The Spectrum and Pathogenesis of Antibody-mediated Neuropathies

Abstract

Antibodies reacting with carbohydrate epitopes on neural glycoconjugates are present in several forms of neuropathy. These include monoclonal antibodies to the myelin-associated glycoprotein (MAG) and to gan gliosides in patients with neuropathy in association with IgM gammopathy, as well as polyclonal antibodies to gangliosides in inflammatory polyneuropathies, such as Guillain-Barré syndrome and multifocal motor neuropathy. There are several correlations between antibody specificity and clinical symptoms, including anti-MAG antibodies with demyelinating sensory or sensorimotor neuropathy, anti-GM1 ganglioside anti bodies with motor nerve disorders, anti-GQ1b ganglioside antibodies with Miller-Fisher syndrome, and antibodies to gangliosides containing disialosyl moieties with sensory ataxic neuropathy. This review will emphasize recent developments concerning the origins of the anti-glycoconjugate antibodies in patients, pathogenic mechanisms by which the antibodies may cause the neuropathies, and the implications of these findings for therapy. NEUROSCIENTIST 3:195-204, 1997