Anti-phospholipid antibodies in serum from patients with Guillain-Barré syndrome.

OBJECTIVE: The Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy related to autoimmunity. However, no conclusive etiological concept has yet been found. We examined the variation in autoantibodies to lipids in serum of GBS patients in response to the course of the disease but investigated titer modifications during treatment with gamma-globulin. DESIGN AND SETTING: Prospective clinical study in a 14-bed general ICU. PATIENTS: Nine patients with GBS and nine controls were included in the study. MEASUREMENTS AND RESULTS: Four blood samples were obtained before and after treatment. Serum samples, diluted 1:60, were tested by enzyme-linked immunosorbent assay for IgM, IgA, and IgG antibodies to phosphatidylcholine, phosphatidylinositol, cardiolipin, phosphatidic acid, phosphatidylserine, phosphatidylglycerol, phosphatidylethanolamine, sphingomyelin, and gangliosides. Anti-phospholipid antibodies of the IgM, IgA, and IgG families were detected in all GBS patients but in none of the controls. Phosphatidylinositol, cardiolipin, phosphatidylcholine, and phosphatidic acid were the main antigens. All patients developed anti-phosphatidylinositol antibodies of the IgM family and anti-cardiolipin antibodies of the IgA and IgG families. A decrease in the level of anti-phospholipid autoantibodies was observed after 1 day of treatment with gamma-globulin. Two days after ending gamma-globulin administration the IgG antibodies increased again. CONCLUSIONS: Our findings suggest that in GBS there is an extensive immune reaction, which is altered after gamma-globulin treatment. Anti-cardiolipin and anti-phosphatidylinositol antibodies could be useful markers for the response to treatment.

Antihistamine activity of Bryophyllum calycinum.

1. The juice obtained by pressing the leaves of Bryophyllum calycinum (Crassulaceae) exhibited histamine-blocking activity. 2. The juice contains flavonoid compounds, carbohydrates and mineral salts. A flavonoid fraction (fraction B) obtained by partitioning the juice between n-butanol and water contained the substance responsible for the antihistamine activity. 3. When assayed on the isolated guinea pig ileum, 50 mg/ml juice and 0.15 mg/ml fraction B produced parallel and concentration-dependent rightward displacement of the concentration-response curve to histamine (EC50 (FL): 1.30 (0.26-5.28) x 10(-7) M, 15.80 (5.90-23.30) x 10(-7) M, 12.50 (7.62-14.90) x 10(-7) M, in the absence and presence of 50 mg/ml juice and 12 mg/ml fraction B, respectively) apparently in a competitive manner. The antagonism was specific for histamine, i.e., did not modify the response to acetylcholine, KCl and BaCl2 and was reversible upon washing. Vascular permeability responses of rats to intracutaneous 1.0, 5.0 or 10.0 micrograms histamine were decreased by about 20-25% in animals pretreated with 4 ml/kg of juice or with 12 mg/kg fraction B. The juice (4 ml/kg) protected guinea pigs from death by asphyxia induced by 5 mg histamine and the protection lasted at least 1 h. 4. However, since the juice was ineffective in protecting the gastric mucosa from histamine-induced ulceration, we conclude that the antihistamine effect of the juice and fraction B was produced by blockade of H1 and not H2 receptors.

Antihistamine activity of Bryophyllum, calycinum

The juice obtained by pressing the leaves of Bryphyllum calycinum (Crassulaceae) exhibited histamine-blocking activity. The juice contains flavonoid compounds, carbohydrates and mineral salts. A flavonoid fraction (fraction B) obtained by partioning the juice between n-butanol and water contained the substance responsible for the antihistamine activity. When assayed on the isolated guinea pig ileum, 50 mg/ml juice and 0.15 mg/ml fraction B produced parallel and concentration-dependent rightward displacement of the concentration-response curve to histamine (EC50 (FL): 1.30 (0.26-5.28) x 10-7 M, 15.80 (5.90 -23.30) x 10-7 M, 12.50 (7.62 -14.90) x 10-7 M, in the absence and presence of 50 mg/ml juice and 12 mg/ml fraction B, respectively) apparently in a competitive manner. The antagonism was specific for histamine, i. e., did not modify the response to acetylcholine, KCl and BaCl2 and was reversible upon washing. Vascular permeability responses of rats to intracutaneous 1.0, 5.0 or 10.0 ug histamine were decreased by about 20-25% in animals pretreated with 4 ml/kg of juice or with 12 mg/kg fraction B. The juice (4 ml/kg) protected guinea pigs from death by asphyxia induced 5 mg histamine and the protection lasted at least at 1 h. However, since the juice was ineffective in protecting the gastric mucosa from histamine-induced ulceration, we conclude that the antihistaminic effect of the juice and fraction B was produced by blockade of H1 and not H2 receptors