Demyelination Induced by Intraneural Injection of Human Antimyelin-associated Glycoprotein Antibodies

IgM monoclonal antibodies present in the sera from some patients with peripheral neuropathy react with an antigenic carbohydrate determinant that is present on the myelin-associated glycoprotein (MAG) and other peripheral nerve glycoproteins and glycolipids. It is generally believed that the neuropathy in these patients may be caused by antibody- mediated nerve damage. Intraneural injection of serum from patients with this disease produced an extensive inflammatory, macrophage-mediated demyelination of feline peripheral nerve. This only occurred with very fresh sera which had been supplemented with additional complement. Injection of sera from normal subjects failed to produce any demyelination. These results are in accordance with a recent study by Hays et al. and contradict earlier negative reports of similar studies. It is important to note that the pathology observed in these experimental studies bears little resemblance to that seen in the human neuropathy, and caution must therefore be exercised when interpreting this data in relation to the pathogenic mechanisms that might operate in the human disease.