Anticuerpos antigangliósido: Cuándo, cuál y para qué

BACKGROUND: We report our experience in the study of antiganglioside antibodies and define their clinical value establishing associations between clinical syndromes and immunological findings. METHODS: We analysed 275 sera: Guillain-Barré syndrome (GBS) (78), Miller-Fisher syndrome (MFS) (37), chronic inflammatory demyelinating polyneuroapthy (CIDP) (17), multifocal motor neuropathy (NMM) (42), chronic axonal mixed polyneuropathy (PNP) (54), amyotrophic lateral sclerosis (ALS) (28) and lower motor neuron disease (LMND) (17). We have studied the presence of IgG and IgM antibodies to 9 gangliosides using ELISA and TLC. RESULTS: We have detected anti-GQ1b antibodies in 36/37 (97,3%) of patients with MFS, being undetectable after 4 weeks in 83%. A 34 % (26/78) of patients with GBS were positive for several antiganglioside specificities being GalGa1NAc the most frequent (54%). Two out of three sera positive for GD1a corresponded to axonal Guillain-Barré. IgM class anti-GM1 antibodies were positive in 10/12 patients with MMN, while only a 3-9% of patients with ALS, CIDP, PNP and LMND presented antiganglioside antibodies. CONCLUSIONS: Analysis of anti-GQ1b antibodies confirms the diagnosis of MFS, excluding other acute brainstem pathologies and, in this study, detection of anti-GD1 a antibodies indicates axonal damage in GBS and suggest a worse prognosis. IgM anti-GM1 antibodies are only found in MMN. These findings confirm a disease specific correlation between specific neuropathies and antiganglioside antibodies clinically useful.