Antiglycosphingolipid Immune Responses in Neurology: The Vienna Experience with Isotypes, Subclasses, and Diseasea

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Abstract
IgM, IgG, IgA, and IgG subclass anti‐GM1, anti‐GQ1b, and anti‐asialo‐GM1 (anti‐GA1) antibodies, respectively, were investigated by ELISA in serum from neurological and other patients. Increased anti‐GM1 occurred mostly in ∼35–15% of the cases without statistical differences; high percentages were found in Guillain‐Barré syndrome (GBS) preceded by gastrointestinal infection and multifocal motor neuropathy. Roughly, IgM anti‐GM1 was most frequent; however, distinct IgG and IgA reactions were found i.a. in GBS. A particular IgM anti‐mono‐ and disialoganglioside pattern occurred in a patient with sensorimotor neuropathy and paraproteinemia. Anti‐GQ1b was elevated in all Miller‐Fisher patients, with some prevalence of IgG2 among IgG subclasses. Cross‐reactivity of anti‐GQ1b was demonstrated with Campylobacter jejuni lipopolysaccharides. Increased anti‐GM1 and/or anti‐GA1 was more frequent in systemic lupus erythematosus with central nervous system involvement than without. Incidence of anti‐GM1 and anti‐GA1 in X‐adrenoleukodystrophy was relatively high.Although anti‐GSL antibodies seem to have limited diagnostic value, studies of isotypes, subclass patterns, and cross‐reactivities may lead to further insight into the origin of (auto)immune responses and their immunepathogenetic role in disease.

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