Spontaneous Recovery from the Guillain-Barré Syndrome Is Associated with Anti-idiotypic Antibodies Recognizing a Cross-Reactive Idiotype on Anti-neuroblastoma Cell Line Antibodies

Abstract

The presence of suppressive antibody activity in sera from patients spontaneously recovered from the Guillain-Barré syndrome was investigated by analyzing the ability of postrecovery serum to inhibit anti-neuroblastoma cell line antibody binding in sera from seven patients in the prerecovery phase or with a chronic form of the disease. All 12 recovered patients analyzed were found to have inhibitory IgG antibodies in their postrecovery sera, of which the F(ab′) 2 fragments mediated the inhibitory effect. The pattern of inhihition suggests that about half of the patients share crossreactive idiotypes of high affinity. The efficiency of the inhibition mediated by anti-idiotypic antibodies in spontaneously recovered patients was twice as high as that mediated by anti-idiotypes present in therapeutical preparations of polyclonal immunoglobulins for intravenous use (IVIG). Affinity chromatography of IVIG and serum from a recovered Gullain-Barré syndrome patient on autoantibodycontaining F(ab′) 2 fragments revealed, first, that inhibitory anti-idiotypic antibodies are specifically retained on autoantibodies and, second, that these antibodies constitute less than 1% of the total IgG antibody content.