Prospective study on anti-ganglioside antibodies in childhood Guillain-Barré syndrome

Joachim Schessl ¹, Michiaki Koga ², Kei Funakoshi ², Janbernd Kirschner ¹, Wolfgang Muellges ³, Andreas Weishaupt ³, Ralf Gold ⁴ and Rudolf Korinthenberg ^1*

¹ University Hospital Freiburg, Germany
² Dokkyo Medical University School of Medicine, Japan
³ University Hospital Wuerzburg, Germany
⁴ Medical Faculty Goettingen, Germany

^* To whom correspondence should be addressed. E-mail: rudolf.korinthenberg{at}uniklinik-freiburg.de.

Accepted 12 August 2006

Abstract

Aims: Anti-ganglioside antibodies have been reported to play a role in the pathophysiology of Guillain-Barré syndrome (GBS). It was the aim of this study to investigate their prevalence and correlation with clinical data in children with GBS in a multicentre clinical trial.

Methods: IgG and IgM antibodies to GM1, GM1b, GD1a, GalNAc-GD1a, GD1b, GT1a, and GQ1b were measured by enzyme-linked immunosorbent assay in sera obtained before treatment. In addition, serological testing for Campylobacter jejuni was performed. In parallel, a group of adults with GBS and a control group of children without GBS or other inflammatory diseases were investigated.

Results: Sera from 63 children with GBS, 36 adults with GBS, and 41 children without GBS could be evaluated. Four of the GBS children showed positive IgG antibodies to GM1, in one case combined with anti-GalNAc- GD1a, and in one with anti-GD1b. Two others showed isolated positive IgG-antibodies to GD1b and GT1a. One showed increased anti-GalNAc-GD1a IgM. In five of the 63 children, serological evidence of a recent infection with C. jejuni was found, and this correlated significantly with the raised antibodies. In the control group without GBS, no child showed positive IgG antibodies, but one showed anti-GalNAc-GD1a IgM antibody. Compared with the adults with GBS, the frequency of antibodies in children was only insignificantly lower. The patients with positive antibodies in our study did not show a more severe GBS course or worse outcome than those who were sero- negative, and we could not demonstrate an increased incidence of axonal dysfunction.

Conclusions: In some children with GBS, one can detect raised IgG antibodies against various gangliosides similar as in adults. A recent infection with C. jejuni is significantly associated with the presence of these antibodies. However, in contrast to what has been reported in adults, in this study we were unable to demonstrate a negative effect of these findings on the clinical course.

Keywords: Campylobacter jejuni, Guillain-Barré syndrome, anti-ganglioside antibodies, childhood, polyneuropathy

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