Clinical features of Guillain-Barré syndrome with anti-neurofascin 155 antibody

Acta Neurol Scand. 2022 Nov;146(5):553-561. doi: 10.1111/ane.13678. Epub 2022 Aug 4.

Abstract

Objective: Anti-neurofascin 155 (NF155) antibody has been discovered in chronic demyelinating conditions. However, the positive rate and clinical description were insufficient in acute demyelinating conditions, such as Guillain-Barré syndrome (GBS). This study aimed to explore the positive rate of anti-NF155 antibody in GBS patients and determine whether there were unique clinical characteristics in these patients.

Materials & methods: Serum anti-NF155 antibody was detected from 94 GBS patients and 50 sex- and age-matched healthy controls using cell-based assay and tissue-based assay with immunostaining of mouse teased sciatic nerve fibers. Clinical characteristics, laboratory data, and electrophysiology examinations were retrospectively collected.

Results: Seven of 94 (7.45%) GBS patients were positive for anti-NF155 antibody, and the main IgG subclass was IgG1. Compared with anti-NF155 antibody-negative GBS patients, anti-NF155 antibody-positive GBS patients had a higher GBS disability score at nadirs (p = .010), higher modified Erasmus GBS outcome score (p = .022), higher rate of abnormal compound motor action potential (CMAP) amplitude (p = .002), higher frequency of prolonged F-wave latency (p < .001), lower frequency of abnormal sensory conduction velocity (p < .001) and sensory nerve action potential amplitude (p < .001), more axonal type (p = .040), and poorer therapeutic effect (p = .017).

Conclusions: Anti-NF155 antibody exists in a small portion of GBS patients. Anti-NF155 antibody-positive GBS patients possibly have a more severe clinical course, less sensory nerves involved, higher proportion of axonal type, poorer therapeutic effect, and worse prognosis, but the pathogenicity of the anti-NF155 antibody in GBS needs further study.

Keywords: Guillain-Barré syndrome; anti-neurofascin 155 antibody; axonal type; cell-based assay; tissue-based assay.

MeSH terms

  • Animals
  • Female
  • Guillain-Barre Syndrome* / diagnosis
  • Humans
  • Immunoglobulin G
  • Male
  • Mice
  • Neural Conduction
  • Retrospective Studies

Substances

  • Immunoglobulin G