The clinical effect and the effect on serum IgG antibodies to peripheral nerve tissue of plasma exchange in patients with Guillain-Barré syndrome

Abstract

The mixed haemagglutination technique was used to demonstrate IgG antibodies to peripheral nerve tissue in sera from patients with the Guillain-Barré syndrome. The clinical effect and the effect on the antibodies of plasma exchange were examined in 18 patients. Neurological examination with muscle testing and neurophysiological examination of the patients were performed before and immediately after plasma exchange. Before the exchange antibodies were detected in sera from 11 of the patients. These patients showed clinical improvement during the treatment. After plasma exchange, antibodies were detected in sera from only two of the patients. The seven patients without detectable antibodies showed no clinical improvement.

Levels of calprotectin (leukocyte L1 protein) during apheresis

“…The possibility that calprotectin itself could play a pathogenetic role in GBS, which has been found for the peripheral nerve antibodies [16], is unlikely to be due to low levels of calprotectin in CSF. Alternatively, complement-fixing antiperipheral nerve antibodies in GBS [15] could promote C5a generation and subsequently leukocyte release of calprotectin.…”

IgG immunoadsorption in experimental allergic neuritis: effect on antibody levels and clinical course.

“…In the treatment group, each IgG immunoadsorption decreased circulating anti-myelin IgG concentrations by 55-65%. Rapid post-treatment antibody rebound was observed after each procedure so that levels were re-established within 24 significant differences in anti-myelin IgG concentrations between control and treatment groups (2-tailed Student's t test, p < 0 001). Anti-myelin IgG levels quickly increased after cessation of treatment so that two days later, that is, day nine post-allocation there was no significant difference in levels between groups.…”

Plasma exchange in chronic inflammatory demyelinating polyradiculoneuropathy

“…In the largest series to date of plasma exchange in CIDP, marked clinical improvement (two patients) and partial improvement (three patients) occurred in five o f seven patients undergoing plasma exchange. 25 The use of supplemental corticosteroids or other immunosuppr-essants was not described.…”