‐Barré sera containing antibodies against glycolipids in cultures of rat Schwann cells and sensory neurons. J Neurol Sci 112: 223–232, 1992. [DOI] [PubMed] [Google Scholar]
  • 58. Brinkmeier H, Wollinsky KH, Hulser PJ, et al.: The acute paralysis in Guillain‐Barré syndrome is related to the Na+ channel blocking factor in the cerebrospinal fluid. Pflugers Arch 421: 552–557, 1992. [DOI] [PubMed] [Google Scholar]
  • 59. Sawant‐Mane S, Clark MB, Koski CL: In vitro demyelination by serum antibody from patients with Guillain‐Barré syndrome requires terminal complement complexes. Ann Neurol 29: 397–404, 1991. [DOI] [PubMed] [Google Scholar]
  • 60. Ilyas AA, Mithen FA, Chen IW, Cook SD: Anti‐GM1 IgA antibodies in Guillain‐Barré syndrome. J Neuroimmunol 36: 69–76, 1992. [DOI] [PubMed] [Google Scholar]
  • 61. Simone IL, Annunziata P, Majnone D, Liguori M, Leante R, Livrea P: Serum and CSF anti‐GM1 antibodies in patients with Guillain‐Barré syndrome and chronic inflammatory demyelinating polyneuropathy. J Neurol Sci 114: 49–55, 1993. [DOI] [PubMed] [Google Scholar]
  • 62. Gregson NA, Kollar S, Hughes RAC: Antibodies to gangliosides in Guillain‐Barré syndrome:specificity and relationship to clinical features. Quart J Med 86: 111–117, 1993. [PubMed] [Google Scholar]
  • 63. Gregson NA, Jones D, Thomas PR, Willison HJ: Acute motor neuropathy with antibodies to GM1 ganglioside. J Neurol 238: 447–451, 1991. [DOI] [PubMed] [Google Scholar]
  • 64. Chiba A, Kusunoki S, Obata H, et al.: Serum anti‐GQ1b antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain Barré syndrome:Clinical and immunohistochemical studies. Neurology 43: 1911–1917, 1993. [DOI] [PubMed] [Google Scholar]
  • 65. Willison HJ, Veitch J, Paterson G, Kennedy PGE: Miller Fisher syndrome is associated with serum antibodies with GQ1b gangliosides. J Neurol Neurosurg Psychiatry 56: 204–206, 1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 66. Ilyas AA, Mithen FA, Dalakas MC, et al.: Antibodies to acidic glycolipids in Guillain‐Barré syndrome and chronic inflammatory demyelinating polyneuropathy. J Neurol Sci 107: 111–121, 1992. [DOI] [PubMed] [Google Scholar]
  • 67. Enders U, Karch H, Toyka KV, et al.: The spectrum of immune responses to Campylobacter jejuni and glycoconjugates in Guillain‐Barré syndrome and in other neuroimmunological disorders. Ann Neurol 34: 136–144, 1993. [DOI] [PubMed] [Google Scholar]
  • 68. Winer JB, Gray IA, Gregson NA, et al.: A prospective study of acute idiopathic neuropathy. III Immunological studies. J Neurol Neurosurg Psychiatry 51: 619–625, 1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 69. Ilyas AA, Mithen FA, Dalakas MC, et al.: Antibodies to sulfated glycolipids in Guillain‐Barré syndrome. J Neurol Sci 105: 108–117, 1991. [DOI] [PubMed] [Google Scholar]
  • 70. van den Berg LH, Marrik J, de Jager AFJ, Van Inshoff GW, Oator N, Sadig SA: Anti‐GM1 antibodies in patients with Guillain‐Barré syndrome. J Neurol Neurosurg Psychiatry 55: 8–11, 1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 71. Koski CL, Chou DKH, Jungalwala FB: Anti‐peripheral nerve myelin antibodies in Guillain‐Barré syndrome bind a neutral glycolipid of peripheral myelin and cross‐react with Forssman antigen. J Clin Invest 84: 280–287, 1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 72. Quarles RH, Ilyas AA, Willison HJ: Antibodies to gangliosides and myelin proteins in Guillain‐Barré Syndrome. Ann Neurol 27 (suppl): S48–S58, 1990. [DOI] [PubMed] [Google Scholar]
