Acute motor neuropathy with antibodies to GM1 ganglioside

Summary We describe a 52-year-old man who had an acute-onset purely motor neuropathy fulfilling the diagnostic criteria for the Guillain-Barré syndrome, in whom virtually complete spontaneous recovery occurred by 1 year, and in whom high titres of polyclonal serum antibody to GM1, GD1b, asialo-GM1 and lacto-N-tetraose were detected. The titre of IgM antibody to GM1 fell during the course of the disease with a concomitant rise in the IgG titre. This case adds to the widening spectrum of disease associated with anti-GM1 antibodies and provides further evidence for a relationship between anti-GM1 antibodies and motor system disease.     

Antibodies to GM1 ganglioside in motor neuron disease--in comparison with demyelinating neuropathy]

We studied serum antibodies to GM1 ganglioside by enzyme linked immunosorbent assay (ELISA) in 55 patients with motor neuron disease (MND) composed of 36 ALS and 19 lower motor neuron disease (LMND), 44 patients with demyelinating neuropathy (DN) composed of 29 Guillain-Barré syndrome (GBS) and 15 chronic inflammatory demyelinating polyneuropathy (CIDP), and 21 healthy controls. High levels of serum antibodies against GM1 were confirmed by thin-layer chromatography overlay procedure. In MND group, the mean level of anti-GM1 IgM antibodies was not significantly elevated in comparison with controls. There was no significant difference in anti-GM1 antibodies between ALS group and LMND group, while anti-GM1 IgM antibodies in DN group, especially in GBS group, were significantly elevated (p < 0.001). High levels of anti-GM1 IgM antibodies (greater than the mean level plus 3 standard deviations of controls) were detected in 9 patients (6 with ALS and 3 with LMND) with MND (16.4%) and 16 patients (11 with GBS and 5 with CIDP) with DN (36.4%). Serum antibodies to GM1 reacted with GD1b ganglioside in only one patient with MND and 10 patients (8 with GBS and 2 with CIDP) with DN. Anti-GM1 IgG antibodies were elevated significantly in DN group. There was no correlation among anti-GM1 IgM antibodies and both duration and severity of illness in MND. In some patients with MND, levels of anti-GM1 IgM antibodies became high in the advanced stage. It is unclear whether these antibodies are primary manifestation or consequence of motor neuron disease.(ABSTRACT TRUNCATED AT 250 WORDS)     

Intrathecal GM1 ganglioside and local nerve anesthesia reduce nociceptive behaviors in rats with experimental peripheral mononeuropathy.

Our previous experiments demonstrated that systemic treatment with GM1 ganglioside reduces nociceptive behaviors and spinal cord metabolic activity in a rat model of painful peripheral mononeuropathy produced by experimental sciatic nerve ligation (chronic constrictive injury, CCI). In the present study, we examined the effects of intrathecal (i.t.) GM1 treatment on thermal hyperalgesia and spontaneous pain behaviors resulting from nerve ligation in order to determine the locus of GM1 action. In addition, a local anesthetic agent, bupivacaine, given alone or combined with i.t. GM1, was applied to the injured sciatic nerve to determine if peripheral nerve anesthesia would influence post-injury nociceptive behaviors. Thermal hyperalgesia to radiant heat decreased in a dose-dependent manner when GM1 (10-80 nmol, i.t.) was administered once daily onto the lumbar segments of the spinal cord beginning 1 h after experimental nerve injury and continued for the first 9 days after nerve ligation. Moreover, this GM1 (80 nmol) treatment regimen reliably lowered spontaneous pain behavior rating scores in CCI rats suggesting the possible attenuation of spontaneous pain. The central site of i.t. GM1 action is located at the caudal (probably lumbar) spinal cord, since i.t. injection of 20 nmol GM1 onto the cervical spinal cord did not produce any protective effect. A single perinerve injection of a local anesthetic agent, bupivacaine (0.5%, 0.6 ml), on the 3rd day after nerve ligation reduced thermal hyperalgesia for at least 24 h following injection, a duration longer than that of the local anesthetic action of bupivacaine. Neither a single bupivacaine injection nor four daily i.t.(ABSTRACT TRUNCATED AT 250 WORDS)     

