Circulating Demyelinating Factors in Acute Idiopathic Polyneuropathy

Abstract

Sera from 26 of 31 patients with the GuillainBarr\l=e'\ syndrome (GBS) demyelinated peripheral nervous tissue cultures. The GBS sera produced primary demyelination rather than Wallerian degeneration. Demyelination was complement-dependent. Cytotoxic effects were limited to neural tissue. Fractionation of sera revealed demyelinating activity in both 19S and 7S fractions. Serum demyelinating factors were not specific for GBS and were also found in some patients with other neurologic disorders (24:136-144, 1971).

Anti-peripheral myelin antibody in patients with demyelinating neuropathy: quantitative and kinetic determination of serum antibody by complement component 1 fixation.

“…The role of the cellular and humoral immune system in initiation of myelin breakdown has not been defined. Antibodies (Abs) against peripheral nerve (3,4), peripheral nerve myelin (PNM) (4)(5)(6), dorsal root ganglia (7), spinal cord tissue components (3), and neuroblastoma cells (8) have been identified in the serum of some GBS patients. However, it is not known whether these Abs actively participate in myelin destruction or whether they are an epiphenomenon reflecting a host response to PNM antigen(s) following myelin destruction.…”

“…Ab was also measured in serum of patients with a variety of other diseases, including 2 patients with systemic lupus erythematosis, 3 with rheumatoid arthritis, 1 with sarcoid, 1 with alcoholic neuropathy, 2 with paraproteinemia without neuropathy, 1 carpal tunnel syndrome, 1 with poliomyelitis with quadriparesis, and 1 with wound botulism. Among these controls, 4 with measurable titers were those patients with carpal tunnel syndrome, wound botulism, and 2 of the 3 rheumatoid arthritis; titers were 8, 10, 2, and 4, respectively. Seven of 12 patients, 1 with systemic lupus erythematosis, 1 with sarcoidosis, 1 rheumatoid arthritis, 1 with alcoholic neuropathy, 2 with cancer, and 1 with carpal tunnel syndrome had clinically significant neuropathies.…”

Aplastic Anaemia and Polyneuropathy

“…Se rum inhibitors of in vitro myelopoiesis have been demonstrated in 28% of pa tients with idiopathic aplastic anaemia [4], We describe a patient in whom AIP and aplastic anaemia occurred simultaneously and suggest that this was due to an anti body crossreacting with myelin and stem cells.…”

Treatment-Related Fluctuation in a Case of Guillain-Barré Syndrome after Plasma Exchange

“…Acute inflammatory demyelinating poly neuropathy or Guillain-Barre syndrome (GBS) is a prototype of immune-mediated peripheral neuropathies [1], Evidence of anti bodies to nerve antigens and demyelinating serum factors in affected patients has pro vided a rationale for the use of plasma ex change in treatment [2,3]. Early relapses, however, have occurred in patients after an initial beneficial response [4,5].…”