  • 73. Piddlesden SJ, Lassmann H, Zimprich F, et al.: The demyelinating potential of antibodies to myelin oligodendrocyte glycoprotein is related to their ability to fix complement. Am J Pathol 143: 555–564, 1993. [PMC free article] [PubMed] [Google Scholar]
  • 74. Zweiman B, Rostami A, Lisak R, et al.: Immune reactions to P2 protein in human demyelinative neuropathies. Neurology 33: 234–237, 1983. [DOI] [PubMed] [Google Scholar]
  • 75. Khalili‐Shirazi A, Atkinson P, Gregson N, Hughes RAC: Antibody responses to P0 and P2 myelin proteins in Guillain‐Barré syndrome and chronic idiopathic demyelinating polyradiculo‐neuropathy. J Immunol 46: 245–252, 1993. [DOI] [PubMed] [Google Scholar]
  • 76. Wang WZ, Olsson T, Kostulas V, et al.: Myelin antigen reactive T cells in cerebrovascular disease. Clin Exp Immunol 88: 157–162, 1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 77. Gilburd B, Stein M, Tomer Y, et al.: Autoantibodies to phospholipids and brain extract in patients with the Guillain‐Barré syndrome:Cross‐reactive or pathogenic. Autoimmunity 16: 23–27, 1993. [DOI] [PubMed] [Google Scholar]
  • 78. Frampton G, Winer JB, Cameron JS, Hughes RA: Severe Guillain Barré syndrome:An association with IgA anti‐cardiolipin antibody in a series of 92 patients. J Neuroimmunol 19: 133–139, 1988. [DOI] [PubMed] [Google Scholar]
  • 79. Connolly AM, Pestronk A, Trotter JL, Fellman EL, Cornblath DR, Olney RK: High titer selective serum anti‐b̃ tubulin antibodies in chronic inflammatory demyelinating polyneuropathy. Neurology 43: 557–562, 1993. [DOI] [PubMed] [Google Scholar]
  • 80. Mokuno K, Yasuda T, Sugimura K, et al.: Cerebrospinal fluid neuronspecific enolase (NSE) and S‐100b protein in Guillain‐Barré syndrome‐Their relations to prognosis. Rinsho Shinkeigaku (Japan) 32: 535–537, 1992. [PubMed] [Google Scholar]
  • 81. Chalk CH, Homburger HA, Dyck PJ: Anti‐neutrophil cytoplasmic antibodies in vasculitic peripheral neuropathy. Neurology 43: 1826–1827, 1993. [DOI] [PubMed] [Google Scholar]
  • 82. Feutren G, Gerbal JL, Allinquant B, Schuller E: Association of Guillain Barré syndrome and B‐virus hepatitis:Simultaneous presence of anti‐DS‐DNA antibodies and HBs antigen in cerebrospinal fluid. J Clin Lab Immunol 11: 161–164, 1983. [PubMed] [Google Scholar]
  • 83. Olbricht CJ, Stark E, Helmchen U, et al.: Glomerulonephritis associated with inflammatory demyelinating polyradiculoneuropathy:A case report and review of the literature. Nephron 64: 139–141, 1993. [DOI] [PubMed] [Google Scholar]
  • 84. Costallat LTL, de Oliveira RM, Santiago MB, et al.: Neuropsychiatric manifestations of systemic lupus erythematosis:The value of anticardiolipin, antigangliosides and antigalactocerebrosides antibodies. Clin Rheumatol 9: 489–497, 1990. [DOI] [PubMed] [Google Scholar]
  • 85. Avila JL, Rojas M, Carrasco H: Elevated levels of antibodies against sulfatide are present in all chronic chagasic and dilated cardiomyopathy sera. Clin Exp Immunol 92: 460–465, 1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 86. Zanone MM, Peakman M, Purewal T, et al.: Autoantibodies to nervous tissue structures are associated with neuropathy in Type 1 (insulin‐dependent) diabetes mellitus. Diabetologia 36: 564–569, 1993. [DOI] [PubMed] [Google Scholar]
  • 87. Khalili A, Cooper RC: A study of immune responses to myelin and cardiolipin in patients with systemic lupus erythematosus (SLE). Clin Exp Immunol 85: 365–372, 1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 88. McFarlane I: Autoimmunity and hepatotropic viruses. Semin Liver Dis 11: 223–233, 1991. [DOI] [PubMed] [Google Scholar]
