Autoantibody screening in Guillain-Barre syndrome
Por:
Lleixa, C, Martin-Aguilar, L, Pascual-Goni, E, Franco, T, Caballero, M, De Luna, N, Gallardo, E, Suarez-Calvet, X, Martinez-Martinez, L, Diaz-Manera, J, Rojas-Garcia, R, Cortes-Vicente, E, Turon, J, Casasnovas, C, Homedes, C, Gutierrez-Gutierrez, G, Jimeno-Montero, MC, Berciano, J, Sedano-Tous, MJ, Garcia-Sobrino, T, Pardo-Fernandez, J, Marquez-Infante, C, Rojas-Marcos, I, Jerico-Pascual, I, Martinez-Hernandez, E, de la Tassa, GM, Dominguez-Gonzalez, C, Juarez, C, Illa, I, Querol, L
Publicada:
1 nov 2021
Resumen:
Background Guillain-Barre syndrome (GBS) is an acute inflammatory neuropathy with a heterogeneous presentation. Although some evidences support the role of autoantibodies in its pathogenesis, the target antigens remain unknown in a substantial proportion of GBS patients. The objective of this study is to screen for autoantibodies targeting peripheral nerve components in Guillain-Barre syndrome. Methods Autoantibody screening was performed in serum samples from all GBS patients included in the International GBS Outcome study by 11 different Spanish centres. The screening included testing for anti-ganglioside antibodies, anti-nodo/paranodal antibodies, immunocytochemistry on neuroblastoma-derived human motor neurons and murine dorsal root ganglia (DRG) neurons, and immunohistochemistry on monkey peripheral nerve sections. We analysed the staining patterns of patients and controls. The prognostic value of anti-ganglioside antibodies was also analysed. Results None of the GBS patients (n = 100) reacted against the nodo/paranodal proteins tested, and 61 (61%) were positive for, at least, one anti-ganglioside antibody. GBS sera reacted strongly against DRG neurons more frequently than controls both with IgG (6% vs 0%; p = 0.03) and IgM (11% vs 2.2%; p = 0.02) immunodetection. No differences were observed in the proportion of patients reacting against neuroblastoma-derived human motor neurons. Reactivity against monkey nerve tissue was frequently detected both in patients and controls, but specific patterns were only detected in GBS patients: IgG from 13 (13%) patients reacted strongly against Schwann cells. Finally, we confirmed that IgG anti-GM1 antibodies are associated with poorer outcomes independently of other known prognostic factors. Conclusion Our study confirms that (1) GBS patients display a heterogeneous repertoire of autoantibodies targeting nerve cells and structures; (2) gangliosides are the most frequent antigens in GBS patients and have a prognostic value; (3) further antigen-discovery experiments may elucidate other potential antigens in GBS.
Filiaciones:
Lleixa, C:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Martin-Aguilar, L:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Pascual-Goni, E:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Franco, T:
Univ Autonoma Barcelona, Immunol Dept, Hosp Santa Creu & St Pau, Barcelona, Spain
Caballero, M:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
De Luna, N:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Gallardo, E:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Suarez-Calvet, X:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Martinez-Martinez, L:
Univ Autonoma Barcelona, Immunol Dept, Hosp Santa Creu & St Pau, Barcelona, Spain
Diaz-Manera, J:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Rojas-Garcia, R:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Cortes-Vicente, E:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Turon, J:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Casasnovas, C:
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Bellvitge Univ Hosp, Dept Neurol, Neuromuscular Unit, Barcelona, Spain
Bellvitge Biomed Res Inst IDIBELL, Neurometab Dis Grp, Barcelona, Spain
Homedes, C:
Bellvitge Univ Hosp, Dept Neurol, Neuromuscular Unit, Barcelona, Spain
Gutierrez-Gutierrez, G:
Hosp Univ Infanta Sofia, Dept Neurol, Madrid, Spain
Jimeno-Montero, MC:
Hosp Univ Infanta Sofia, Dept Neurol, Madrid, Spain
Berciano, J:
CIBERNED, Ctr Invest Biomed Red Enfermedades Neurodegenerat, Madrid, Spain
Univ Cantabria, Hosp Univ Marques Valdecilla IDIVAL, Dept Neurol, Santander, Spain
Sedano-Tous, MJ:
Univ Cantabria, Hosp Univ Marques Valdecilla IDIVAL, Dept Neurol, Santander, Spain
Garcia-Sobrino, T:
Hosp Clin Univ Santiago, Dept Neurol, Santiago, Spain
Pardo-Fernandez, J:
Hosp Clin Univ Santiago, Dept Neurol, Santiago, Spain
Marquez-Infante, C:
Hosp Univ Virgen Rocio, Dept Neurol, Seville, Spain
Rojas-Marcos, I:
Hosp Univ Reina Sofia, Dept Neurol, Cordoba, Spain
Jerico-Pascual, I:
Complejo Hosp Navarra, Dept Neurol, Pamplona, Spain
Martinez-Hernandez, E:
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Hosp Clin Barcelona, Dept Neurol, Barcelona, Spain
de la Tassa, GM:
Hosp Univ Cent Asturias, Dept Neurol, Oviedo, Spain
Dominguez-Gonzalez, C:
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Hosp Univ 12 Octubre, Res Inst Imas12, Dept Neurol, Neuromuscular Dis Unit, Madrid, Spain
Juarez, C:
Univ Autonoma Barcelona, Immunol Dept, Hosp Santa Creu & St Pau, Barcelona, Spain
Illa, I:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
Querol, L:
Univ Autonoma Barcelona, Dept Neurol, Neuromuscular Dis Unit, Hosp Santa Creu & St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain
gold, Green Submitted, Green Published
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