g(m1)-ganglioside and Acute-Disease

Spinal cord injury (SCI) results in loss of feeling and movement. The consequences can be devastating for the patient and his or her carers. Global estimates of the number of new cases annually range from 15 to 40 per million. Leading causes of acute SCI are road traffic injury, violence, and injuries sustained in sports and other recreational activities. Care for people with SCI has improved, leading to an increase in survival rates. Attempts to improve patients' feeling and movement have involved the use of a wide range of treatments. Gangliosides are compounds that occur naturally in cell membranes. Laboratory studies have suggested they may have protective effects on nerves and even help them to re-grow. Clinical trials have taken place using gangliosides (usually GM1 ganglioside) for a number of neurological conditions.. To quantify the evidence for the effectiveness and safety of gangliosides when used to treat acute SCI.. We searched the following databases to identify trials for inclusion: CENTRAL, MEDLINE, EMBASE, and the National Research Register. We also searched web-based trials registers, such as Current Controlled Trials. We approached the manufacturers of the most widely used ganglioside and researchers in this field to try to locate any unpublished data.. Randomised controlled trials of any ganglioside versus controls, in patients with SCI. Outcome measures specified were: mortality, recovery of motor function, improvement in sensory measures, measures of functional activity, infections and any other adverse events.. Data were extracted from published studies and authors were contacted for further information. All data found was dichotomous and odds ratios (with 95% CIs) were calculated. A fixed-effects model was assumed.. Two studies met the inclusion criteria. There were no deaths in one (n=37). In the other (n=760), there were slightly more deaths in the treatment group than in the control group; odds ratio 1.07 (0.57, 2.00 95%CI) - a result that can be explained by the play of chance. Methodological weaknesses regarding the collection and presentation of data from the two studies made it impossible to reach any conclusions regarding the effect of gangliosides on the other specified outcomes.. The evidence available does not support the use of ganglioside treatment to reduce the death rate in SCI patients. No evidence has yet emerged that ganglioside treatment improves recovery or quality of life in survivors.

Topics: Acute Disease; G(M1) Ganglioside; Gangliosides; Humans; Randomized Controlled Trials as Topic; Spinal Cord Injuries

To review the major pharmacological trials in acute spinal cord injury (SCI) that have been conducted over the past 25 years.. Review article.. The publication of the first National Acute Spinal Cord Injury (NASCIS) trial in 1984 ushered in the era of pharmacological trials of therapies intended to improve neurologic outcome in acute SCI. Subsequent trials of methylprednisolone sodium succinate (MPSS) and GM-1 have added to the evidence basis that informs the current management practices for acute SCI.. The last 50 years have seen a conceptual shift from the pessimism of the past to a cautious optimism that the meager prognosis for neurologic recovery in acute SCI will yield to the progress of medical science. Major advances in the understanding of primary and secondary injury mechanisms have led to the preclinical study of many promising pharmacological therapies, all with the goal of improving neurologic outcome. A few of these drugs have stood the test of animal model experiments and have made it to the forum of human clinical trials. The NASCIS trials of methylprednisolone have been acknowledged widely as the first human studies to claim improved neurologic outcome. Although the results of these trials remain controversial, the MPSS therapy that they reported has been adopted widely by clinicians around the world as the best currently available, even if not a consensus "standard of care." Clearly, the challenge for medical science remains. The search for effective treatment has only begun.

Topics: Acute Disease; Clinical Trials as Topic; G(M1) Ganglioside; Humans; Methylprednisolone Hemisuccinate; Neuroprotective Agents; Spinal Cord Injuries

There is insufficient evidence to support treatment standards.. There is insufficient evidence to support treatment guidelines.. Treatment with methylprednisolone for either 24 or 48 hours is recommended as an option in the treatment of patients with acute spinal cord injuries that should be undertaken only with the knowledge that the evidence suggesting harmful side effects is more consistent than any suggestion of clinical benefit. GM-1 GANGLIOSIDE:. Treatment of patients with acute spinal cord injuries with GM-1 ganglioside is recommended as an option without demonstrated clinical benefit.

Topics: Acute Disease; Cervical Vertebrae; Critical Pathways; Evidence-Based Medicine; G(M1) Ganglioside; Humans; Methylprednisolone; Practice Guidelines as Topic; Spinal Cord Injuries

Topics: Acute Disease; Aged; Antibodies, Antinuclear; Antibody Specificity; Autoantibodies; Autoimmune Diseases; Evoked Potentials; Female; France; G(M1) Ganglioside; Gastroenteritis; Guillain-Barre Syndrome; Humans; Immunoglobulin M; Neurologic Examination

Gangliosides may have a protective effect on the central and peripheral nervous systems.. The objective of this review was to assess the effect of exogenous gangliosides in acute ischaemic stroke.. We searched the Cochrane Stroke Group trials register (last searched: May 2001) and contacted drug companies and main investigators of included trials.. Randomised trials of gangliosides compared with placebo or standard treatment in people with definite or presumed ischaemic stroke. Trials were included if people were randomised within 15 days of symptom onset and if mortality data were available.. One reviewer applied the inclusion criteria. Two reviewers independently extracted the data. Trial quality was assessed.. Twelve trials involving 2265 people were included. All the trials tested purified monosialoganglioside GM1. Only three trials described the randomisation procedure. Follow-up was between 15 to 180 days. Death at the end of follow-up showed no significant difference (odds ratio 0.91, 95% confidence interval 0.73 to 1.13). There was no difference shown between early (within 48 hours) and delayed treatment. For disability, three trials did not show any improvement in Barthel index score with gangliosides (weighted mean difference 2.1; 95% confidence interval -4.8 to 8.9). In two trials, eight patients experienced adverse effects that led to discontinuation of ganglioside treatment, seven had skin reactions and one developed Guillain-Barré syndrome.. There is not enough evidence to conclude that gangliosides are beneficial in acute stroke. Caution is warranted because of reports of sporadic cases of Guillain-Barré syndrome after ganglioside therapy.

Topics: Acute Disease; Brain Ischemia; G(M1) Ganglioside; Gangliosides; Humans; Stroke

The search for a pharmacologic treatment of acute spinal cord injury (SCI) dates back to the 1960s. It was not until 1990 that the pharmacologic agent methylprednisolone demonstrated improved outcomes in humans. Methylprednisolone has shown superiority to placebo in humans in two large, multicenter trials, and is the standard of care thus far. Other potentially useful agents include tirilazad, ganglioside (GM-1), and naloxone. Additional studies are needed for these agents to determine the optimal dose and timing of administration.

Topics: Acute Disease; Antioxidants; G(M1) Ganglioside; Humans; Methylprednisolone; Naloxone; Narcotic Antagonists; Neuroprotective Agents; Pregnatrienes; Spinal Cord Injuries

The search for a pharmacologic treatment of acute spinal cord injury (SCI) dates back to the 1960s. It was not until 1990 that the pharmacologic agent methylprednisolone demonstrated improved outcomes in humans. Methylprednisolone has shown superiority to placebo in humans in two large, multicenter trials, and is the standard of care thus far. Other potentially useful agents include tirilazad, ganglioside (GM-1), and naloxone. Additional studies are needed for these agents to determine the optimal dose and timing of administration.

