The role of sulfoglucuronosyl glycosphingolipids in the pathogenesis of monoclonal IgM paraproteinemia and peripheral neuropathy

In IgM paraproteinemia and peripheral neuropathy, IgM M-protein secretion by B cells leads to a T helper cell response, suggesting that it is antibody-mediated autoimmune disease involving carbohydrate epitopes in myelin sheaths. An immune response against sulfoglucuronosyl glycosphingolipids (SGGLs) is presumed to participate in demyelination or axonal degeneration in the peripheral nervous system (PNS). SGGLs contain a 3-sulfoglucuronic acid residue that interacts with anti-myelin-associated glycoprotein (MAG) and the monoclonal antibody anti-HNK-1. Immunization of animals with sulfoglucuronosyl paragloboside (SGPG) induced anti-SGPG antibodies and sensory neuropathy, which closely resembles the human disease. These animal models might help to understand the disease mechanism and lead to more specific therapeutic strategies. In an in vitro study, destruction or malfunction of the blood-nerve barrier (BNB) was found, resulting in the leakage of circulating antibodies into the PNS parenchyma, which may be considered as the initial key step for development of disease

Antibodies to glycolipids in demyelinating diseases of the human peripheral nervous system

Antibodies to complex glycolipids occur in patients with a variety of diseases of the peripheral nervous system. Many patients with demyelinating neuropathy occurring in association with IgM paraproteinemia have a monoclonal antibody that reacts with a carbohydrate determinant shared between sulfate-3-glucuronyl paragloboside (SGPG), the myelin-associated glycoprotein and other glycoproteins of peripheral nerve. Other patients with neuropathy in association with IgM paraproteinemia have monoclonal antibodies reacting with carbohydrate determinants on various gangliosides. More than 80% of the IgM monoclonal antibodies from patients of this type that have been screened in our laboratory react with SGPG or ganglioside antigens. High levels of antibodies reacting with ganglioside antigens are also found in some patients with inflammatory neuropathies such as Guillain-Barré Syndrome and chronic relapsing inflammatory polyneuropathy. The pathogenetic significance of these antibodies reacting with acidic sphingoglycolipids remains to be established

Mouse monoclonal and rabbit polyclonal antibodies prepared to human myelin-associated glycoprotein also react with glycosphingolipids of peripheral nerve

A panel of mouse monoclonal antibodies and rabbit polyclonal antisera that were raised to myelin-associated glycoprotein (MAG) were screened for reactivity with acidic glycolipids from brain and peripheral nerve by enzyme-linked immunosorbent assay (ELISA) and/or a thin-layer chromatogram overlay technique. Seven out of 7 mouse monoclonal antibodies that recognize carbohydrate epitopes in human MAG also reacted with acidic glycolipids from human and cat peripheral nerve, while monoclonal antibodies that react with polypeptide epitopes on MAG did not react with these glycolipids. Rabbit anti-human MAG antisera also strongly reacted with the glycolipids from peripheral nerve, while rabbit antisera raised to rat MAG did not. None of the antibodies reacted with similar glycolipid fractions prepared from adult human brain. Overlay of thin-layer chromatograms revealed that all the mouse and rabbit antibodies showing reactivity with peripheral nerve glycolipids were binding to the same two sphingoglycolipids that react with human anti-MAG IgM paraproteins in neuropathy and with HNK-1 (anti-Leu-7), a mouse IgM monoclonal antibody that identifies a subset of human lymphocytes with natural killer function. Thus, the carbohydrate epitope(s) in MAG which is shared with nerve acidic glycolipids appears to be highly immunogenic in mice and rabbits. Further, it is clear that the antibodies that react with the carbohydrate moieties of human MAG cannot be used as specific probes for this glycoprotein

Glycoconjugates in nervous tissue and small cell lung cancer share immunologically cross-reactive carbohydrate determinants

Small cell lung cancer (SCLC) is a bronchogenic carcinoma of neuroectodermal origin that expresses a variety of nervous system markers characteristic of neuroendocrine cells. In addition, SCLC cell lines and biopsies have been shown immunocytochemically to express an antigen recognized by HNK-1, a mouse monoclonal antibody which recognizes a surface antigen on natural killer cells and on the myelin-associated glycoprotein (MAG) and other nervous system glycoconjugates. Immunoblot data are presented which identify 2 groups of HNK-1-reactive plasma membrane glycoproteins with Mrs of about 80 000 and 130 000, respectively, from several SCLC cell lines. Using antibodies to MAG carbohydrate and protein determinants as probes, it is shown that the SCLC glycoproteins reacting with HNK-1 do not appear to share structural similarity with MAG apart from carbohydrate determinants. Using similar techniques with a panel of polyclonal antibodies, data are shown indicating that there is no cross-reactivity of SCLC proteins with other myelin proteins including P0, P1, P2, proteolipid protein and myelin basic protein. A possible role of the carbohydrate antigen in mediating nervous system disease associated with SCLC is suggested