Post-injury treatment with GM1 ganglioside reduces nociceptive behaviors and spinal cord metabolic activity in rats with experimental peripheral mononeuropathy

In a rat model of painful peripheral mononeuropathy, this study examined the effects of post-injury treatment with a monosialoganglioside, GM1, on abnormal nociceptive behaviors and spinal cord neural activity resulting from loose ligation of the rat common sciatic nerve (chronic constrictive injury, CCI). Thermal hyperalgesia and spontaneous pain behaviors of CCI rats were assessed by measuring foot-withdrawal latencies to radiant heat and by rating spontaneous hind paw guarding positions, respectively. Neural activity within different regions of the spinal cord was inferred in both CCI and sham-operated rats by employing the [14C]-2-deoxyglucose (2-DG) autoradiographic technique to measure spinal cord glucose metabolism. Intraperitoneal (i.p.) GM1 treatment (10 mg/kg) initiated 1 h or 24 h after injury and once daily for the first 9 post-injury days reduced thermal hyperalgesia of the hind paw ipsilateral to nerve ligation and lowered spontaneous pain behavior rating scores in CCI rats. Sciatic nerve ligation reliably increased basal 2-DG metabolic activity of CCI rats in all four sampled regions (laminae I-IV, V-VI, VII, VIII-IX) of spinal cord lumbar segments (L2-L5) both ipsilateral and contralateral to nerve ligation 10 days after injury. Consistent with the drug's effects on spontaneous pain behaviors, 10 daily GM1 treatments (10 mg/kg, i.p.) initiated 1 h after nerve ligation reduced spinal cord 2-DG metabolic activity in laminae V-VI and VII ipsilateral to nerve ligation and in all four sampled regions contralateral to nerve ligation. This attenuation of the increased spinal cord glucose utilization that occurs in the absence of overt peripheral stimulation may reflect an influence of GM1 on increased neural activity contributing to spontaneous pain. Since gangliosides are thought to protect neurons from excitotoxic effects of excitatory amino acids, these results suggest that ganglioside treatment may result in attenuation of excitatory neurotoxicity that may occur following peripheral nerve injury. Thus, ganglioside treatment could provide a new approach to the clinical management of neuropathic pain syndromes following peripheral nerve injury.     

Transplant and ganglioside GM1 mediated neuronal recovery in rats with brain lesions

Transplants of fetal brain tissue or injections of ganglioside GM1, given to rats with unilateral, left medial frontal cortex lesions, altered the concentrations of neuronal and glial marker proteins in cortex both adjacent and contralateral to the lesion. The markers were: the neural cell adhesion molecule (NCAM) and D3-protein, both present in neuronal and synaptic membranes; synaptophysin, present in synaptic vesicles; glial fibrillary acidic protein (GFAP) enriched in reactive astrocytes, and the astrocytic glutamine synthetase. After 21 days the concentrations of NCAM, D3 and synaptophysin in brain tissue adjacent to the lesions were decreased by 39, 32 and 42%, respectively, indicating neuronal damage. In the injured rats the GFAP concentration was increased 77%, indicating activation of astrocytes. However, astroglial proliferation was not altered as indicated by the nearly unchanged glutamine synthetase concentrations. The levels of the neuronal markers NCAM, D3 and synaptophysin showed significantly less decline in injured rats treated 7 days after the lesions with transplants or with daily injections of 30 mg/kg GM1. The decrease respectively constituted 23 (NCAM), 31 (D3) and 41% (synaptophysin) in rats with transplants and 23 (NCAM), 16 (D3) and 28% (synaptophysin) in rats treated with GM1. In another group of rats the efficacy of transplants was studied 34 days after lesions. NCAM and D3 in tissue adjacent to the lesions were decreased by 50 and 29%, respectively. In rats which received transplants the decrease was only 27 and 16%, respectively. Moreover, as measured by GFAP concentration, activation of astrocytes was less in rats with transplants (93% increased) compared with rats with lesions only (163%). In contralateral frontal cortex, the effects of lesions were similar but less pronounced. In this brain area also the treatments significantly counteracted the loss of neuronal and glial markers. Previous studies have demonstrated that synaptic remodelling is reflected by the ratios of NCAM to marker proteins for mature synapses. Twenty-one days after the initial injury to the brain the ratios of NCAM to D3 and synaptophysin were significantly increased in frontal cortex ipsilateral to the injury in rats with transplants (26 and 33%, respectively). In contrast, compared with values for injured rats, the calculated ratios were not changed, whereas all neuronal marker proteins were significantly increased in rats treated with GM1. The results suggest that transplants mediate neuronal recovery by inducing dendritic sprouting followed by synaptic remodelling whereas gangliosides mediate recovery by counteracting neuronal degeneration.     