  • 89. Adelmann M, Linington C: Molecular mimicry and the autoimmune response to the peripheral nerve myelin PO glycoprotein. Neurochem Res 17: 887–881, 1992. [DOI] [PubMed] [Google Scholar]
  • 90. Rothbard JB, Taylor WR: A sequence pattern common to T cell epitopes. EMBO J 7: 93–100, 1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 91. Fujinami RS, Oldstone MBA: Amino acid homology between the encephalitogenic site of myelin basic protein and virus:Mechanism for autoimmunity. Science 230: 1043–1045, 1985. [DOI] [PubMed] [Google Scholar]
  • 92. Shoenfeld Y, Isenberg D, eds: The Mosaic of Autoimmunity. Elsevier, Amsterdam, 1989, pp. 343–387. [Google Scholar]
  • 93. Hojeberg B, Ingemarsson R, Kristensson K, et al.: A monoclonal antibody against HSV type 1 ribonucleotide reductase cross reacts with the P0 protein of peripheral nerve myelin. J Neurol Sci 106: 91–95, 1991. [DOI] [PubMed] [Google Scholar]
  • 94. Arai M, Yoshino H, Kusano Y, et al.: Ataxic polyneuropathy and anti‐Pr2 IgMk M proteinemia. J Neurol 106: 91–95, 1991. [DOI] [PubMed] [Google Scholar]
  • 95. Stevens A, Weller M, Wietholter H: A characteristic ganglioside antibody pattern in the CSF of patients with amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 56: 361–364, 1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 96. Teplizki H, Buskila D, Argov S, et al.: Low serum antimycobacterial glycolipid antibody titers in patients with systemic lupus erythematosus associated with central nervous system involvement. J Rheumatol 14: 507–511, 1987. [PubMed] [Google Scholar]
  • 97. McLean BN, Luxton RW, Thompson EJ: A study of immunoglobulin G in the cerebrospinal fluid of 1007 patients with suspected neurological disease using isoelectric focusing and the log IgG‐index. Brain 113: 1269, 1990. [DOI] [PubMed] [Google Scholar]
  • 98. Link H, Wahren B, Norrby E: Pleocytosis and immunoglobulin changes in cerebrospinal fluid and herpes‐virus serology in patients with Guillain Barré syndrome. J Clin Microbiol 9: 305–316, 1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 99. Ratzmann KP: Autoimmunity and the development of diabetes mellitus in relation to mumps infection. Diabetologia 29: 673–674, 1986. [DOI] [PubMed] [Google Scholar]
  • 100. van den Berg LH, Lankamp CLAM, deJager AEJ, et al.: Anti‐sulphatide antibodies in peripheral neuropathy. J Neurol Neurosurg Psychiatry 56: 1164–1168, 1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 101. Alosachie I, Shoenfeld Y, Mevorach D, et al.: Central nervous system (CNS) involvement in SLE: The diagnostic role of antibodies to neuronal antigens. Arthritis Rheum submitted, 1993. [DOI] [PubMed]
  • 102. Willison HJ, Kennedy PGE: Gangliosides and bacterial toxins in Guillain‐Barré Syndrome. J Neuroimmunol 46: 105–112, 1993. [DOI] [PubMed] [Google Scholar]
  • 103. Yuki N, Yamada M, Sato S, et al.: Association of IgG anti‐GD1a antibody with severe Guillain‐Barré syndrome. Muscle Nerve 16: 642–647, 1993. [DOI] [PubMed] [Google Scholar]
  • 104. Hayashi H, Park‐Matsumoto YC, Yuki N, Itoh T, Amakawa T, Muneyuki T: A case of current Guillain Barré syndrome preceded by different infections. J Neurol 240 (3): 196–197, 1993. [PubMed] [Google Scholar]
  • 105. Barthalomaeus WN, O'Donoghue H, Foti D, et al.: Multiple autoantibodies following cytomegalovirus infection:Virus distribution and specificity of autoantibodies. Immunology 64: 397–405, 1988. [PMC free article] [PubMed] [Google Scholar]
  • 106. Hendrickse MT, Triger DR: Autonomic and peripheral neuropathy in primary biliary cirrhosis. J Hepatol 19: 401–407, 1993. [DOI] [PubMed] [Google Scholar]
