The role of antibodies to peripheral nerve antigens in pathogenesis and laboratory evaluation of immune-mediated neuropathies

Abstract

Detection of antiganglioside autoantibodies and their association with clinically defined subtypes implicate an autoimmune mechanism of peripheraland cranial nerve damage in peripheral neuropathies. Increased titer of antibodies that react with human peripheral nerve antigens have been reported in patients with motor neuropathy including Guillain-Barré syndrome,chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy and sensory motor neuropathy. This study represents review of the data related to increased titers of anti-glucoconjugate antibodies in different autoimmune neuropathies and their correlation with existence of structural homology between bacterial and glycoconjugated structures, as a basis for understanding the immune pathological response to glycoproteins and glycolipids present in the human peripheral nerve as target antigens in autoimmune neuropathies. Evaluation of presence and increased level of autoantibodies against peripheral nerve antigens could be an important parameter in laboratory evaluation, diagnosis and prognosis of autoimmune neuropathies and contribute in more efficient therapeutic approaches in treatment of these pathological conditions. Keywords: anti-glycoconjugate antibodies, anti-ganglioside antibodies, peripheral nerves, autoimmune neuropathies

Potential clinical implications of molecular mimicry‐induced autoimmunity

“…Vaccines using ganglioside‐mimicking antigens are being explored to induce tolerance to these peripheral nerve targets and reduce risk of subsequent autoimmunity 98 . Studies aim to better characterize cross‐reactive T cells and their myelin or axonal protein targets, which could enable antigen‐specific immunomodulation 99 . Overall, substantial challenges remain in elucidating the specific molecular targets and pathways involved in GBS.…”

“… 98 Studies aim to better characterize cross‐reactive T cells and their myelin or axonal protein targets, which could enable antigen‐specific immunomodulation. 99 Overall, substantial challenges remain in elucidating the specific molecular targets and pathways involved in GBS. But research continues on leveraging antigen‐specific approaches to predict, prevent, and treat GBS.…”