Topics: Acute Disease; Anti-Inflammatory Agents; Drug Interactions; G(M1) Ganglioside; Humans; Methylprednisolone; Naloxone; Narcotic Antagonists; Neuroprotective Agents; Pregnatrienes; Research Design; Spinal Cord Injuries; Treatment Outcome

This review focuses on the recent advances in the management of acute ischemic stroke. We highlight the best current treatment, as proposed by different authors, as well as future lines of treatment.

Topics: Acute Disease; Cerebral Infarction; Female; G(M1) Ganglioside; Humans; Male; N-Methylaspartate; Nimodipine; Tissue Plasminogen Activator; Treatment Outcome

Randomized, double-blind, sequential, multicenter clinical trial of two doses of Sygen versus placebo.. To determine efficacy and safety of Sygen in acute spinal cord injury.. An earlier, single-center trial in 28 patients showed an improvement (50.0% vs. 7.1%, P = 0.034) in marked recovery with Sygen.. Standard clinical trial techniques.. The prospectively planned analysis at the prespecified endpoint time for all patients was negative. There was a significant effect in all patients in the primary outcome variable (the percentage of marked recovery) at week 8, the end of the dosing period. There was a significant effect in all patients in the time at which marked recovery is first achieved. Restricted to severity Group B, which has small sample size, the primary efficacy analysis showed a trend but did not reach significance. There is a large, consistent and, at some time points, significant effect in the primary outcome variable in the nonoperated patients through week 26. The American Spinal Injury Association motor, light touch, and pinprick scores showed a consistent trend in favor of Sygen, as also did bowel function, bladder function, sacral sensation, and anal contraction. The less severely injured patients appeared to have a greater beneficial drug effect. Evidence against an effect of Sygen was minimal and scattered.. Although not proven in the primary efficacy analysis of this trial, Sygen appears to be beneficial in patients with severe spinal cord injury.

Topics: Acute Disease; Adolescent; Adult; Aged; Double-Blind Method; Female; G(M1) Ganglioside; Humans; Logistic Models; Male; Middle Aged; Neuroprotective Agents; Prospective Studies; Recovery of Function; Spinal Cord Injuries; Treatment Outcome

Eosinophilia myalgia syndrome (EMS) has been related to intake of "contaminated" L-tryptophan, and an alteration in tryptophan 5-hydroxytryptamine (5-HT, serotonin) metabolism has been reported in EMS patients. Recently we found that a defined autoantibody pattern consisting of antibodies to nucleoli, gangliosides, and phospholipids is closely related to the fibromyalgia syndrome (FS) which clinically resembles the EMS. We were therefore interested to see whether these antibodies can also be detected in patients with EMS. Studied were 27 patients with acute EMS (13 of whom were also examined 2 years after acute onset), 100 patients with FS, and 40 patients with progressive systemic sclerosis (PSS). As controls, sera from 100 blood donors were analyzed. Antibodies to nucleoli were demonstrated by immunofluorescence test on cell cultures in 52% of patients with acute EMS, 62% of patients with chronic EMS, and 37% of FS patients. Western blotting with a nuclear extract from HeLa cells revealed in both diseases the same epitopes at 63, 57, and 53 kDa. Antibodies to 5-HT, gangliosides (Gm1), and phospholipids were determined by enzyme-linked immunosorbent assay. Among patients with FS 73% had antibodies to 5-HT, in contrast to only 19% of patients with acute EMS. However, 77% of the 13 EMS patients analyzed 2 years later had become anti-5-HT antibody positive during that time. Also the incidence of antibodies to Gm1 increased from 37% at acute onset to 69% in patients with chronic EMS (30%). The various antibodies were detected in only 18% of healthy controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acute Disease; Adult; Aged; Antibodies, Antiphospholipid; Autoantibodies; Blotting, Western; Cell Nucleolus; Chronic Disease; Eosinophilia-Myalgia Syndrome; Female; Fibromyalgia; Follow-Up Studies; G(M1) Ganglioside; Humans; Male; Middle Aged; Serotonin; Tryptophan

We sought to assess the safety and efficacy of ganglioside GM1 in acute (< or = 48 hours), anterior circulation ischemic stroke.. We screened more than 5000 patients at 13 centers in a randomized, double-blind, placebo-controlled, parallel-treatment, clinical trial and enrolled 287 patients. They received 100 mg GM1 or placebo intramuscularly daily for 28 days and were evaluated regularly for 84 days. Number of deaths, the Toronto Stroke Scale, and the Barthel Index were primary outcomes; improvements on the Fugl-Meyer Scale and on a neuropsychological battery were secondary outcomes.. The groups were balanced for severity, side of stroke, age, sex, race, years of schooling, prior illness, and depression scores. Analyzable data were available on 275 patients; 217 patients completed the trial. Protocol-specified primary and secondary outcome measures showed no significant difference between treatment arms. However, improvement from baseline in the motor component of the Toronto Stroke Scale favored the GM1-treated group at day 28 when GM1 treatment stopped (P = .020); at day 84, the difference still favored the GM1-treated group (P = .057). All 10 components of the Barthel Index, the Fugl-Meyer Scale, and four of the five tests in the neuropsychological battery also favored the GM1 group. Adverse experiences were similar in the two groups.. GM1 is safe. However, since only certain post hoc tests showed statistically significant differences or trends favoring GM1, another clinical trial is needed to demonstrate efficacy.

Topics: Activities of Daily Living; Acute Disease; Aged; Brain Ischemia; Cause of Death; Cerebrovascular Disorders; Double-Blind Method; Female; Follow-Up Studies; G(M1) Ganglioside; Humans; Injections, Intramuscular; Male; Motor Activity; Movement; Neurologic Examination; Neuropsychological Tests; Placebos

Topics: Acute Disease; Aged; Cerebral Hemorrhage; Cerebral Infarction; Cerebrovascular Disorders; Clinical Trials as Topic; Double-Blind Method; Electroencephalography; Female; G(M1) Ganglioside; Gangliosides; Humans; Male; Middle Aged