  • 107. Schattner A, Rager Z: Virus‐induced autoimmunity. Rev Infect Dis 12: 204, 1990. [DOI] [PubMed] [Google Scholar]
  • 108. Sharma KR, Sriram S, Fries T, et al.: Lumbosacral radiculoplexopathy as a manifestation of Epstein‐Barr virus infection. Neurology 43: 2550–2554, 1993. [DOI] [PubMed] [Google Scholar]
  • 109. Ratzmann KP, Strese J, Rjasanowski I, et al.: Metabolic, hormonal and immunological alterations in subjects with antecedent mumps infections. Exp Clin Endocrinol 86: 323–334, 1985. [DOI] [PubMed] [Google Scholar]
  • 110. Nicoletti F, Scalia G, Lunetta M, et al.: Correlation between islet cell antibodies and anti‐cytomegalovirus IgM and IgG antibodies in healthy first degree relatives of type I (insulin‐dependent) diabetic patients. Clin Immunol Immunopathol 55: 139–147, 1990. [DOI] [PubMed] [Google Scholar]
  • 111. Price P, Olver SD, Gibbons AE, Shellam GR: B‐cell activation following murine cytomegalovirus infection:implications for autoimmunity. Immunology 78: 14–21, 1993. [PMC free article] [PubMed] [Google Scholar]
  • 112. Hmama Z, Lina G, Normier G, et al.: Role of acyl residues in polyclonal murine B cell activation by acylpoly (1,3) galactosides form Klebsiella pneumoniae. J Immunol 151: 5440–5449, 1993. [PubMed] [Google Scholar]
  • 113. Toivanen A, Lahesmaa‐Rantala R, Vuento R, Granford K: Association of persisting IgA response with yersinia triggered reactive arthritis:A study of 104 patients. Ann Rheum Dis 46: 898–901, 1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 114. Abu‐Shakra M, Shoenfeld Y: Natural Autoantibodies. Shoenfeld Y, Isenberg D, eds. CRC Press, Boca Raton, 1993, p 15–33. [Google Scholar]
  • 115. Sun J‐B: Autoreactive T and B cells in nervous system diseases. Acta Neurol Scand 87 (S143): 5–55, 1993. [PubMed] [Google Scholar]
  • 116. Jones BM, Cheng KLP, Wong RWS, Kung AWC: CD5‐positive and CD5‐negative Rheumatoid factor‐secreting B cells in IgA nephropathy, rheumatoid arthritis and Grave's disease. Scand J Immunol 38: 575–580, 1993. [DOI] [PubMed] [Google Scholar]
  • 117. Wekerle H, Schwab M, Linington C, Meyerman R: Antigen presentation in the peripheral nervous system:Schwann cells present endogenous myelin autoantigens to lymphocytes. Eur J Immunol 16: 1551–1557, 1986. [DOI] [PubMed] [Google Scholar]
  • 118. Simone IL, Annunziata P, Maimone D, et al.: Serum and CSF anti‐GM1 antibodies in patients with Guillain‐Barré syndrome and chronic inflammatory demyelinating polyneuropathy. J Neurol Sci 114: 49–55, 1993. [DOI] [PubMed] [Google Scholar]
  • 119. Yi Q, Bergenbrant S, Osterborg A, et al.: T cell stimulation induced by idiotypes on monoclonal immunoglobulins in patients with monoclonal gammopathies. Scand J Immunol 38: 529–534, 1993. [DOI] [PubMed] [Google Scholar]
  • 120. Khalili‐Shirazi A, Hughes RAC, Brostoff SW, et al.: T cell responses to myelin proteins in Guillain‐Barré syndrome. J Neurol Sci 111: 200–203, 1992. [DOI] [PubMed] [Google Scholar]
  • 121. Kumar V, Sercarz EE: The involvement of T cell receptor peptide specific regulatory CD4+ T cells in recovery from antigen‐induced autoimmune disease. J Exp Med 178: 909–916, 1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 122. Schmied M, Breitschopf H, Gold R, et al.: Apoptosis of T lymphocytes in experimental autoimmune‐encephalomyelitis. Am J Pathol 143: 446–452, 1993. [PMC free article] [PubMed] [Google Scholar]
  • 123. Lundkuist I, van Doorn PA, Vermeulen M, et al.: Spontaneous recovery from Guillain‐Barré syndrome is associated with anti‐idiotypic antibodies recognizing a cross‐reactive idiotype on anti‐neuroblastoma cell line antibodies. Clin Immunol Immunopathol 67: 192–198, 1993. [DOI] [PubMed] [Google Scholar]
