g(m1)-ganglioside and Lupus-Erythematosus--Systemic

In the last few years it has become clear that in cells of the immune system, specialized microdomains present in the plasma membrane, called lipid rafts, have been found to play a central role in regulating signalling by immune receptors. Recent studies have looked at whether lipid rafts may be connected to the abnormalities in signalling seen in T lymphocytes isolated from patients with systemic lupus erythematosus (SLE). These early findings show that in SLE T cells, the expression and protein composition of lipid rafts is different when compared with normal T cells. These results also demonstrate changes in the function and localization of critical signalling molecules such as the LCK tyrosine kinase and the CD45 tyrosine phosphatase.

Topics: G(M1) Ganglioside; Humans; Intracellular Signaling Peptides and Proteins; Lupus Erythematosus, Systemic; Lymphocyte Specific Protein Tyrosine Kinase p56(lck); Membrane Proteins; Phosphoproteins; Signal Transduction; T-Lymphocytes

Topics: Autoantibodies; Biomarkers; Diagnosis, Differential; G(M1) Ganglioside; Humans; Lupus Erythematosus, Systemic; Peripheral Nervous System Diseases; Severity of Illness Index

In systemic lupus erythematosus (SLE), peripheral neuropathies are relatively uncommon and rarely present as the initial symptom. We herein describe a 61-year-old woman who developed a sudden onset of drop foot, which was indistinguishable from Guillain-Barré syndrome based on the clinical symptoms alone. Antibodies against ganglioside GM1 were detected in the serum, while no antibodies to Campylobacter jejuni were observed. An electrophysiological study showed axonal impairment rather than demyelination. A pathological examination of a sural nerve biopsy specimen and further laboratory examinations suggested the observed peripheral neuropathies to have arisen due to lupus vasculitis. The serological activities of SLE responded well to treatment with corticosteroids, mizoribine and immunoadsorption therapies, however, the drop foot symptoms did not change remarkably.

Topics: Autoantibodies; Biopsy; Drug Therapy, Combination; Female; Foot; G(M1) Ganglioside; Glucocorticoids; Humans; Hypesthesia; Immunosuppressive Agents; Lupus Erythematosus, Systemic; Middle Aged; Peripheral Nervous System Diseases; Plasmapheresis; Sural Nerve

Antibodies to the ganglioside GD1b have been reported in various forms of immune-mediated neuropathy, but their clinical relevance for diagnosis and prognosis is unknown. We investigated the prevalence of anti-GD1b antibodies in acute and chronic immune-mediated neuropathies, and the clinical presentation and outcome in Guillain-Barré syndrome (GBS) and Miller Fisher-GBS overlap syndrome (MF-GBS). Anti-GD1b, anti-GM1 and anti-GQ1b antibodies were tested in serum of patients with GBS (N = 165), Miller Fisher syndrome (N = 10), MF-GBS (N = 28), monoclonal gammopathy of unknown significance neuropathy (MGUS; N = 101), chronic inflammatory demyelinating polyneuropathy (N = 29), paraneoplastic syndrome with anti-Hu-associated neuropathy (PNS; N = 11), other auto-immune diseases (AID; N = 60), and healthy controls (HC; N = 60). All samples were tested by enzyme-linked immunosorbent assay according to the Inflammatory Neuropathy Cause and Treatment protocol. IgM anti-GD1b antibodies were found in GBS (N = 4; 2.4%), MGUS (N = 3; 3.0%), and PNS patients (N = 1; 9.1%). IgG anti-GD1b antibodies were found in GBS (N = 20; 12.1%) and MF-GBS (N = 4; 14.3%) patients, but not in the AID and HC group. In the combined group of MF-GBS and GBS patients ((MF-)GBS), 14/36 (38.9%) patients with IgG anti-GD1b antibodies also had IgG anti-GM1 antibodies, and IgG anti-GD1b and IgG anti-GQ1b antibodies were found in 3/29 (10.3%) patients. Patients with (MF-)GBS and anti-GD1b without anti-GM1 antibodies did not differ regarding sensory disturbances or disease severity but recovered faster regarding the ability to walk independently compared with patients without anti-GD1b antibodies (P = 0.031) and with patients with both anti-GD1b and anti-GM1 antibodies (P = 0.034). In conclusion, testing for anti-GD1b antibodies may identify a specific group of immune-mediated neuropathies and (MF-)GBS patients with only anti-GD1b antibodies tend to recover faster.

