ANTIGANGLIOSIDE GM(1) ANTIBODIES IN GUILLAIN-BARRE-SYNDROME AND THEIR RELATIONSHIP TO CAMPYLOBACTER-JEJUNI INFECTION

To clarify the association between Campylobacter jejuni (Cj) infection and antibodies to ganglioside GM, (anti-GM,) in Guillain-Barre syndrome (GBS), we have carried out a prospective case-control study of 96 patients with GBS. Cj infection occurred in 25 (26%) patients. IgG and/or IgM anti-GM(1) were identified in 24 (25%) patients and in 1 of 71 (1.4%) household controls (P < 0.001). Thirteen of the 25 (52%) Cj-positive patients had anti-GM(1) compared with 11 of the 71 (15%) Cj-negative patients (P < 0.001). Neither the peak overall disability nor the 1-year disability differed between the anti-GM(1)-positive and anti-GM(1)-negative patients. However, patients with the combination of Cj infection and anti-GM, positivity recovered more slowly than Cj/anti-GM(1)-negative patients (P = 0.05), were more likely to have axonal degeneration, and were significantly more disabled at the end of 1 year (P = 0.02). The presence of Cj infection is more important than anti-GM(1) positivity in determining the extent of axonal involvement and, hence, prognosis. Since the presence of anti-GM(1) is not a significant poor-prognostic factor, a search should be made for other properties of Cj infection that would account for its relationship to axonal degeneration.