目的:抗神经节苷脂抗体(AGAs)可能参与多种神经系统疾病的发病机制,如米勒-费希尔综合征(MFS)和格林-巴利综合征(GBS)。在常规临床护理期间,有关AGA阳性率和AGA之间交叉反应性的可用综合参考数据很少(其中一线免疫印迹对≥1AGA呈阳性)。
方法:在这项为期10年的单中心回顾性研究中,使用脑脊液(CSF)和1342名患者的血清样品获得的3560个免疫球蛋白(Ig)G和IgM系印迹(GA通用检测\'抗神经节苷脂斑点试剂盒)分析了14个诊断类别和AGA交叉反应性的AGA阳性。
结果:在所有3560行印迹中,158(4.4%)和所有CSF样品中,0.4%(4/924)CSF行印迹是AGA阳性。对于血清IgG,阳性率高于15.6%的标准偏差的印迹与MFS相关(GD3、GD1a、GT1a和GQ1b)和急性运动性轴索神经病(AMAN)(GM1,GD1a和GT1a)。对于血清IgM,阳性率高于8.1%的标准偏差的印迹与AMAN(GM2、GT1a和GQ1b)相关,MFS(GM1、GT1a和GQ1b),多灶性运动神经病(MMN)(GM1,GM2和GQ1b)和慢性炎症性脱髓鞘性多发性神经病(CIDP)(GM1)。在所有阳性血清AGA的39.6%中观察到交叉反应。
结论:在常规临床护理期间对AGA的检测很少导致阳性结果,血清和脑脊液中更少,除了诊断阿曼,MFS,MMN和CIDP。作为不同AGA样本之间的交叉反应性发现的非特异性发现经常发生,影响大多数AGA亚型的阳性。
OBJECTIVE: Antiganglioside antibodies (AGAs) might be involved in the etiopathogenesis of many neurological diseases, such as Miller-Fisher syndrome (MFS) and Guillain-Barré syndrome (GBS). Available comprehensive reference data regarding AGA positivity rates and cross-responsiveness among AGAs (where one line immunoblot is positive for ≥1 AGA) during routine clinical care are scant.
METHODS: In this 10-year monocentric retrospective study, 3560 immunoglobulin (Ig) G and IgM line blots (GA Generic Assays\' Anti-Ganglioside Dot kit) obtained using cerebrospinal fluid (CSF) and serum samples from 1342 patients were analyzed for AGA positivity in terms of 14 diagnosis categories and AGA cross-responsiveness.
RESULTS: Of all 3560 line blots 158 (4.4%) and of all CSF samples 0.4% (4/924) CSF line blots were AGA positive. For serum IgG, blots with positivity rates higher than the standard deviation of 15.6% were associated with MFS (GD3, GD1a, GT1a and GQ1b) and acute motor axonal neuropathy (AMAN) (GM1, GD1a and GT1a). For serum IgM, blots with positivity rates higher than the standard deviation of 8.1% were associated with AMAN (GM2, GT1a and GQ1b), MFS (GM1, GT1a and GQ1b), multifocal motor neuropathy (MMN) (GM1, GM2 and GQ1b) and chronic inflammatory demyelinating polyneuropathy (CIDP) (GM1). Cross-responsiveness was observed in 39.6% of all positive serum AGA.
CONCLUSIONS: Testing for AGAs during routine clinical care rarely led to positive findings, both in serum and even less in CSF, except for the diagnoses AMAN, MFS, MMN and CIDP. Nonspecific findings found as cross-responsiveness between different AGA samples occur frequently, impacting the positivity of most AGA subtypes.