Alterations of lymphocyte responsiveness in Guillain‐Barré syndrome

Abstract

Various antibodies and immune complexes have been demonstrated in patients with Guillain-Barré syndrome (GBS). These factors may be part of the pathogenesis of the disease process through immune complex deposition and/or suppression of the immune system. Four patients with typical GBS were treated by plasma exchange. Aliquots from the first 100 ml of plasma removed from each patient were incubated with cultures of normal human peripheral lymphocytes that subsequently were exposed to mitogens, followed by incubation with tritiated thymidine. A decrease (p less than 0.001) in response to each of the mitogens was noted after incubation with patient plasma. Peripheral lymphocytes were taken from the patients before and after plasma exchange. An increase (p less than 0.01) in DNA synthesis following mitogen exposure was observed after plasma exchange in each patient. All patients exhibited subjective and objective clinical improvement. Plasma exchange for GBS appeared to remove a lymphocyte suppressor factor, which was characterized by column fractionation. The suppressor factor was determined to be a substance of approximately 10,000 to 12,000 daltons that reproducibly decreased the responsiveness of normal lymphocytes to mitogens.