Autonomic dysfunction in Guillain-Barré syndrome: circulating IgG alter noradrenaline synthesis in sympathetic neurons

Background: Autonomic dysfunction is a common and possible life threatening complication of Guillain-Barré syndrome (GBS). Clinical studies suggest an imbalance of sympathetic and parasympathetic nerve fiber functions, however, the underlying pathomechanism is unclear. Methods: We studied the effects of purified IgG from patients with GBS, chronic inflammatory demyelinating polyneuropathy (CIDP) and relapsing-remitting multiple sclerosis (RRMS) in a model of synaptic transmission between sympathetic neurons and cardiomyocytes. Noradrenaline synthesis was determined in cell supernatants and by changes in neuronal…