Topics: Adult; Aged; Autoantibodies; Autoantigens; Autoimmune Diseases of the Nervous System; G(M1) Ganglioside; Gangliosides; Guillain-Barre Syndrome; Humans; Immunoglobulin G; Immunoglobulin M; Lupus Erythematosus, Systemic; Middle Aged; Miller Fisher Syndrome; Monoclonal Gammopathy of Undetermined Significance; Paraneoplastic Polyneuropathy; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating; Sjogren's Syndrome

Patients with the autoimmune rheumatic disease systemic lupus erythematosus (SLE) have multiple defects in lymphocyte signaling and function that contribute to disease pathogenesis. Such defects could be attributed to alterations in metabolic processes, including abnormal control of lipid biosynthesis pathways. Here, we reveal that CD4+ T cells from SLE patients displayed an altered profile of lipid raft-associated glycosphingolipids (GSLs) compared with that of healthy controls. In particular, lactosylceramide, globotriaosylceramide (Gb3), and monosialotetrahexosylganglioside (GM1) levels were markedly increased. Elevated GSLs in SLE patients were associated with increased expression of liver X receptor β (LXRβ), a nuclear receptor that controls cellular lipid metabolism and trafficking and influences acquired immune responses. Stimulation of CD4+ T cells isolated from healthy donors with synthetic and endogenous LXR agonists promoted GSL expression, which was blocked by an LXR antagonist. Increased GSL expression in CD4+ T cells was associated with intracellular accumulation and accelerated trafficking of GSL, reminiscent of cells from patients with glycolipid storage diseases. Inhibition of GSL biosynthesis in vitro with a clinically approved inhibitor (N-butyldeoxynojirimycin) normalized GSL metabolism, corrected CD4+ T cell signaling and functional defects, and decreased anti-dsDNA antibody production by autologous B cells in SLE patients. Our data demonstrate that lipid metabolism defects contribute to SLE pathogenesis and suggest that targeting GSL biosynthesis restores T cell function in SLE.

Topics: 1-Deoxynojirimycin; Adult; Aged; Antigens, CD; B-Lymphocytes; CD4-Positive T-Lymphocytes; Female; Flow Cytometry; G(M1) Ganglioside; Gene Expression Regulation; Glycosphingolipids; Homeostasis; Humans; Lactosylceramides; Leukocytes, Mononuclear; Liver X Receptors; Lupus Erythematosus, Systemic; Lymphocyte Activation; Male; Membrane Microdomains; Middle Aged; Orphan Nuclear Receptors; Signal Transduction; Time Factors; Trihexosylceramides

Gangliosides GM1 is a good marker of membrane microdomains (lipid rafts) with important function in cellular activation processes. In this study we found that GM1 expression on CD4+ T cells and memory T cells (CD45RO/CD4) were dramatic increased after stimulation with phytohaemagglutinin in vitro. Next, we examined the GM1 expression on peripheral blood CD4+ T cells and CD8+ T cells from 44 patients with SLE and 28 healthy controls by flow cytometry. GM1 expression was further analyzed with serum soluble CD30 (sCD30), IL-10, TNF-alpha and clinical parameters. The mean fluorescence intensity of GM1 on CD4+ T cells from patients with SLE was significantly higher than those from healthy controls, but not on CD8+ T cells. Increased expression of GM1 was more marked on CD4+/CD45RO+ memory T cells from active SLE patients. Patients with SLE showed significantly elevated serum sCD30 and IL-10, but not TNF-alpha levels. In addition, we found that enhanced GM1 expression on CD4+ T cells from patients with SLE positively correlated with high serum levels of sCD30 and IgG as well as disease activity (SLEDAI scores). Our data suggested the potential role of aberrant lipid raft/GM1 on CD4+ T cells and sCD30 in the pathogenesis of SLE.

