T cell responses to myelin proteins in Guillain-Barré syndrome

We have investigated the hypothesis that the pathogenesis of Guillain-Barré syndrome (GBS) involves an autoimmune T cell response to P 0 and P 2 proteins of peripheral nerve myelin. The proliferative responses of blood mononuclear cells (MNC) to myelin proteins and synthetic peptides derived from them were determined in patients with GBS and chronic idiopathic demyelinating polyradiculoneuropathy (CIDP), normal controls (NC) and patients with other neuropathies (ONP). Twelve out of 19 GBS patients responded to P 0 or P 2, 6 to P 0 and its peptides only, 3 to P 2 and its peptides only, and 3 to both P 0 and P 2 antigens. Responses to at least one of the antigens were also found in 6 13 of CIDP patients, but in only 4 17 NC and 2 6 ONP. Immune responses in GBS are heterogeneous. The early T cell responses to P 0 protein, described here for the first time, may be important in the pathogenesis of some cases.