Invited Speakers' Session

2019 Rinsho Shinkeigaku  
Peripheral neuropathies caused by autoimmune mechanisms, such as Guillain-Barré syndrome (GBS) , chronic inflammatory demyelinating polyneuropathy (CIDP) , and IgM paraproteinemic neuropathy (IgM-N) , are called as autoimmune neuropathies. Anti-glycolipid antibodies are frequently detected in IgM-N and in GBS. Antiglycolipid antibodies are first reported in IgM-N. In about half of the patients with IgM-N, IgM M-protein recognizes the HNK-1 epitope of myelin-associated glycoprotein and that of a
more » ... glycolipid named sulfated glucuronyl paragloboside to cause demyelinating polyneuropathy. Subsequently, anti-GM1 IgM antibodies were reported to be raised in the sera from patients with multifocal motor neuropathy (MMN) , a subtype of CIDP. Then the frequent elevation of antiglycolipid antibodies were also reported in the sera from GBS patients in the acute-phase. In particular, the frequency and the specificity of the anti-GQ1b antibodies in Fisher syndrome, a subtype of GBS, are remarkably high. The antibodies specific to GD1b were present in IgM-N or GBS with sensory ataxia. Those antibodies may cause neurological disturbance by binding to the areas where the target antigens are localized. This theory was confirmed by the induction of sensory ataxic neuropathy by sensitization of the rabbits with GD1b, which is localized in the primary sensory neurons mediating deep sensation. IgG antibodies to GM1, GalNAc-GD1a and GD1a are associated with acute motor axonal neuropathy type of GBS preceded by Campylobacter jejuni infection. In contrast, the antibodies to galactocerebroside (Gal-C) , localized in myelin, are associated with acute inflammatory demyelinating polyneuropathy type of GBS preceded by Mycoplasma pneumoniae infection. The production of those antibodies may be induced by the immune reaction to the glycoconjugates on the cell membranes of C. jejuni or those of M pneumoniae. Some GBS sera have antibodies to the novel epitope formed by two different gangliosides (ganglioside complexes) . LM1 is a glycolipid localized in human peripheral nerve myelin. Some patients with CIDP have antibodies to LM1 or glycolipid complexes containing LM1. Anti-GQ1b antibodies and anti-Gal-C antibodies are present in some patients with the involvement of the central nervous system. In this lecture, our principal research results, recent findings and future perspectives will be presented. Further investigations on antiglycolipid antibodies may lead to the development of more useful biomarkers and novel therapeutic strategies of autoimmune neuropathies. 大会長講演 5月23日 (木)13:15 ~ 14:00 第1会場(大阪国際会議場5F 大ホール)
doi:10.5692/clinicalneurol.59_supplement_s1 fatcat:wmyyawi7ujetnodmmdysgbgpii