Anti-ganglioside antibodies in peripheral neuropathy

There have recently been reports that patients with motor neuropathy with multifocal conduction block have high circulating levels of antibodies to the ganglioside GM1. Other reports have described the presence of these antibodies in patients with inflammatory demyelinating neuropathy and patients with lower motor neurone forms of motor neurone disease. We have established an ELISA assay for IgG and IgM antibodies to asialo-GM1 (Sigma). We used this assay to measure such antibodies in serum from normal subjects and from patients with various neurological conditions. In normal subjects, antibodies to asialo-GM1 were present only in low levels. An arbitrary scale with an upper limit of normal was established. Initial studies have found that abnormally high levels of IgG antibodies to asialo-GM1 were present in 4 of 9 patients with inflammatory demyelinating neuropathies (Guillain-Barré syndrome or chronic inflammatory demyelinating polyradiculoneuropathy). We found one patient with a monoclonal IgM circulating paraprotein and a motor neuropathy who had a high titre of antibody to asialo-GM1. As yet we have found no patients with motor neurone disease with antibodies to asialo-GM1.