To investigate the effects of ganglioside [monostalotetra-hexosylganglioside (GM1)] on the expressions of caspase-3 and nerve growth factor (NGF) in rats with acute spinal cord injury (SCI).. Male Sprague- Dawley (SD) rats were selected and randomly divided into Sham group, SCI group and GM1 administration group. The rats in Sham group, SCI group and GM1 group were subjected to behavioral examinations of Basso Beattie Bresnahan (BBB) and oblique-plate test at 1, 7 and 14 d after operation. The content of methylene dioxyamphetamine (MDA) and the activity of superoxide dismutase (SOD) of every rat in each group were measured by enzyme-linked immunosorbent assay (ELISA). Immunofluorescence staining assay was used to detect the expression levels of caspase-3 and NGF of rats in each group. The messenger ribonucleic acid (mRNA) and protein expressions of caspase-3 and NGF of rats in Sham group, SCI group and GM1 group were detected using reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blotting assay.. The BBB scores and the results of oblique-plate test in Sham group, SCI group and GM1 group at 1, 7 and 14 d showed that the BBB scores and the results of oblique-plate test of rats in each group were significantly decreased at 1 d after SCI, and had different degrees of recovery at 7 and 14 d after injury. The results of ELISA detection revealed that SCI group had increased content of MDA and clearly decreased activity of SOD in comparison with Sham group; at the same time, MDA content in GM1 group was overtly lower than that in SCI group, while SOD activity was enhanced evidently in GM1 group compared with that in SCI group. According to immunofluorescence assay, significantly increased expression of caspase-3 and distinctly decreased expression of NGF were found in SCI group. However, this phenomenon was significantly reversed by GM1. RT-PCR and Western blotting assay severally proved that the mRNA and protein expressions of caspase-3 were raised in SCI group and decreased clearly after the administration of GM1; while the mRNA and protein expressions of NGF was significantly reduced in SCI group and overtly elevated after the administration of GM1. ANOVA showed that there were statistically significant differences in expressions of caspase-3 and NGF among Sham group, SCI group and GM1 group (p<0.05).. GM1 has an evident effect on the expressions of caspase-3 and NGF in rats with acute SCI, and is able to down-regulate the expression of caspase-3 and up-regulate the expression of NGF, so as to achieve its therapeutic effect on SCI.

Topics: Acute Disease; Animals; Caspase 3; G(M1) Ganglioside; Male; Nerve Growth Factor; Rats; Rats, Sprague-Dawley; Spinal Cord Injuries; Superoxide Dismutase

Topics: Acute Disease; Demyelinating Diseases; G(M1) Ganglioside; Gangliosides; Humans; Male; Peripheral Nervous System Diseases; Reflex, Abnormal; Young Adult

Antiganglioside antibodies are found in various neurological disorders that constitute a continuum from peripheral neuropathy to encephalitis. However, nystagmus has rarely been described in patients with ataxia associated with antiganglioside antibodies.. From January 2008 to July 2009, we identified 3 patients with acute ataxia and nystagmus in 2 University Hospitals of Korea, who were found to have anti-GD1b, anti-GM1, or anti-GQ1b antibodies.. In addition to acute ataxia, all 3 patients showed various combinations of nystagmus, which included central positional nystagmus (n = 3), vertical nystagmus (n = 1), and periodic alternating nystagmus (n = 1). The spontaneous and positional nystagmus were mostly detectable only with the elimination of fixation and magnification of the eyes using video goggles. Two patients also exhibited gaze-evoked nystagmus that was noticeable without the aid of video goggles. Patients had serum IgG antibodies to GD1b, GM1, or GQ1b. Cerebrospinal fluid examination, nerve conduction studies, and brain MRI were normal. In all patients, the symptoms and signs resolved over 3-12 months.. Various forms of nystagmus with acute ataxia may be a sole or predominant manifestation of disorders related to antiganglioside antibodies. The nystagmus indicates a central pathology involving the cerebellum or brainstem in this antibody-associated disorder. Antiganglioside antibodies should be measured in patients with nystagmus and acute ataxia of undetermined etiology.

Topics: Acute Disease; Adolescent; Adult; Ataxia; Autoantibodies; Autoantigens; Autoimmune Diseases; Cerebrospinal Fluid; Dizziness; Enzyme-Linked Immunosorbent Assay; Female; G(M1) Ganglioside; Gangliosides; Humans; Immunoglobulin G; Male; Nystagmus, Pathologic; Postural Balance; Sensation Disorders; Vertigo

Experimental, controlled, animal study.. To evaluate the effect of GM1 ganglioside, hyperbaric oxygen and both in combination, in the treatment of experimental spinal cord lesions in rats.. Brazil.. Thirty-two Wistar rats with spinal cord lesions were divided into four groups: one group received GM1 ganglioside, one was submitted to hyperbaric oxygen therapy (HBOT), the third received both treatments and the fourth received no treatment (control).. There were no significant differences between the groups in the histological analysis, for any of the variables (necrosis, hemorrhage, hyperemia, cystic degeneration, P>0.06). Neither were there any significant differences in the comparison of left and right sides in the functional tests (P>0.06 for all). No significant differences were found in the locomotor ratings, in the comparison of groups at 2, 7, 21 and 28 days after the surgical procedure. However, in the evaluation on day 14, group 3, which received the combined therapy, showed a significantly higher Basso Beattie and Bresnahan score than the other groups (P=0.015).. The therapeutic effect of GM1 in locomotor evaluation of rats submitted to spinal cord lesion is anticipated by HBOT.

Topics: Acute Disease; Animals; Combined Modality Therapy; Disease Models, Animal; G(M1) Ganglioside; Hyperbaric Oxygenation; Male; Nerve Regeneration; Neuroprotective Agents; Rats; Rats, Wistar; Spinal Cord Injuries

Campylobacter enteritis is commonly associated with various forms of the Guillain-Barré syndrome but not central nervous system (CNS) inflammation. We present a case of Campylobacter enteritis associated with acute inflammatory encephalomyelitis and high titre antiganglioside GM1 IgG antibodies. The finding of antiganglioside antibodies in inflammatory demyelination of the CNS may identify avenues for research into pathogenesis. The relationship between antiganglioside antibodies and CNS inflammation is discussed.

Topics: Acute Disease; Campylobacter Infections; Cerebellum; Encephalomyelitis; Female; G(M1) Ganglioside; Humans; Immunoglobulin G; Magnetic Resonance Imaging; Spinal Cord; Young Adult

Acute motor axonal neuropathy (AMAN) in humans is associated with the presence of GM1-specific antibodies. Immunization of rabbits with GM1-containing ganglioside mixtures, purified GM1, or Campylobacter jejuni lipo-oligosaccharide exhibiting a GM1-like structure elicits GM1-specific antibodies, but axonal polyneuropathy only occurs in a subset of animals. This study aimed to dissect the molecular basis for the variable induction of AMAN in rabbits. Therefore, we analyzed the pro-inflammatory characteristics of GM1-specific antibodies in plasma samples from ganglioside-immunized rabbits with and without neurological deficits. GM1-specific plasma samples from all rabbits with AMAN were capable of activating both complement and leukocytes, in contrast to none of the plasma samples from rabbits without paralysis. Furthermore, GM1-specific IgG-mediated activation of leukocytes was detected before the onset of clinical signs. These data suggest that AMAN only occurs in rabbits that develop GM1-specific antibodies with pro-inflammatory properties.

Topics: Acute Disease; Animals; Autoantibodies; Axons; Cell Degranulation; Complement Activation; G(M1) Ganglioside; Immunoglobulin Fab Fragments; Immunoglobulin G; Leukocytes; Motor Neuron Disease; Muscle Hypotonia; Paralysis; Rabbits; Receptors, IgG

We report a case of partially treated brucellosis that developed quadriparesis, sixth and seventh cranial nerve palsy, and apnea. Electrodiagnostic studies were in favor of acute axonal poly-radiculoneuropathy. Crossreactive immunological responses due to molecular mimicry between Brucella lipooligosaccharide and GM1 ganglioside may justify the development of acute axonal polyradiculoneuropathy after brucellosis.

