抗GD1a抗体血清阳性患者的临床谱及预后特征
Clinical spectrum and prognostic features of patients seropositive for anti-GD1a antibody.
摘要(中文译文)
抗GD1a抗体与一系列免疫介导的神经病相关，尤其是急性运动轴索性神经病（AMAN）及其他吉兰-巴雷综合征（GBS）变异型。然而，由于系统性研究有限，其完整的临床谱系及预后意义仍不明确。本研究探讨了抗GD1a抗体相关的临床表型、血清学特征、脑脊液（CSF）特点及治疗转归。回顾性收集并分析了19例抗GD1a抗体阳性中国患者的临床、辅助检查及治疗资料。本队列平均发病年龄为50.6岁。19例患者中，14例（74%）表现为急性综合征，其余5例（26%）表现出符合慢性神经病的特点。常见表现包括腱反射消失（84%）、肢体无力（84%）、感觉障碍（58%）及脑神经受累（53%）。仅5例患者为单纯抗GD1a抗体阳性，其余患者合并其他抗神经节苷脂抗体，最常见为抗GQ1b抗体和抗GM1抗体。电生理检查显示轴索性和脱髓鞘性神经病模式。伴有脑神经受累及蛋白细胞分离的患者与较高的改良Erasmus GBS预后评分（mEGOS）相关。免疫治疗对急性病例有效，57%的患者在6个月随访时达到完全康复。抗GD1a抗体血清阳性患者表现出显著的临床和电生理异质性，且常与其他抗神经节苷脂抗体共存。急性表现通常对免疫治疗反应良好，而慢性病例需个体化管理。
Abstract
Anti-GD1a antibodies are associated with a range of immune-mediated neuropathies, particularly acute motor axonal neuropathy (AMAN) and other Guillain-Barré syndrome (GBS) variants. However, their full clinical spectrum and prognostic significance remain unclear due to limited systematic studies. Here, we investigated the clinical phenotypes, serological profiles, cerebrospinal fluid (CSF) characteristic, and therapeutic outcomes associated with anti-GD1a antibodies. The clinical, paraclinical and therapeutic data were retrospectively collected and analyzed from 19 Chinese patients who tested positive for anti-GD1a antibodies. The mean age at onset in this cohort was 50.6 years. Among the 19 patients, 14 (74%) presented with acute syndromes. The remaining five patients (26%) exhibited features consistent with chronic neuropathies. Common manifestations included absent tendon reflexes (84%), limb weakness (84%), sensory impairment (58%), and cranial nerve involvement (53%). Isolated anti-GD1a antibody positivity was observed in only 5 patients, while others had co-existing antiganglioside antibodies, most commonly anti-GQ1b, and anti-GM1. Electrophysiological studies revealed axonal and demyelinating neuropathic patterns. Patients with cranial nerve involvement and albuminocytologic dissociation were associated with higher modified Erasmus GBS Outcome Score (mEGOS). Immunotherapy was effective in acute cases, with 57% achieving complete recovery at 6-month follow-up. Patients seropositive for anti-GD1a antibody exhibits significant clinical and electrophysiological heterogeneity and frequently coexists with other antiganglioside antibodies. Acute presentations generally respond well to immunotherapy, while chronic cases require individualized management.
如何引用
AMA
Xujun Chu, Xinyu Liu, Ziling Zeng, Jinping Li, Xiaoyu Liu, Shougang Guo, et al. Clinical spectrum and prognostic features of patients seropositive for anti-GD1a antibody.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1825556.
APA
Xujun Chu, Xinyu Liu, Ziling Zeng, Jinping Li, Xiaoyu Liu, Shougang Guo, et al (2026). Clinical spectrum and prognostic features of patients seropositive for anti-GD1a antibody.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1825556
GB/T 7714
Xujun Chu, Xinyu Liu, Ziling Zeng, Jinping Li, Xiaoyu Liu, Shougang Guo, et al. Clinical spectrum and prognostic features of patients seropositive for anti-GD1a antibody.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1825556.
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