Identification and characterization of gangliosides reacting with IgM paraproteins in three patients with neuropathy associated with biclonal gammopathy

IgM monoclonal antibodies from three patients with polyneuropathy associated with biclonal gammopathy reacted with monosialoganglioside GM1 on thin-layer chromatograms. An IgM paraprotein in one of the patients with a predominantly motor neuropathy also reacted strongly with the ganglioside GD1b and asialo-GM1. All three of these antigenic lipids have a Gal(beta 1-3)GalNAc moiety in common which would appear to be the antigenic determinant. However, this IgM also cross-reacted weakly with paragloboside which has an N-acetyllactosaminyl [Gal(beta 1-4)GlcNAc] terminal structure. The specificity of the other paraprotein in this patient is not known. The IgM paraproteins reacting with GM1 in both of the other patients exhibited different specificity because they did not react with GD1b and asialo-GM1, but reacted strongly with GM2 ganglioside. The data suggest that the epitope for both of these IgMs is in the GalNAc(beta 1-4)(NeuAc alpha 2-3)Gal(beta 1-4)Glc region of the gangliosides that is common to both GM2 and GM1. The second IgM paraproteins in both of these latter patients react with the myelin-associated glycoprotein (MAG) and two 3-sulfoglucuronyl glycolipids that share antigenic determinants with MAG

The species distribution of nervous system antigens that react with anti-myelin-associated glycoprotein antibodies

The reactivity of monoclonal and polyclonal antibodies directed against human central nervous system (CNS) myelin-associated glycoprotein (MAG) was investigated in a number of animal species. The antibodies included mouse monoclonal antibodies obtained by immunization with human MAG; HNK-1, a mouse monoclonal antibody raised against a human lymphoblastoma and used to identify a subset of lymphocytes with natural killer function; human IgM paraproteins associated with neuropathy; and polyclonal antibodies obtained from rabbits immunized with rat or human MAG. Following polyacrylamide gel electrophoresis of CNS and peripheral nervous system (PNS) tissue from human, bovine, cat, rabbit, guinea pig, rat, mouse, frog, gold fish and chicken, proteins were electrophoretically transferred onto nitrocellulose. The immune-staining of electroblots showed distinct interspecies variation in the reactivity of the antibodies with MAG. In addition, the species distribution of several low molecular weight glycoproteins present in PNS tissue that cross-react with anti-MAG antibodies was determined. These low molecular weight antigens are not present in CNS homogenates or in purified human CNS myelin. It was also shown that IgM from a patient with peripheral neuropathy and paraproteinemia associated with anti-MAG antibodies recognized these low molecular weight antigens. The results suggest that IgM paraproteins, HNK-1 and some mouse monoclonal antibodies react with carbohydrate determinants shared by MAG and several lower molecular weight glycoproteins present only in human, bovine, cat and chicken PNS. Rabbit polyclonal anti-rat MAG antisera and mouse monoclonal antibodies reacting with peptide epitopes of MAG are much more specific for detecting MAG than antibodies reacting with carbohydrate epitopes of human MAG. The results are discussed in relation to human demyelinating peripheral neuropathy associated with IgM paraproteinemia

Myelin-associated glycoprotein and related glycoconjugates in developing cat peripheral nerve: a correlative biochemical and morphometric study

The expression and accumulation of the myelin-associated glycoprotein (MAG) and other glycoconjugates have been studied during myelination in the developing cat peripheral nervous system. The glycoconjugates studied have in common a similar carbohydrate determinant which is bound by many antibodies, including the mouse monoclonal antibody HNK-1, and human IgM paraproteins from patients with neuropathy. In addition to MAG, the reactive glycoconjugates include a 60-kilodalton (kD) glycoprotein and a group of 20-26 kD glycoproteins, as well as a group of recently identified acidic glycolipids, the major one of which is sulfate-3-glucuronyl paragloboside (SGPG). The accumulation of these glycoproteins and glycolipids is compared with the established myelin proteins P0, P1, and P2 and with morphometric indices of myelin volume and axonal perimeter. The study demonstrates that MAG appears and accumulates very early during myelination, being present at 15% of the maximum level prior to the appearance of P0, and at 80% of the maximum level when P0 is at 30% of its maximum level. In the adult, the level of MAG falls to 60% maximum. The 60 kD and 20-26 kD glycoproteins accumulate at the same time as or later than P0, suggesting that they are either compact myelin proteins or in membranes closely associated with compact myelin. SGPG accumulates with P0 early in myelination, but falls to 60% of maximum in the adult. By comparing biochemical and morphometric data, we demonstrate that P0 and other compact myelin proteins accumulate synchronously with the increase in myelin area. MAG accumulation, however, is closely related to changes in axonal perimeter, consistent with a predominant localization of MAG to the periaxonal membranes in the peripheral nervous system