  • 124. Sutjita M, Hohmann A, Comacchio R, et al.: A common anti‐cardiolipin antibody idiotype in autoimmune disease:Identification using a mouse monoclonal antibody directed against a naturally‐occurring anti‐phospholipid antibody. Clin Exp Immunol 75: 211–216, 1989. [PMC free article] [PubMed] [Google Scholar]
  • 125. Castro LH, Ropper AH: Human immune globulin infusion in Guillain‐Barré syndrome:Worsening during and after treatment. Neurology 43: 1034–1036, 1993. [DOI] [PubMed] [Google Scholar]
  • 126. Ross MA, Silbert P, Knezevic W, et al.: Immunoglobulins and stroke. Neurology 42: 1847–1848, 1992. [DOI] [PubMed] [Google Scholar]
  • 127. Guillain‐Barré Syndrome Steroid Trial Group : Double‐blind trial of intravenous methylprednisolone in Guillain‐Barré syndrome. Lancet 341: 586–590, 1993. [PubMed] [Google Scholar]
  • 128. van der Meche FGA, Ng KKP, Bleck TP, et al.: Intravenous immunoglobulin versus plasma exchange in Guillain Barré syndrome. Neurology 43: 2729–2731, 1993. [DOI] [PubMed] [Google Scholar]
  • 129. Gea S, Ordonez P, Cerban F, et al.: Chagas' disease cardioneuropathy:association of anti‐trypanosoma cruzi and anti‐sciatic nerve antibodies. Am J Trop Med Hyg 49: 581–588, 1993. [DOI] [PubMed] [Google Scholar]
  • 130. Nitsche A, Leiguarda RC, Maldonado JA, et al.: Neurological features in overlap syndrome. Clin Rheumatol 10: 5–9, 1991. [DOI] [PubMed] [Google Scholar]
  • 131. Weller M, Stevens A, Sommer N, Witholter H: Are CSF or serum ganglioside antibodies related to peripheral nerve demyelination in neuroborreliosis, Guillain‐Barré syndrome or chronic inflammatory demyelinating polyradiculoneuropathy? Eur Arch Psych Clin Neurosci 242: 122–126, 1992. [DOI] [PubMed] [Google Scholar]
  • 132. Quarles RH, Barbarash GR, Figlewicz DA, McIntyre U: Purification and partial characterization of the myelin associated glycoprotein from adult rat brain. Biochim Biophys Acta 757: 140–143, 1983. [DOI] [PubMed] [Google Scholar]
  • 133. Giegerich G, Pette M, Wekerle H, et al.: Rapid method based on RP‐HPLC for purification of human myelin basic protein and its thrombic and endoproteinase Lys‐C peptides. J Chromatog 528: 79–90, 1990. [DOI] [PubMed] [Google Scholar]
  • 134. Ariga T, Kohriyama T, Freddo L, et al.: Characterization of sulfated glucuronic acid‐containing glycolipids reacting with IgM M‐proteins in patients with neuropathy. J Biol Chem 262: 848–853, 1987. [PubMed] [Google Scholar]
  • 135. Felgenhauer K, Reiber H: The diagnostic significance of antibody specificity indices in multiple sclerosis and herpesvirus‐induced diseases of the nervous system. Clin Invest 70: 28–37, 1992. [DOI] [PubMed] [Google Scholar]
  • 136. Ladisch S, Becker H, and Ulsh L: Immunosuppression by human gangliosides:I. Relationship of carbohydrate structure to the inhibition of T cell responses. Biochim Biophys Acta 1125: 180–188, 1992. [DOI] [PubMed] [Google Scholar]
  • 137. National Institute of Neurological Communicative Disease and Stroke, Ad Hoc Committee : Diagnostic Criteria for GBS. Ann Neurol 3: 565–566, 1978. 677829 [Google Scholar]
  • 138. National Institute of Neurological Disease and Stroke , Guillain‐Barré Syndrome, Publication #922902, 1992.
  • 139. Magi S, Sabatelli M, Mignogna T, et al.: Acute axonal idiopathic polyneuropathy:a Guillain‐Barré Syndrome variant? Ital J Neurol Sci 13: 481–486, 1992. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Laboratory Analysis are provided here courtesy of Wiley

RESOURCES