Sensitization against brain gangliosides after therapeutic swine brain implantation in a multiple sclerosis patient

Abstract

The case history is presented of a patient with multiple sclerosis who developed acute polyradiculoneuritis 11 days after subcutaneous implantation of a swine brain preparation. By means of lymphocyte transformation tests (LTT), sensitization against brain gangliosides could be demonstrated 16 days after the implantation. A second patient who underwent the same treatment showed neither clinical symptoms nor sensitization against brain gangliosides in the LTT. Patients did not show reactivity when tested with myelin basic protein. The polyradiculoneuritis was caused by the immune response to the implanted swine brain cross-reacting with human nervous system gangliosides.

Acute pure motor neuropathy with antibodies to gangliosides in a patient with multiple sclerosis

“…On the other hand, AGA do not seem to increase significantly following ganglioside intramuscular administration in normal subjects [4], and the widespread use of gangliosides in our country during recent years has not been associated with an increasing incidence of GBS [Italian Consiglio Superiore di Sanità, unpublished data]. Thus, it is possible that exogenous gangliosides are immunogenic only in some sensitized subjects, as in the patient with chronic-progressive MS described by Knorr-Held et al [7], who developed an axonal GBS after therapeutic swine brain implantation, and in the present case, in view of an abnormal hypersensitivity to gangliosides, which may occur in active MS [6]. In our case, in view of the markedly prolonged DML and normal conduction velocities, motor nerve terminals may have been primarily involved since, at this level, the blood-nerve barrier is more permeable to antibody penetration, and binding with anti-GM1 and GD1b antibodies is possible in GBS [5].…”