Topics: Acute Disease; Adult; Apnea; Brucellosis; Cranial Nerve Diseases; Electrodiagnosis; G(M1) Ganglioside; Humans; Male; Polyradiculoneuropathy

We previously showed that beta2-microglobulin knockout mice treated with anti-asialoGM1 (beta2M/alphaAsGM1 mice) exhibit less hypothermia, reduced production of proinflammatory cytokines, less metabolic acidosis, and improved survival after cecal ligation and puncture (CLP) compared with wild-type mice. The present study was designed to assess hemodynamics and left ventricular contractility at 18 h after CLP. Arterial pressure was measured by carotid artery cannulation, and left ventricular pressure-volume loops were obtained by insertion of a 1.4-F conductance catheter into the left ventricle. Heart rate, stroke volume, and cardiac output were not significantly different between wild-type and beta2M/alphaAsGM1 mice after CLP. However, beta2M/alphaAsGM1 mice exhibited improved mean arterial pressure and systemic vascular resistance compared with wild-type mice. Myocardial function was also better preserved in beta2M/alphaAsGM1 mice as indicated by improved left ventricular pressure development over time, time-varying maximum elastance, endsystolic pressure-volume relationship, and preload recruitable stroke work. Overall, this study shows that cardiovascular collapse characterized by hypotension, myocardial depression, and low systemic vascular resistance occurs after CLP in wild-type mice. However, beta2M/alphaAsGM1 mice exhibit improved hemodynamics and cardiac contractile function after CLP that may account, in part, for our previously observed survival benefit.

Topics: Abdomen; Acute Disease; Animals; beta 2-Microglobulin; Blood Pressure; Female; G(M1) Ganglioside; Hemodynamics; Hypotension; Mice; Mice, Inbred C57BL; Mice, Knockout; Myocardial Contraction; Sepsis; Vascular Resistance; Ventricular Function, Left

Patients with Guillain-Barré syndrome (GBS) after Mycoplasma pneumoniae infection often have antibodies to galactocerebroside (GalC). Electrodiagnosis may show acute inflammatory demyelinating polyneuropathy (AIDP).. The authors report a patient with acute motor axonal neuropathy (AMAN) after Mycoplasma infection and review seven cases of Mycoplasma-associated GBS. They investigated anti-GalC serology under various conditions associated with Mycoplasma infection.. The patient had immunoglobulin (Ig)G and IgM antibodies against GM1 and GalC, which cross-reacted. During the acute phase, IgM selectively immunostained axons. The cholera toxin B-subunit and rabbit anti-GM1 IgG stained a band in the lipid extract from M pneumoniae, indicative of the presence of a GM1 epitope. Six Mycoplasma-associated GBS patients with anti-GalC antibodies had non-AIDP electrodiagnoses, whereas one with Mycoplasma-associated AIDP had no anti-GalC antibodies. Anti-GalC antibodies were positive in two of five patients who had neurologic diseases other than GBS after Mycoplasma infection and in one of 12 who had acute respiratory disease caused by M pneumoniae not followed by a neurologic disease.. Anti-GalC antibodies in Mycoplasma-associated GBS may be an epiphenomenon. In certain cases, anti-GM1 antibodies induced by molecular mimicry with M pneumoniae may cause acute motor axonal neuropathy.

Topics: Acute Disease; Adult; Animals; Autoantibodies; Axons; Cross Reactions; Electrodiagnosis; Enzyme-Linked Immunosorbent Assay; Epitopes; G(M1) Ganglioside; Galactosylceramides; Guillain-Barre Syndrome; Humans; Immunoglobulin G; Immunoglobulin M; Immunoglobulins, Intravenous; Male; Molecular Mimicry; Mycoplasma Infections; Neural Conduction; Rabbits; Rats; Serologic Tests

Raised anti-GQ1b antibody is associated with Miller Fisher syndrome, Guillain-Barre syndrome (GBS) with ophthalmoplegia, Bickerstaff's brain stem encephalitis, acute ophthalmoparesis without ataxia and ataxic GBS without opthalmoplegia. We report a rare case of acute ophthalmoplegia associated with anti-GQ1b antibody that also had pupillary areflexia. A 35-year-old Chinese lady presented with external ophthalmoplegia, pupillary areflexia and no other abnormalities of cranial nerves, muscle tone, deep tendon reflexes, limb power or cerebellar dysfunction. Anti-GQ1b IgG antibody titre was significantly elevated, while neuroimaging of brain and orbital structures, nerve conduction study and cerebral spinal fluid examination were normal. Pupillary areflexia should be recognized as another feature that may be present in conditions associated with raised anti-GQ1b antibody.

Topics: Acute Disease; Adult; Antibodies; Female; G(M1) Ganglioside; Humans; Ophthalmoplegia; Pupil Disorders

Anti-GM1 immunoglobulin G (IgG) antibodies are frequently present in sera from patients with Guillain-Barré syndrome (GBS). A previous report on a patient who had a neuropathy with immunoglobulin M (IgM) M-protein binding to a conformational epitope formed by phosphatidic acid (PA) and gangliosides prompted us to investigate the binding of IgG antibodies in GBS sera to a mixture of GM1 and PA (GM1/PA). Of 121 GBS patients, 32 had anti-GM1 IgG antibodies. All 32 also had antibody activity against GM1/PA. Twenty-five (78%) of 32 patients had greater activity against GM1/PA than against GM1 alone. Twelve patients who had no anti-GM1 IgG antibodies had IgG antibody activity against GM1/PA. No GBS patient had IgG antibody against PA alone. In contrast, two rabbit anti-GM1 antisera had greater activity against GM1 alone than against GM1/PA. IgG antibody with greater binding activity against a mixture of GM1 and a phospholipid than against GM1 alone may have an important role in the pathogenesis of GBS and has implications for diagnosis.

Topics: Acute Disease; Antibody Specificity; Autoantibodies; Biomarkers; Enzyme-Linked Immunosorbent Assay; G(M1) Ganglioside; Guillain-Barre Syndrome; Humans; Immunoglobulin G; Phospholipids

Topics: Acute Disease; Adult; Antibody Specificity; Autoantibodies; Autoantigens; Autoimmune Diseases of the Nervous System; Axons; Brain; Female; G(M1) Ganglioside; Gait Disorders, Neurologic; Humans; Magnetic Resonance Imaging; Motor Neurons; Plasma Exchange; Polyneuropathies; Reflex, Abnormal; Respiratory Tract Infections

Topics: Acute Disease; Autoantibodies; Female; G(M1) Ganglioside; Guillain-Barre Syndrome; Humans; Immunoglobulin G; Middle Aged; Vocal Cord Paralysis

This study reports the efficacy of i.v. immunoglobulin in a patient with cranial polyneuropathy resulting from Campylobacter jejuni infection who had high titers of serum IgG antibodies against gangliosides GD1a and GT1b in the acute phase. Treatment with i.v. immunoglobulin (400 mg/kg/day x 5 days) led to rapid partial resolution of his neurologic manifestations, but complete recovery was not obtained until 6 months later. The present case suggests that i.v. immunoglobulin therapy prevents further progression of the disease but that it may not shorten the clinical course of cranial polyneuropathy in some cases associated with Campylobacter jejuni infection.

