Multifaceted features of IgG anti ‐GM1 antibodies in Guillain‐Barré syndrome

AbstractIgG anti-GM1 antibodies, the most common autoantibodies in Guillain-Barr é syndrome (GBS), have diverse characteristics regarding IgG subclass, complement activation, affinity, and fine specificity. In this review, I provide an update on multifaceted aspects of IgG anti-GM1 antibodies, emphasizing their roles in creating a varying clinical picture of GBS and in developi ng pure motor neuropathy after antecedent infection. Diversity in IgG subclass and cross-reactivity, both of which are closely related to the type of antecedent infection, appears to cause the variation in clinical features and severity of the disease. The environment around GM1 expression in neural tissue is thought to interfere with the binding of anti-GM1 antibodies by modulating the immunoreactive epitope, allowing only anti-GM1 antibodies with specific fine specificity to bind to the GM1 ganglioside. This might create the characteristic clinical picture of pure motor neuropathy in anti-GM 1-positive GBS, although GM1 is present equally in motor and sensory nerves. The environment around the GM1 epitope onCampylobacter jejuni, the most frequently identified agent in antecedent infections of GBS, might also be important in creating diversity in the fine specificity of anti-GM1 antibodies, possibly preventing the development of GBS in most patients with enteritis by the GM1 epitope-bearingC.jejuni. Because there remains no direct evidence indicative that diversity of anti-GM1 antibodies is involved ...

Source: Clinical and Experimental Neuroimmunology - June 10, 2021 Category: Neurology Authors: Michiaki Koga Tags: REVIEW ARTICLE Source Type: research