Topics: CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; G(M1) Ganglioside; Humans; Immunoglobulin G; Immunologic Memory; Interleukin-10; Ki-1 Antigen; Kinetics; Lupus Erythematosus, Systemic; Lymphocyte Activation; Membrane Microdomains; Phytohemagglutinins; Solubility; Time Factors; Tumor Necrosis Factor-alpha

Loss of tolerance to self-Ags in patients with systemic lupus erythematosus (SLE), a prototypic autoimmune disease, is associated with dysregulation of T cell signaling, including the depletion of total levels of lymphocyte-specific protein kinase (Lck) from sphingolipid-cholesterol-enriched membrane microdomains (lipid rafts). Inhibitors of 3-hyroxy-3-methylgluteryl CoA reductase (statins) can modify the composition of lipid rafts, resulting in alteration of T cell signaling. In this study, we show that atorvastatin targets the distribution of signaling molecules in T cells from SLE patients, by disrupting the colocalization of total Lck and CD45 within lipid rafts, leading to a reduction in the active form of Lck. Upon T cell activation using anti-CD3/anti-CD28 in vitro, the rapid recruitment of total Lck to the immunological synapse was inhibited by atorvastatin, whereas ERK phosphorylation, which is decreased in SLE T cells, was reconstituted. Furthermore, atorvastatin reduced the production of IL-10 and IL-6 by T cells, implicated in the pathogenesis of SLE. Thus, atorvastatin reversed many of the signaling defects characteristic of SLE T cells. These findings demonstrate the potential for atorvastatin to target lipid raft-associated signaling abnormalities in autoreactive T cells and provide a rationale for its use in therapy of autoimmune disease.

Topics: Adult; Aged; Anticholesteremic Agents; Atorvastatin; Cells, Cultured; Enzyme Activation; Female; G(M1) Ganglioside; Heptanoic Acids; Humans; Intracellular Fluid; Kinetics; Lupus Erythematosus, Systemic; Lymphocyte Specific Protein Tyrosine Kinase p56(lck); Male; Membrane Microdomains; Middle Aged; Protein Prenylation; Pyrroles; Receptors, Antigen, T-Cell; Signal Transduction; T-Lymphocyte Subsets

Systemic lupus erythematosus (SLE) is characterized by abnormalities in T lymphocyte receptor-mediated signal transduction pathways. Our previous studies have established that lymphocyte-specific protein tyrosine kinase (LCK) is reduced in T lymphocytes from patients with SLE and that this reduction is associated with disease activity and parallels an increase in LCK ubiquitination independent of T cell activation. This study investigated the expression of molecules that regulate LCK homeostasis, such as CD45, C-terminal Src kinase (CSK), and c-Cbl, in lipid raft domains from SLE T cells and investigated the localization of these proteins during T cell receptor (TCR) triggering. Our results indicate that the expression of raft-associated ganglioside, GM1, is increased in T cells from SLE patients and LCK may be differentially regulated due to an alteration in the association of CD45 with lipid raft domains. CD45 tyrosine phosphatase, which regulates LCK activity, was differentially expressed and its localization into lipid rafts was increased in T cells from patients with SLE. Furthermore, T cells allowed to "rest" in vitro showed a reversal of the changes in LCK, CD45, and GM1 expression. The results also revealed that alterations in the level of GM1 expression and lipid raft occupancy cannot be induced by serum factors from patients with SLE but indicated that cell-cell contact, activating aberrant proximal signaling pathways, may be important in influencing abnormalities in T cell signaling and, therefore, function in patients with SLE.

Topics: Adolescent; Adult; Aged; Cholera Toxin; G(M1) Ganglioside; Humans; Leukocyte Common Antigens; Lupus Erythematosus, Systemic; Lymphocyte Specific Protein Tyrosine Kinase p56(lck); Membrane Microdomains; Middle Aged; Signal Transduction; T-Lymphocytes

Acute symmetric demyelinating polyneuropathy of the Guillain-Barré type is known in systemic lupus erythematosus (SLE). Chronic idiopathic demyelinating polyneuropathy (CIDP) has been reported rarely with SLE. A case is reported of CIDP accompanying SLE with autoantibodies against GM1- and GM3-gangliosides. There was no historical evidence to suggest SLE, and CIDP was the first manifestation of SLE. The 38-year-old patient had elevated CSF-protein, slow nerve conduction velocities, sural nerve biopsy revealed mixed axon loss with demyelination and CIDP white matter lesions were observed in magnetic resonance imaging, the GM1- and GM3-autoantibodies may play a role in the pathogenesis of CIDP in SLE.