Topics: Acute Disease; Adolescent; Antibodies, Bacterial; Campylobacter Infections; Campylobacter jejuni; Cranial Nerve Diseases; G(M1) Ganglioside; Gangliosides; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins, Intravenous; Male; Treatment Outcome

Post hoc secondary analysis of data from 1992 to 1998 in the trial of Sygen in Acute Spinal Cord Injury.. Quasi-epidemiologic understanding of injury and treatment patterns and of recruitment in an SCI trial. No drug efficacy results.. The most recent large epidemiologic study was the National SCI Database by Stover and colleagues around 1980.. Emphasis on descriptive, rather than inferential, statistics: consistent with secondary analysis.. The study involved 760 patients at 28 centers in North America. Cervical injuries were more common than thoracic, and complete injuries were more common than incomplete injuries. Recruitment in the complete cervical stratum was 332, but the incomplete thoracic strata had only 31 patients combined. Vital signs at arrival and on randomization show fair stability. Clock times show more injuries on weekends and nights but suggest immediate attention was given. Elapsed times to treatment (especially EMT and Medevac arrival) are short. The rate of direct admission to tertiary centers, traction weight, and time to surgery vary among centers. Inpatient rehabilitation appeared driven by insurance in addition to severity.. The imbalances in favor of cervical and of complete injuries would make it hard for studies to attain results for SCI in general. The vital signs and time patterns suggest local protocol-driven stabilization to prevent secondary physiologic injury early after SCI. Some features of care vary among centers, but the sparseness of prospective data in specific injury and treatment categories suggests that treatment guidelines have limited empirical support and should be made cautiously.

Topics: Acute Disease; Adolescent; Adult; Aged; Decompression, Surgical; Female; G(M1) Ganglioside; Humans; Male; Middle Aged; Neuroprotective Agents; North America; Patient Selection; Randomized Controlled Trials as Topic; Retrospective Studies; Spinal Cord Injuries; Time Factors

Topics: Acute Disease; G(M1) Ganglioside; Humans; Multicenter Studies as Topic; Neuroprotective Agents; Randomized Controlled Trials as Topic; Spinal Cord Injuries; Treatment Outcome

Toxoplasmosis is a potentially fatal opportunistic infection of immunocompromised hosts. Improved animal models of toxoplasmosis are needed to more nearly approximate conditions that occur in immunocompromised humans. The development of models of toxoplasmosis using human peripheral blood lymphocytes (hu-PBL) transplanted into severe combined immunodeficiency (SCID) mice is described here. Transplantation of hu-PBL into SCID mice without prior conditioning of the mice resulted in detectable differences in quantitative histological scores of brain inflammation due to Toxoplasma gondii infection, but did not alter mortality when compared to SCID mouse controls. The lack of detectable differences in survival were due to inadequate engraftment of hu-PBL, as assessed by flow cytometry. Unconditioned hu-PBL SCID mice had low titre T. gondii-specific antibody detectable after infection. When pretransplantation conditioning with irradiation and antiasialo GM 1 (n-glucolyl neuraminic acid) antibody was used, prolonged hu-PBL engraftment was observed in SCID mice, which was associated with worsened histopathology and usually impaired survival when compared with SCID mouse controls. When pretransplantation conditioning with irradiation, antiasialo GM antibody and polyethylene glycol-conjugated IL-2 was used, prolonged hu-PBL engraftment was also documented, but this did not affect survival from T. gondii infection when compared with similarly conditioned SCID mouse controls. The latter conditioning protocol resulted in hu-PBL SCID mice producing high titre T. gondii-specific antibody after infection. Conditioned hu-PBL SCID mice had evidence of increased T. gondii-induced inflammatory scores when compared with conditioned SCID mice. These models show promise for the study of the pathogenesis of toxoplasmosis and conditioned hu-PBL SCID mice may have applications for the evaluation of novel therapies for toxoplasmosis in immunocompromised humans.

Topics: Acute Disease; Animals; Antibodies; Antibodies, Protozoan; Chronic Disease; Cytotoxicity Tests, Immunologic; Disease Models, Animal; Flow Cytometry; G(M1) Ganglioside; Humans; Killer Cells, Natural; Liver; Lymphocyte Count; Lymphocyte Transfusion; Mice; Mice, SCID; Spleen; Survival Rate; Toxoplasma; Toxoplasmosis, Animal; Transplantation Conditioning; Whole-Body Irradiation

We examined the effects of interleukin-18 (IL-18) in a mouse model of acute intraperitoneal infection with herpes simplex virus type 1 (HSV-1). Four days of treatment with IL-18 (from 2 days before infection to 1 day after infection) improved the survival rate of BALB/c, BALB/c nude, and BALB/c SCID mice, suggesting innate immunity. One day after infection, HSV-1 titers were higher in the peritoneal washing fluid of control BALB/c mice than in that of IL-18-treated mice. A genetic deficiency of gamma interferon (IFN-gamma), however, diminished the survival rate and the inhibition of HSV-1 growth at the injection site in the mice. Anti-asialo GM1 treatment had no influence on the protective effect of IL-18 in infected mice. IL-18 augmented IFN-gamma release in vitro by peritoneal cells from uninfected mice, while no appreciable IFN-gamma production was found in uninfected mice administered IL-18. Although IFN-gamma has the ability to induce nitric oxide (NO) production by various types of cells, administration of the NO synthase inhibitor NG-monomethyl-L-arginine resulted in superficial loss of the improved survival, but there was no influence on the inhibition of HSV-1 replication at the injection site in IL-18-treated mice. Based on these results, we propose that IFN-gamma produced before HSV-1 infection plays a key role as one of the IL-18-promoted protection mechanisms and that neither NK cells nor NO plays this role.

Topics: Acute Disease; Animals; Cytokines; Female; G(M1) Ganglioside; Herpes Simplex; Interferon-gamma; Interleukin-18; Mice; Mice, Inbred BALB C; Mice, SCID; Nitric Oxide; omega-N-Methylarginine; Virus Replication

Topics: Acute Disease; Adult; Female; G(M1) Ganglioside; Humans; Immunoglobulin G; Motor Neuron Disease; Pneumonia, Mycoplasma; Polyradiculoneuropathy

IgG antibodies to the minor gangliosides GM1b and GalNAc-GD1a frequently are present in sera of Japanese patients with Guillain-Barré syndrome. The relationship between these autoantibodies and Campylobacter jejuni infection, the type of disease (acute motor axonal neuropathy [AMAN], or acute inflammatory demyelinating polyneuropathy [AIDP]) has yet to be established. Sera samples were obtained from 55 Chinese patients with clinically defined Guillain-Barré syndrome. An electrophysiology study showed nine AIDP, 28 had AMAN, and 18 unclassified. C. jejuni serology was positively correlated with anti-GM1b and anti-GalNAc-GD1a IgG antibodies (respective P values, 0.007 and 0.02). The frequencies of positive anti-GM1b and anti-GalNAc-GD1a serology were greater in AMAN (32 and 21%) than in AIDP (11 and 0%), but the differences were not significant. Infection by C. jejuni may induce IgG anti-GM1b antibody in some patients and IgG anti-GalNAc-GD1a antibody in others. A larger population of patients must be studied to show whether there is a definite correlation.