单唾液酸四己糖神经节苷脂钠治疗糖尿病周围神经病变临床疗效观察

目的探讨单唾液酸四己糖神经节苷脂钠(GM1)治疗糖尿病周围神经病变临床应用前景。方法将56例糖尿病周围神经病变患者随机分为GM1治疗组和甲钴胺治疗组,两组均给予常规降糖、改善循环等治疗,3个月后观察治疗前后临床症状改善情况并测定治疗前后患者血清一氧化氮(NO)水平。结果①GM1组治疗有效率高于甲钴胺组,但差异无统计学意义,(P>0.05);②治疗前两组NO水平差异无统计学意义,治疗后两组自身比较,差异有统计学意义(P<0.001),且治疗后GM1组明显高于甲钴胺组(P<0.001)。结论 GM1治疗糖尿病周围神经病变有良好前景,待进一步观察。     

Reduction of cerebral edema with GM1 ganglioside

Administration of exogenous gangliosides has been reported to accelerate neurite outgrowth in vitro, and to enhance peripheral nerve regeneration and central nervous system recovery subsequent to damage. After injury, facilitation of CNS recovery with GM1 ganglioside treatment has been postulated to be due to enhanced neuronal regeneration. Since maximal recovery is achieved when experimental animals are treated before injury with GM1 ganglioside, an alternative or parallel mechanism is that gangliosides are "protecting" the CNS by limiting the extent of damage (ie, cell loss, process degeneration, membrane disruption). This may be due to a reduction in the edema subsequent to injury. In this study, rats were treated for 2 days with 20 mg/kg/day of GM1 ganglioside. On the third day they were subjected to a unilateral lesion (mechanical) of one cerebral hemisphere and given another 20 mg/kg of GM1. On the fourth day brains were removed for analysis of edema resulting from the injury. In treated animals there was a significant reduction in edema as measured either in the entire injured hemisphere (23%) or in the area of injury (33%). No effect was seen outside the damaged area. Since exogenous gangliosides can spontaneously "insert" into membranes, it is postulated that the effect of the GM1 may be due to alterations of membrane processes (eg, lipid hydrolysis, phospholipase activation, levels and membrane action of arachidonic acid, ionic permeation) that are characteristic of edema.     

GM1 ganglioside does not stimulate reinnervation of the striatum by substantia Nigra grafts

Ganglioside GM1 has been reported to promote reinnervation of the striatum by dopaminergic fibers following brain hemisection in the rat. In the present study, the possibility that chronic ganglioside GM1 (10 or 50 mg/kg day for 3 weeks) would promote reinnervation of the dopamine-denervated striatum by embryonic substantia nigra grafts was studied. No enhancement of the ingrowth of fibers from the grafts was observed. It is concluded that under this circumstance, the growth of catecholaminergic fibers is restricted by factors other than the availability of ganglioside GM1.     

