Composite ganglioside autoantibodies and immune treatment response in MMN and MADSAM

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Abstract

Introduction: Multifocal motor neuropathy (MMN) is a motor only, asymmetric onset neuropathy that is relatively treatment-refractory compared with classic chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy. Methods: We reviewed 35 patients seropositive for GM1 (monosialo-asialo [immunoglobulin M, IgM; immunoglobulin G, IgG]) and/or GD1b (disialo [IgG, IgM]) autoantibodies having MMN, classic CIDP, or MADSAM. Immune-treatment responsiveness and clinical course was compared with antibody negative disease controls. Results: Seventy-nine percent of seropositives with an initial diagnosis of MMN were immunotherapy responsive compared with 46% of seronegatives (P = 0.045). Eight ganglioside antibody positive MMN patients of 19 (42%) developed sensory findings consistent with MADSAM compared with 3 of 41 (7%) seronegative MMN patients (P = 0.003). MMN and MADSAM patients with ganglioside antibody positivity had more sustained treatment responses (P = 0.03). Discussion: Patients initially diagnosed with MMN seropositive for diverse GM1 autoantibodies appear more likely to have sustained treatment response and evolution to MADSAM.

Original languageEnglish (US)
JournalMuscle and Nerve
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Gangliosides
Autoantibodies
Chronic Inflammatory Demyelinating Polyradiculoneuropathy
Immunoglobulin M
Immunoglobulin G
Antibodies
Therapeutics
Immunotherapy

Keywords

  • CIDP
  • Gangliosides
  • MADSAM
  • MMN

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

Cite this

@article{ccf581f39f7545e2b595f2363bd651d4,
title = "Composite ganglioside autoantibodies and immune treatment response in MMN and MADSAM",
abstract = "Introduction: Multifocal motor neuropathy (MMN) is a motor only, asymmetric onset neuropathy that is relatively treatment-refractory compared with classic chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy. Methods: We reviewed 35 patients seropositive for GM1 (monosialo-asialo [immunoglobulin M, IgM; immunoglobulin G, IgG]) and/or GD1b (disialo [IgG, IgM]) autoantibodies having MMN, classic CIDP, or MADSAM. Immune-treatment responsiveness and clinical course was compared with antibody negative disease controls. Results: Seventy-nine percent of seropositives with an initial diagnosis of MMN were immunotherapy responsive compared with 46{\%} of seronegatives (P = 0.045). Eight ganglioside antibody positive MMN patients of 19 (42{\%}) developed sensory findings consistent with MADSAM compared with 3 of 41 (7{\%}) seronegative MMN patients (P = 0.003). MMN and MADSAM patients with ganglioside antibody positivity had more sustained treatment responses (P = 0.03). Discussion: Patients initially diagnosed with MMN seropositive for diverse GM1 autoantibodies appear more likely to have sustained treatment response and evolution to MADSAM.",
keywords = "CIDP, Gangliosides, MADSAM, MMN",
author = "Jennifer Martinez-Thompson and Snyder, {Melissa R.} and Michael Ettore and Andrew McKeon and Pittock, {Sean J} and Roforth, {Matthew M.} and Jayawant Mandrekar and Mauermann, {Michelle M} and Taylor, {Bruce V.} and Dyck, {Peter J} and Windebank, {Anthony John} and Klein, {Christopher Jon}",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/mus.26051",
language = "English (US)",
journal = "Muscle and Nerve",
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T1 - Composite ganglioside autoantibodies and immune treatment response in MMN and MADSAM

AU - Martinez-Thompson, Jennifer

AU - Snyder, Melissa R.

AU - Ettore, Michael

AU - McKeon, Andrew

AU - Pittock, Sean J

AU - Roforth, Matthew M.

AU - Mandrekar, Jayawant

AU - Mauermann, Michelle M

AU - Taylor, Bruce V.

AU - Dyck, Peter J

AU - Windebank, Anthony John

AU - Klein, Christopher Jon

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Multifocal motor neuropathy (MMN) is a motor only, asymmetric onset neuropathy that is relatively treatment-refractory compared with classic chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy. Methods: We reviewed 35 patients seropositive for GM1 (monosialo-asialo [immunoglobulin M, IgM; immunoglobulin G, IgG]) and/or GD1b (disialo [IgG, IgM]) autoantibodies having MMN, classic CIDP, or MADSAM. Immune-treatment responsiveness and clinical course was compared with antibody negative disease controls. Results: Seventy-nine percent of seropositives with an initial diagnosis of MMN were immunotherapy responsive compared with 46% of seronegatives (P = 0.045). Eight ganglioside antibody positive MMN patients of 19 (42%) developed sensory findings consistent with MADSAM compared with 3 of 41 (7%) seronegative MMN patients (P = 0.003). MMN and MADSAM patients with ganglioside antibody positivity had more sustained treatment responses (P = 0.03). Discussion: Patients initially diagnosed with MMN seropositive for diverse GM1 autoantibodies appear more likely to have sustained treatment response and evolution to MADSAM.

AB - Introduction: Multifocal motor neuropathy (MMN) is a motor only, asymmetric onset neuropathy that is relatively treatment-refractory compared with classic chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy. Methods: We reviewed 35 patients seropositive for GM1 (monosialo-asialo [immunoglobulin M, IgM; immunoglobulin G, IgG]) and/or GD1b (disialo [IgG, IgM]) autoantibodies having MMN, classic CIDP, or MADSAM. Immune-treatment responsiveness and clinical course was compared with antibody negative disease controls. Results: Seventy-nine percent of seropositives with an initial diagnosis of MMN were immunotherapy responsive compared with 46% of seronegatives (P = 0.045). Eight ganglioside antibody positive MMN patients of 19 (42%) developed sensory findings consistent with MADSAM compared with 3 of 41 (7%) seronegative MMN patients (P = 0.003). MMN and MADSAM patients with ganglioside antibody positivity had more sustained treatment responses (P = 0.03). Discussion: Patients initially diagnosed with MMN seropositive for diverse GM1 autoantibodies appear more likely to have sustained treatment response and evolution to MADSAM.

KW - CIDP

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KW - MADSAM

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