Topics: Acute Disease; Adolescent; Adult; Autoantibodies; Axons; Campylobacter Infections; Campylobacter jejuni; Child; Child, Preschool; China; Female; G(M1) Ganglioside; Gangliosides; Humans; Male; Middle Aged; Motor Neuron Disease; Polyradiculoneuropathy

To investigate the incidence of hyperreflexia in patients with Guillain-Barré syndrome (GBS), and its relation with electrodiagnosis of acute motor axonal neuropathy (AMAN), antiganglioside GM1 antibody, and Campylobacter jejuni infection. It was reported that patients with AMAN in northern China often had hyperreflexia in the recovery phase.. In 54 consecutive Japanese patients with GBS, sequential findings of tendon reflexes were reviewed. By electrodiagnostic criteria, patients were classified as having AMAN or acute inflammatory demyelinating polyneuropathy (AIDP). Anti-GM1 and anti-C jejuni antibodies were measured by enzyme linked immunosorbent assays.. Seven (13%) patients developed hyperreflexia with the spread of the myotatic reflex to other segments in the early recovery phase, one of whom already had hyperreflexia in the acute progressive phase. Of the seven patients, six had AMAN and all seven had anti-GM1 antibodies, whereas only two had anti-C jejuni antibodies. Hyperreflexia was more often found in patients with AMAN than AIDP (6/23 v 1/18, p=0. 002), and in patients with anti-GM1 antibodies than without them (7/26 v 0/28, p=0.01). Hyperreflexic patients had milder peak disabilities than patients without hyperreflexia (p=0.03). Increased motor neuron excitability in the hyperreflexic patients was supported by increased soleus H-reflex amplitudes and the appearance of H-reflexes in the small hand or foot muscles.. Hyperreflexia often occurs in patients with GBS especially with AMAN, anti-GM1 antibodies, and milder disease. Increased motor neuron excitability further characterises the subgroup of patients with GBS with AMAN and anti-GM1 antibodies.

Topics: Acute Disease; Adult; Antibodies; Antibodies, Bacterial; Campylobacter jejuni; Electrodiagnosis; Female; G(M1) Ganglioside; H-Reflex; Humans; Male; Middle Aged; Motor Neuron Disease; Polyradiculoneuropathy; Reflex, Abnormal; Reflex, Stretch; Syndrome

Topics: Acute Disease; Animals; Antiparkinson Agents; Brain Ischemia; Drugs, Investigational; G(M1) Ganglioside; Humans; Neuroprotective Agents; Parkinson Disease; Stroke

A chimeric severe combined immunodeficient mouse engrafted with human peripheral blood (hu-PBL-SCID) model has been developed to test anti-T-cell monoclonal antibody (mAb) effects on systemic symptoms of the host and the survival of human skin grafts. To obtain consistent engraftment without lethal acute graft-versus-host disease (GVHD), SCID mice were pretreated with a combination of total body irradiation (2.5 Gy, day 0) and anti-asialo GM1 (anti-mouse natural killer cell) antiserum (50 micrograms i.p., day 3) before the intraperitoneal injection of 40-50 X 10(6) human PBL on day 4. With this protocol, the engraftment rate was 82% with 5-98% human CD45-positive cells in the peripheral blood. Mortality at 30 days was 0% in the mice bearing 5-50% human cells compared with 70% in those with more than 50%. Using hu-PBL-SCID mice with 5-50% human cells in their peripheral blood, we demonstrated the following results: 1) Human T cells isolated from these mice proliferated in response to immobilized OKT3 stimulation in vitro. 2) Hu-PBL-SCID mice but not normal SCID mice were able to reject human skin grafts in vivo 16-21 days after grafting. 3) Both OKT3 (anti-human CD3 mAb) and T10B9 (anti-human alpha beta T-cell receptor mAb) treatment prevented human skin graft rejection in hu-PBL-SCID mice. 4) OKT3 but not T10B9 induced first dose reactions characterized by hypothermia and hypoactivity which were consistently observed within 90 min of intravenous injection into hu-PBL-SCID mice. 5) Human cytokines were detected in the serum of the hu-PBL-SCID mice treated with anti-T-cell mAbs. The close similarity of these responses to human clinical mAb immunosuppressive therapy suggests that the hu-PBL-SCID mouse model may be an excellent tool for investigating the immunosuppression, side effects, and mechanism of action of agents that are specific for human and higher apes and not reactive with lower animals.

Topics: Acute Disease; Animals; Antibodies, Monoclonal; Cell Division; Cytokines; Disease Models, Animal; G(M1) Ganglioside; Graft Survival; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Hypothermia; Immune Sera; Immunoglobulin M; Immunosuppressive Agents; Leukocytes; Lymphocyte Activation; Mice; Mice, SCID; Muromonab-CD3; Receptors, Antigen, T-Cell, alpha-beta; Skin Transplantation; Survival Rate; T-Lymphocytes; Transplantation, Heterologous; Whole-Body Irradiation

Investigation of pathophysiology of F wave disappearance in demyelinating neuropathies.. The peripheral motor nerve conduction was studied by motor evoked potential (MEP) on transcranial magnetic stimulation as well as conventional nerve conduction studies before and after the treatment in 26 patients with inflammatory demyelinating neuropathies. In addition, serum antiganglioside antibodies in the acute or active stage were examined.. The F wave was abolished in 10 patients. Seven of the 10 patients showed motor evoked potentials (MEPs) on transcranial magnetic stimulation that ranged from 1-4 mV. In six of them the F wave reappeared in the recovery stage, but the MEP size did not change. This may be caused by humoral factors, because the F wave reappeared immediately after plasma exchange or intravenous immunoglobulin treatment. A correlation of F wave disappearance with the presence of serum antiganglioside antibodies was found.. The major pathophysiology of F wave disappearance in demyelinating neuropathies is impairment of motor neuron excitability or prolonged refractoriness of the most proximal axon for backfiring. The conventional interpretation that absent F waves suggest a conduction block at the proximal site is often inadequate.

