Distinct Immunoglobulin Class and Immunoglobulin G Subclass Patterns against Ganglioside GQ1b in Miller Fisher Syndrome following Different Types of Infection

Abstract

We studied serum antibodies against gangliosides GQ1b and GM1 in 13 patients with Miller Fisher syndrome (MFS) and in 18 patients with Guillain-Barré syndrome (GBS) with cranial nerve involvement. Anti-GQ1b titers were elevated in all patients with MFS cases (immunoglobulin G [IgG] > IgA, IgM), and in 8 of the 18 with GBS. Lower frequencies of increased anti-GM1 titers were observed in MFS patients (3 of 13), as well as in GBS patients (5 of 18). During the course of MFS, anti-GQ1b titers of all Ig classes decreased within 3 weeks after onset. By contrast, anti-GM1 titers (mainly IgM) transiently increased during the course of MFS in five of six patients, suggesting a nonspecific secondary immune response. In patients with MFS following respiratory infections, IgG was the major anti-GQ1b Ig class (six of six patients) and IgG3 was the major subclass (five of six). In contrast, four of five patients with MFS following gastrointestinal infections showed predominance of anti-GQ1b IgA or IgM over IgG and predominance of the IgG2 subclass; anti-GQ1b IgG (IgG3) prevailed in one patient only. These distinct Ig patterns strongly suggest that different infections may trigger different mechanisms of anti-GQ1b production, such as via T-cell-dependent as opposed to T-cell-independent pathways. Thus, the origin of antibodies against GQ1b in MFS may be determined by the type of infectious agent that precipitates the disease.

Pathogenic roles of antiganglioside antibodies in immune‐mediated neuropathies

“…The IgG subclass of anti‐GM1 antibodies in GBS and anti‐GQ1b antibodies in FS are IgG1 or IgG3 . IgG3 is the major subclass of anti‐GQ1b antibodies in patients with FS after respiratory infection . A study of the IgG subclass of anti‐GM1 antibodies showed that the IgG1 subclass is associated with slow recovery and IgG3 with rapid recovery .…”

Prevalence of IgG Autoantibodies against GD3 Ganglioside in Acute Zika Virus Infection

“…Our data indicate that there is not a specific subclass of anti-GD3 antibodies developed, although a significance difference is found for IgG4 in pregnant acutely infected patients. Previous findings in GBS show that anti-GM1 and anti-GT1a antibodies are predominantly IgG1 and IgG3 ( 30 ) and anti-GQ1b can either be IgG2 or IgG3, depending on the clinical manifestation ( 31 ). However, it has been described that the antibody response to GD3 in general is made of different subclasses of antibodies ( 32 ), these data are in line with our findings for adult acutely infected individuals.…”

A Review of Third Nerve Palsies

“…These antibodies are directed against membrane ganglioside glycoprotein are found in high density on third, fourth, and sixth nerves. 48 Most patients with MF variant of GBS experience spontaneous recovery which is sometimes hastened by the administration of intravenous immunoglobulins or plasma exchange.…”