Retinal cholinergic and dopaminergic deficits of aged rats are improved following treatment with GM1 ganglioside

Selected cholinergic and dopaminergic markers were compared in the retina of aged (20–22-months-old) and young (3-months-old) rats before and after treatment with GM1 ganglioside. The dopaminergic markers, tyrosine hydroxylase, aromatic L-amino acid decarboxylase, dopamine, 3,4-dihydroxyphenylacetic acid and homovanillic acid were comparable in the young and aged animals and GM1 treatment did not alter them. In contrast, mazindol binding, a marker for the dopamine transporter, was diminished in the aged retina and treatment with GM1 restored binding to values found in the young animals. The cholinergic markers choline acetyltransferase and hemicholinium-3 binding, a marker for the high-affinity choline transport, were depressed in aged rats and GM1 corrected the deficits.     

Astrocytes in cell culture incorporate GM1 ganglioside

Ganglioside GM1 3H-labelled at the terminal galactose was added to astrocyte cell cultures. GM1 incorporation was studied in the two typical forms of astrocytes in cell culture of flat and stellate morphology. There was a strong time- and concentration-dependent increase in GM1 incorporation for both cell types of astrocytes. The incorporation of GM1 into the stellate form increased continuously up to 48 h (maximum time studied), while the incorporation into the flat form reached a plateau at the same time. After 2 h of GM1 incubation additional gangliosides appeared; the latter resulted from the metabolism of the GM1 incorporated, indicating that astrocytes in cell culture can biosynthesize more complex gangliosides. To confirm that GM1 was indeed incorporated into astrocytes, two other different approaches were used. Astrocyte cells treated with 3H-GM1 were visualized using autoradiography. The specific marker for GM1, rhodamine-labelled choleratoxin, was used to detect the incorporated GM1 using fluorescence microsocpy. In both cases GM1 treated cells were intensely labelled. These observations indicate that exogenous GM1 ganglioside can also be integrated into the astrocyte membranes as occurs in other types of cells and membranes.     

Domain-dependent modulation of PDGFRbeta by ganglioside GM1

The regulation of receptor tyrosine kinases (RTKs) is important in several cellular events, including proliferation, differentiation, and apoptosis. Gangliosides are sialic acid-containing glycosphingolipids that can regulate RTK activity. The addition of ganglioside GM1 to the medium of Swiss 3T3 fibroblasts inhibits both platelet-derived growth factor (PDGF)-mediated tyrosine phosphorylation of PDGF receptor beta (PDGFRbeta) and receptor-mediated endocytosis. However, GM1 did not affect PDGF-mediated receptor phosphorylation, neuritogenesis, or endocytosis in PC12 cells stably transfected with the gene for PDGFRbeta. The ability of GM1 to modulate PDGFRbeta in 3T3 cells but not in transfected PC12 cells indicates a cell context-dependent response. We hypothesized that this inhibition of PDGFRbeta by GM1 must map to one or more domains of the receptor. Thus, a chimeric receptor was created that possessed the extracellular and transmembrane domains of the nerve growth factor (NGF) receptor TrkA and the cytoplasmic domain of PDGFRbeta (TTbeta). In 3T3 cells transfected with the TTbeta construct, GM1 did not inhibit NGF-induced tyrosine phosphorylation of the chimeric receptor or of Erk1/2 in this cell line. GM1 still inhibited PDGF-mediated tyrosine phosphorylation of endogenous PDGFRbeta and of Erk1/2 in Swiss TTbeta cells. Thus, the cytoplasmic domain of PDGFRbeta is not required for GM1-dependent inhibition of PDGFRbeta in 3T3 cells. This suggests that the inhibition of PDGFRbeta by GM1 in Swiss 3T3 fibroblasts maps to either the extracellular and/or transmembrane domain of PDGFRbeta.     