Topics: Adult; Autoantibodies; Chronic Disease; Demyelinating Diseases; G(M1) Ganglioside; G(M2) Ganglioside; Humans; Lupus Erythematosus, Systemic; Male; Neurologic Examination; Polyradiculoneuropathy

A high incidence of antibody to asialo GM1 was observed in the sera from the patients with Systemic Lupus Erythematosus (SLE) and Behçet's disease with neurological manifestations, using Enzyme Linked Immunosorbent Assay (ELISA), and Thin-layer Chromatography (TLC) immunostaining. The sera from 60 out of 102 cases of SLE with neurological disorders and 6 out of 10 patients with neuro Behçet's disease showed antibody activity against asialo GM1 but not against the asialo GM2, GM1 and galactocerebroside. In 7 out of 123 cases SLE having a history without neurological manifestations and 1 out of 19 Behçet's patients without neurological disorders, antiasialo GM1 antibody could be detectable. However, sera from the patients with other autoimmune diseases, such as RA (60 cases) and P S S (32 cases) or from normal subjects did not show any antibody activity against asialo GM1. Antiasialo GM1 antibody activity presents in both IgM and IgG immunoglobulin classes by class specific ELISA and TLC immunostaining. These studies suggest that detection of antiasialo GM1 antibody may be useful in clinical diagnosis and these autoantibody plays a important role in the pathogenesis of neurological manifestations accompanying SLE and Neuro-Behçet's disease.

Topics: Antigen-Antibody Complex; Behcet Syndrome; Chromatography, Thin Layer; Enzyme-Linked Immunosorbent Assay; G(M1) Ganglioside; Glycosphingolipids; Humans; Immunoglobulin G; Immunoglobulin M; Lupus Erythematosus, Systemic; Nervous System Diseases

Topics: Animals; Autoantibodies; Autoimmune Diseases; Brain Neoplasms; Cell Line; Cytotoxicity Tests, Immunologic; G(M1) Ganglioside; Glycosphingolipids; Guinea Pigs; Humans; Lupus Erythematosus, Systemic; Mice; Nervous System Diseases; Rabbits

We used a liposome lysis assay to measure antibodies against a panel of glycolipids. Antibodies to one or more compounds were detected in 34 of 46 patients with multiple sclerosis, 19 of 31 patients with systemic lupus erythematosus (SLE), and in the majority of patients with cranial trauma or cerebrovascular accidents. Antibodies against ganglioside GM1 and asialo GM1 were found most commonly, and they were frequently present in the same sera. The specificity of the antibodies was tested in four sera that contained antibodies to both glycolipids. The anti-GM1 antibodies cross-reacted with asialo GM1, but the converse was not true. Among patients whose sera contained antibodies to glycolipids, anti-asialo GM1 alone was more common in patients with SLE (7 of 17) than in multiple sclerosis (2 of 34; p = 0.004). Anti-GM1 alone was found in 9 of 34 patients with multiple sclerosis and 1 of 17 patients with SLE, a difference that was not statistically significant (0.135). No correlation was observed between the presence of anti-glycolipid antibodies and symptoms related to the nervous system in patients with SLE. Because of our inability to detect these antibodies by a solid phase immunoassay (ELISA), a comparison was made of the titers obtained with three monoclonal anti-glycolipid antibodies in the liposome lysis assay and ELISA. The ELISA was less sensitive in all instances, requiring from four to 1000 times as much antibody as the liposome lysis assay to give a positive test. We conclude that antibodies to glycolipids occur frequently in patients with multiple sclerosis, SLE, major cranial trauma, and cerebrovascular accidents. Their role in the initiation or perpetuation of inflammatory disease of the central nervous system has yet to be determined.

Topics: Antibodies; Antibody Specificity; Binding Sites, Antibody; Enzyme-Linked Immunosorbent Assay; G(M1) Ganglioside; Glycosphingolipids; Humans; Lupus Erythematosus, Systemic; Multiple Sclerosis

Topics: Antibodies; Antigen-Antibody Complex; G(M1) Ganglioside; Gangliosides; Glycosphingolipids; Humans; Kinetics; Liposomes; Lupus Erythematosus, Systemic; Multiple Sclerosis