We established anti-
ganglioside antibody profiles in GBS and studied the frequency, fine specificity and clinical correlate.
IgG and
IgM antibodies to 8
gangliosides were tested by immunodot-blot in 249 consecutive patients with
Guillain-Barré syndrome with large variability in clinical expression, referred to our laboratory over a 8-year period.
IgG and
IgM anti-GM1
antibodies were measured by Elisa. Thin-layer chromatography overlayed by serum was used to control positivity. 89/249 GBS (36%) had characteristic anti-
ganglioside antibody profile. Isotypes were,
IgG (62%),
IgG +
IgM (26%) and
IgM (12%). Antecedent
infections were found in 62% of GBS included more frequently Campylobacter jejuni and cytomegalovirus. Various
autoantibody profiles were described with an immunodominant
ganglioside. We detected 6 characteristic anti-
ganglioside profiles with fine specificity and immunodominant
ganglioside corresponding to 6 immuno-clinical variants of GBS: 1) anti-GM1 and GD1b
IgG and
IgG >
IgM in the acute motor axonal neuropathy after Campylobacter jejuni
infection in 41 GBS; 2) anti-GD1a
IgG in 6 severe motor axonal GBS after Campylobacter jejuni
infection; 3) selectively anti-GQ1b
IgG in 17 typical
Miller Fisher syndrome with areflexia,
ataxia and
ophthalmoplegia; 4) anti-
GT1b ganglioside and polysialogangliosides
IgG (n = 9) in two separate cranial nerve variants, ophthalmoplegic SGB and lower cranial nerve variants depending upon the presenting deficit; 5) anti-GD1b
IgG in 5 pure ataxic sensory GBS (4%); 6) anti-GM2
IgM in 11 severe GBS with antecedent CMV
infection (8%). 34 GBS (14%) had low levels of anti-GM1 and GD1b
IgM antibodies which are not disease specific and may simply represent part of the naturally occurring
autoantibody population or a secondary response to disease. 126 GBS (50%) had no
antibodies, predominantly in classical form. Associations between isotype, fine specificity and clinical presentation permit the definition of homogeneous immuno-clinical variants. Various
autoantibody profiles with diagnostic and prognostic value are easy to perform by immunodot blot in acute
peripheral neuropathies.