During an infection, the immune system makes antibodies that must protect someone. However, in patients with GBS antibodies are made that are also harmful to their own nerves. The nerve inflammation that follows is the direct cause of the paralysis and sensory disturbances. Often these toxic antibodies are directed against "gangliosides" (sugared fats) that can be found in everyone's nerves. Dozens of different gangliosides are known and patients with GBS can produce antibodies against all these structures. Sometimes patients produce antibodies against a complex of two different gangliosides. This great diversity of antibodies also makes it difficult to study them. In order to be able to test the antibody cartridges, all antibodies should preferably be determined in 1 laboratory test for each patient. This has recently become possible through the so-called "glyco-array" so that all antibodies can be determined directly.

In 2020, the GBS Foundation contributed to the purchase of an ATS4 device with which all these gangliosides can be printed on a slide in a grid (Figure 1).With this technique, the first 1000 patients from the International GBS Outcome Study (IGOS) cohort are currently being characterized very precisely.Blood samples are also being tested from countries where the Zika virus caused many cases of GBS a few years ago.The research will teach us exactly which antibodies can be found in each individual patient.In the IGOS are also the response to the treatment and the prognosis can be investigated. This also allows us to determine whether the antibodies are related to the previous infection, the type of neurological deficit, the severity of the GBS, the response to treatment and the long-term prognosis.

Figure 1. Set up of the ATS4 device for printing ganglioside on a slide