Interaction of multiple sclerosis serum with liposomes containing ganglioside GM1

Multiple sclerosis serum contains a factor or factors capable of releasing sequestered [¹⁴C]glucose from liposomes containing G_M1, the major ganglioside present in human central nervous system myelin. Although some control sera can also release large quantities of liposomal glucose, multiple sclerosis and control sera differ in the mechanism of this release. Liposomal damage by multiple sclerosis serum does not appear to be complement mediated, but shares certain releasing characteristics of cholera toxin.     

GM1 ganglioside reduces glutamate toxicity to cortical cells

As an in vitro model of CNS excitatory amino acid (EAA) injury, rat cortical neuronal cultures were challenged with glutamate (0.5 or 10 mM) and the levels of released lactate dehydrogenase (LDH) were monitored at 1 h, 1, 2, and 7 d. LDH release is correlated with levels of plasma membrane damage. GM1 has been shown to be continuously distributed on the outer surface of CNS cellular membranes. By staining for the distribution of endogenous GM1 ganglioside using cholera toxin/antitoxin immunohistochemistry, we were able to assess morphologically cellular plasma membrane integrity after damage. We used these two measures (LDH and GM1 localization) to study the neuroprotective effects of exogenous GM1 ganglioside to further elucidate its mechanism. Cortical cultures derived from 15-d rat fetuses were subjected to the glutamate challenge for 30 min. Parallel cultures were either pre- or posttreated with 80 μM of GM1. Exposure to 10 mM glutamate caused a highly significant increase in LDH release at 1–48 h. Pretreatment with GM1 reduced the release, whereas post-treatment reduced the LDH release even more. Plasma membrane changes observed by the GM1 immunohistochemistry reflected the LDH release data. All cultures treated with GM1 evidenced substantial structural integrity (continuous staining of GM1 along perykarya and processes) as compared to untreated cultures. These data support our hypothesis that GM1 treatment (pre- and post-) reduces plasma membrane damage.     

GM1 ganglioside restores abnormal responses to acute thermal and mechanical stimuli in aged rats

We investigated the effect of aging on the responses to thermal and mechanical stimuli in rats. Young (3-5 months old) and aged (22-24 months old) male Sprague-Dawley rats were tested in the hot plate, high- and low-intensity radiant heat tail flick, and von Frey hair assays. Compared to young rats, aged rats displayed longer latencies in the hot plate and the high-intensity tail flick assays (hypoalgesia), but there was no difference in the low-intensity tail flick assay. In addition, aged rats had decreased thresholds to mechanical stimuli produced by von Frey hairs compared with young rats (mechanical allodynia). Administration of GM1 ganglioside, 30 mg/kg, i.p., once daily for 30 days, to aged rats partially restored the responses in the hot plate and von Frey hair assays. GM1 had no effect on the altered responses in the tail flick test in aged rats, and in general, had no effect on any sensory modality tested in young rats.     

Trial of ganglioside GM1 in acute stroke.

Ganglioside GM1 (100 mg) was given daily by intramuscular injection for 28 days in a double-blind placebo controlled trial of acute stroke. No significant difference was detected in a 6 month follow-up period between well matched control and active groups. Although the number of patients studied was small the findings are believed to indicate that GM1 is unlikely to be of value in the treatment of acute stroke in the dose and route of administration used.     

GM1 ganglioside prevented the decline of hippocampal neurogenesis associated with D-galactose

Hippocampal neurogenesis is thought to play a functional role in hippocampal-dependent learning and memory. The neurogenic capability of the hippocampus declines with age and may be associated with a decline in cognitive function. In the present study, an established model of ageing in mice was used to test the protective effects of GM1 ganglioside on hippocampal neurogenesis. This model uses D-galactose treatment to cause neuronal injury and reduced neurogenesis. GM1 significantly increased the proliferation, long-term survival and neuronal differentiation of hippocampal progenitors that had been injured with D-galactose. This study demonstrates that GM1 can protect hippocampal neurogenesis from D-galactose injury. Therefore, GM1 may protect neurogenesis in the ageing brain.