Topics: Acute Disease; Adolescent; Adult; Aged; Antibodies; Axons; Brain; Child; Child, Preschool; Demyelinating Diseases; Enzyme-Linked Immunosorbent Assay; Evoked Potentials, Motor; Female; G(M1) Ganglioside; Humans; Immunoglobulins; Injections, Intravenous; Male; Middle Aged; Motor Neurons; Neural Conduction; Plasma Exchange

The acute motor axonal neuropathy (AMAN) form of the Guillain-Barre syndrome is a paralytic disorder of abrupt onset characterized pathologically by motor nerve fiber degeneration of variable severity and by sparing of sensory fibers. There is little demyelination or lymphocytic inflammation. Most cases have antecedent infection with Campylobacter jejuni and many have antibodies directed toward GM1 ganglioside-like epitopes, but the mechanism of nerve-fiber injury has not been defined. In 7 fatal cases of AMAN, immunocytochemistry demonstrated the presence of IgG and the complement activation product C3d bound to the axolemma of motor fibers. The most frequently involved site was the nodal axolemma, but in more severe cases IgG and C3d were found within the periaxonal space of the myelinated internodes, bound to the outer surface of the motor axon. These results suggest that AMAN is a novel disorder caused by an antibody- and complement-mediated attack on the axolemma of motor fibers.

Topics: Acute Disease; Adolescent; Adult; Axons; Campylobacter jejuni; Child, Preschool; Complement Activation; Complement C3d; Demyelinating Diseases; Female; G(M1) Ganglioside; Humans; Immunoglobulin G; Immunohistochemistry; Male; Middle Aged; Motor Neuron Disease; Nerve Degeneration; Severity of Illness Index

Gamma interferon (IFN-gamma) is known to be a major mediator influencing host defense against Toxoplasma (T.) gondii. To evaluate lymphocyte populations involved in this cytokine-mediated early resistance to T. gondii, the effects of in vivo administration of monoclonal antibodies (MAbs) against T-cell subsets and anti-asialo GM1 antibody on the course of infection and IFN-gamma response were investigated in mice infected acutely with this parasitic protozoan. A single injection of anti-CD8 MAb on day -1 or day 4 severely exacerbated the infection, in accordance with a marked suppression of endogenous IFN-gamma production. Moreover, the administration of anti-IFN-gamma MAb on day 0 but not later than day 4 resulted in a total abrogation of resistance to T. gondii, suggesting that endogenous IFN-gamma produced during the first several days of infection is critical for the generation of antitoxoplasmal resistance in mice. In contrast, no significant increase in mortality was observed when injected with either anti-CD4 MAb or anti-asialo GM1 antibody on day -1, while these antibodies reduced significantly the ability of mice to produce IFN-gamma. Indeed, simultaneous depletion of CD4+ and CD8+ cells had no greater suppressive effect on host defense and endogenous IFN-gamma production than depletion of CD8+ cells alone. Together, these results suggest that CD8+ T cells play a central role for resolution of acute toxoplasmosis by participating in endogenous IFN-gamma production. The possible role of early produced IFN-gamma in the development of protective immune response to T. gondii is also discussed.

Topics: Acute Disease; Animals; Antibodies, Monoclonal; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Female; G(M1) Ganglioside; Immunity, Cellular; Interferon-gamma; Lymphocyte Depletion; Mice; Mice, Inbred ICR; Toxoplasmosis, Animal

This study aimed to investigate the effects of monosialoganglioside (GM1) when administered early in a model of cerebral focal ischemia, in the rabbit. The statistical evaluation of the electroencephalographic changes (quantified EEG analysis, QEEG) due to the ischemic event showed that the early treatment (1-3-24 h) with GM1 reduced the EEgraphic pattern typical of this model of cerebral ischemia. Considering the observation period, we hypothesized that it was due to the formation of an oedema of a lesser degree compared to the untreated group. Particularly, we did not obtain the increase in delta activity on the contralateral hemisphere, which we thought was expression of the diaschisi phenomenon.

Topics: Acute Disease; Animals; Brain Edema; Brain Ischemia; Cell Membrane; Electroencephalography; G(M1) Ganglioside; Intracranial Embolism and Thrombosis; Models, Biological; Rabbits

The acute peripheral neuropathy as one of hypereosinophilic syndrome is known to be a rare disorder. The authors experienced a dramatic case with acute peripheral neuropathy, hypereosinophilia in peripheral blood, and the positive anti-GM1 antibodies. The serum protein electrophoresis showed a diffusely increased gamma-globulin region and the polyclonal gammopathy was found by the immunoelectropheresis. There was no evidence of inflammatory myopathy in vastus lateralis muscle. The sural nerve biopsy was compatible with vascular neuropathy, as there were a few myelin digestion chambers, mild perineuronal fibrosis, and perivascular lymphoplasmocytic infiltration with focal organizing thrombosis. The clinical response to prednisone therapy was excellent.

Topics: Acute Disease; Adult; Antibodies; G(M1) Ganglioside; Humans; Hypereosinophilic Syndrome; Male; Peripheral Nervous System Diseases

Serum antibodies to monosialoganglioside (GM1), disialoganglioside (GD1b), and Campylobacter jejuni, measured by enzyme-linked immunosorbent assay and serum antibodies to peripheral nerve myelin, measured by the C1 fixation and transfer assay, were studied in 58 acute-phase patients with Guillain-Barré syndrome (GBS), 42 disease controls, and 29 normal controls. Anti-peripheral nerve myelin antibodies were elevated in 57 of 58 patients with GBS compared with controls, whereas only 8.6% had increased antibody titers to GM1 and 10.3% to GD1b. Only low antibody titers (GM1) or no antibodies (GD1b) were found in controls. More GBS patients (17.2%) than controls (7%) had antibodies to C jejuni. Poor recovery with inability to walk at 1 year after onset of symptoms was seen in 3 (5%) of the patients with GBS. All 3 patients had serological evidence of recent C jejuni infection but no antibodies to GM1 or GD1b. GBS patients with antibodies to GM1 or GD1b had excellent recovery. Our data indicate that antibodies to GM1 or GD1b do not necessarily mediate the extensive axonal damage seen in these severely affected patients.

Topics: Acute Disease; Adolescent; Adult; Antibodies; Antibodies, Bacterial; Autoantibodies; Campylobacter Infections; Campylobacter jejuni; Case-Control Studies; Female; G(M1) Ganglioside; Gangliosides; Humans; Male; Middle Aged; Myelin Sheath; Polyradiculoneuropathy; Prognosis; Retrospective Studies

Clinical and experimental findings suggest that humoral factors, such as anti-peripheral nerve antibodies and cytokines, may be implicated in the immunopathogenesis of Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Interleukin-6 (IL-6) is a multifunctional cytokine that promotes immunoglobulin synthesis by B lymphocytes. Increased IL-6 release is associated with autoantibody production in a number of immune-mediated and neoplastic disorders. To investigate the possible involvement of abnormal IL-6 release in inflammatory polyneuropathies, we assayed IL-6 levels in the cerebrospinal fluid (CSF) and serum of 23 patients with acute GBS and seven with CIDP. We also studied 69 patients with other non-inflammatory neurological diseases (NIND), 25 with other inflammatory neurological diseases (IND), four with brain tumors (BT), and 15 normal donors (serum alone) as controls. We found detectable levels of IL-6 in the CSF of 57% of GBS, 43% of CIDP, 60% of IND, 75% of BT, and 4% of NIND. In GBS patients, no correlation was found between CSF IL-6 values and other laboratory or clinical parameters, such as CSF total protein, CSF albumin, CSF IgG, CSF/serum albumin ratio, functional disability score, and time elapsed from disease onset. Serum IL-6 levels were increased in six of 23 (26%) GBS, in one of 39 (3%) NIND, and in one of seven (14%) IND, but in none of the CIDP or BT patients. There was no correlation between serum and CSF IL-6 values, but cytokine levels in GBS sera correlated with time elapsed from clinical onset.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Autoantibodies; Chronic Disease; Demyelinating Diseases; Enzyme-Linked Immunosorbent Assay; Female; G(M1) Ganglioside; Humans; Immunoglobulin G; Immunoglobulin M; Interleukin-6; Male; Middle Aged; Nervous System Diseases; Polyradiculoneuropathy

We describe a 52-year-old man who had an acute-onset purely motor neuropathy fulfilling the diagnostic criteria for the Guillain-Barré syndrome, in whom virtually complete spontaneous recovery occurred by 1 year, and in whom high titres of polyclonal serum antibody to GM1, GD1b, asialo-GM1 and lacto-N-tetraose were detected. The titre of IgM antibody to GM1 fell during the course of the disease with a concomitant rise in the IgG titre. This case adds to the widening spectrum of disease associated with anti-GM1 antibodies and provides further evidence for a relationship between anti-GM1 antibodies and motor system disease.

Topics: Acute Disease; Animals; Autoantibodies; Autoimmune Diseases; G(M1) Ganglioside; Humans; Immunoglobulin G; Immunoglobulin M; Male; Middle Aged; Polyradiculoneuropathy; Ranvier's Nodes; Rats

Topics: Acute Disease; Brain Ischemia; Cerebrovascular Disorders; G(M1) Ganglioside; Humans

CTL and NK cells cultured in vitro have been shown to contain a cytolytic pore-forming protein (PFP/perforin/cytolysin). To date, it has not been determined whether perforin is expressed by CTL that have been primed in vivo. Here, we have infected mice with two strains of lymphocytic choriomeningitis virus (LCMV), one of which mainly produces choriomeningitis and, the other, hepatitis. Brain and liver cryostat sections obtained from LCMV-infected mice were stained for various lymphocyte markers, including perforin. We were able to detect a large accumulation of perforin antigen in CD8+/Thy-1+/asialo GM1+/CD4- lymphocytes, which in fact represent the main infiltrating cell type found in brain and liver sections obtained during the late acute stage of LCMV infection. Perforin was also detected in a smaller population of CD8-/asialo GM1+/NK 1.1+/F480- cells, presumably corresponding to NK cells. Perforin-positive cells were found to have the morphology of blasts or large granular lymphocytes (LGL). These observations, together with in vitro studies performed in the past, indicate that perforin may be associated exclusively with LGL-like CTL blasts and NK cells. Our results demonstrate for the first time the presence of perforin in CTL that have been primed in vivo and suggest that perforin-positive CTL may be directly involved in producing the immunopathology associated with the LCMV infection.

Topics: Acute Disease; Animals; Antigens, Differentiation, T-Lymphocyte; CD8 Antigens; Cell Movement; Epitopes; G(M1) Ganglioside; Glycosphingolipids; Immune Sera; Killer Cells, Natural; Lymphocytic Choriomeningitis; Membrane Glycoproteins; Membrane Proteins; Mice; Mice, Inbred BALB C; Mice, Inbred C57BL; Perforin; Phenotype; Pore Forming Cytotoxic Proteins; Staining and Labeling; T-Lymphocytes, Cytotoxic; Tissue Distribution

Topics: Acute Disease; Alopecia; Animals; Chronic Disease; Dermatitis; Female; G(M1) Ganglioside; Glycosphingolipids; Graft vs Host Disease; Mice; Mice, Inbred C57BL; Mice, Inbred DBA

Topics: Acute Disease; Cerebrovascular Disorders; G(M1) Ganglioside; Humans

Enterotoxin production, a possible virulence factor, was determined in Campylobacter jejuni and Campylobacter coli by two different techniques, the CHO cell test and the GM1 enzyme-linked immunosorbent assay. The frequency of enterotoxigenic Campylobacter strains was 32% in strains from both humans with acute enteritis and healthy laying hens, as measured by the CHO cell test. The CHO cell test was significantly more sensitive than the GM1 enzyme-linked immunosorbent assay in the detection of enterotoxigenic strains. Enterotoxin production was compared with the presence of heat-stable and heat-labile antigens. There was no significant correlation between enterotoxin production and serogroups for C. jejuni or C. coli. The difference in enterotoxigenicity between C. jejuni (34.1%) and C. coli (21.9%) was not significant.

Topics: Acute Disease; Adolescent; Adult; Animals; Campylobacter; Campylobacter fetus; Campylobacter Infections; Carrier State; Cell Line; Chickens; Diarrhea; Enterotoxins; Enzyme-Linked Immunosorbent Assay; Female; G(M1) Ganglioside; Humans; Poultry Diseases; Serotyping; Virulence

Graft-versus-host disease (GVHD) was induced in irradiated (750 rad) (CBA x C57BL/6)F1 hybrid mice by an intravenous injection of 30 x 10(6) CBA spleen cells and 5 x 10(6) syngeneic F1 bone marrow cells. The GVHD resulted in the death of 80% of recipients within 9 days. However, when radioresistant Asialo-GM1+ cells were depleted from the recipients with a single injection of anti-Asialo-GM1 antibody 2 days before irradiation and transplantation, mortality decreased significantly (to 11%). During the GVHD, anti-host specific cytotoxic T cell (CTL) activity could be shown in vitro in the spleens of mice suffering from the GVHD if suppressor activity was first abolished by in vitro culture procedures. This CTL activity, however, was not detectable in the spleens of anti-ASGM1 antibody pretreated hosts. The results indicate that radioresistant ASGM1+ cells of host origin are necessary for the induction of both anti-host CTL and lethal GVHD.

Topics: Acute Disease; Animals; Cytotoxicity, Immunologic; G(M1) Ganglioside; Glycosphingolipids; Graft vs Host Disease; Immune Sera; Killer Cells, Natural; Lymphocyte Depletion; Mice; Mice, Inbred CBA; Species Specificity; Spleen; T-Lymphocytes, Cytotoxic

The possibility of using erythrocytic ganglioside diagnostic reagents (EGDR) for the detection of V. cholerae, E. coli and S. typhimurium enterotoxins in the passive hemagglutination (PHA) test has been shown. Museum strains and cultures isolated from patients with acute intestinal diseases were tested for the presence of enterotoxins. Cell-free extracts were studied by biological methods and by serological titration in the PHA test with the use of EGDR. The diagnostic reagent was found to interact only with those enterotoxins whose specific receptors were gangliosides GM1.

Topics: Acute Disease; Animals; Bacterial Infections; Cholera Toxin; Enterotoxins; Erythrocytes; Escherichia coli; G(M1) Ganglioside; Gangliosides; Hemagglutination Tests; Humans; Intestinal Diseases; Rabbits; Receptors, Cell Surface; Receptors, Immunologic; Salmonella; Shigella; Staphylococcus; Vibrio cholerae