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      Association of anti‐gangliosides antibodies and anti‐CMV antibodies in Guillain–Barré syndrome

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          Abstract

          Introduction

          Numerous types of infection were closely related to GBS, mainly including Campylobacter jejuni, Cytomegalovirus, which may lead to the production of anti‐gangliosides antibodies ( AGA) . Currently, although there are increased studies on the AGA and a few studies of anti‐ CMV antibodies in GBS, the association between them remains poorly documented. Therefore, our research aims to analyze the correlation of anti‐ CMV antibodies and AGA in GBS.

          Methods

          A total of 29 patients with GBS were enrolled in this study. The CMV antibodies were tested by the electrochemiluminescence immunoassay “ ECLIA” (Roche Diagnostics GmbH). The serum gangliosides were determined by The EUROLINE test kit.

          Results

          Of the 29 patients with GBS, 9 (31%) were AGA‐seropositive, in which 22 were CMV‐IgG positive in CSF at the same time, but all 29 samples were CMV‐IgM negative in both serum and CSF. In the AGA‐positive group, the rate of both serum and CSF positive was 87.5% (7/8), higher than 50% (7/14) of the negative group, although no statistical significance was found. In addition, we found that there was a trend of higher ratio of men, a younger age onset, less frequent preceding infection, a higher level of CSF proteins, and less frequent cranial nerve deficits, although the data did not reach a statistical significance.

          Conclusion

          In spite of no statistical significance association was found between serum AGA and CMV‐IgG in serum and CSF. However, we found that there was a trend of high positive rate of both serum and CSFCMV‐IgG in AGA‐positive than the negative group. So we should further expand the sample size to analyze the association between AGA and CMV or other neurotropic virus antibodies in various diseases, to observe whether they could be serological marker of these diseases (especially GBS) or the underlying pathogenesis.

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          Most cited references29

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          The spectrum of antecedent infections in Guillain-Barré syndrome: a case-control study.

          To determine which antecedent infections are specifically associated with the Guillain-Barré syndrome (GBS). Infections with many agents have been reported preceding GBS. Some infections are related to specific clinical and immunologic subgroups in GBS. Most agents were reported in case reports and uncontrolled small series of GBS patients only, and their relation to GBS and its subgroups remains unclear. A serologic study for 16 infectious agents in 154 GBS patients and 154 sex- and age-matched controls with other neurologic diseases. Acute phase, pretreatment samples were used from clinically well-defined GBS patients. The seasonal distribution of serum sampling in the GBS and control group was the same. Multivariate analysis showed that in GBS patients, infections with Campylobacter jejuni (32%), cytomegalovirus (13%), and Epstein-Barr virus (10%) were significantly more frequent than in controls. Mycoplasma pneumoniae infections occurred more often in GBS patients (5%) than in controls in univariate analysis. Infections with Haemophilus influenzae (1%), parainfluenza 1 virus (1%), influenza A virus (1%), influenza B virus (1%), adenovirus (1%), herpes simplex virus (1%), and varicella zoster virus (1%) were also demonstrated in GBS patients, but not more frequently than in controls. C. jejuni infections were associated with antibodies to the gangliosides GM1 and GD1b and with a severe pure motor form of GBS. Cytomegalovirus infections were associated with antibodies to the ganglioside GM2 and with severe motor sensory deficits. Other infections were not related to specific antiganglioside antibodies and neurologic patterns. Recent infections with C. jejuni, cytomegalovirus, Epstein-Barr virus, and M. pneumoniae are specifically related to GBS. The variety of infections may contribute to the clinical and immunologic heterogeneity of GBS.
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            Role of Campylobacter jejuni Infection in the Pathogenesis of Guillain-Barré Syndrome: An Update

            Our current knowledge on Campylobacter jejuni infections in humans has progressively increased over the past few decades. Infection with C. jejuni is the most common cause of bacterial gastroenteritis, sometimes surpassing other infections due to Salmonella, Shigella, and Escherichia coli. Most infections are acquired due to consumption of raw or undercooked poultry, unpasteurized milk, and contaminated water. After developing the diagnostic methods to detect C. jejuni, the possibility to identify the association of its infection with new diseases has been increased. After the successful isolation of C. jejuni, reports have been published citing the occurrence of GBS following C. jejuni infection. Thus, C. jejuni is now considered as a major triggering agent of GBS. Molecular mimicry between sialylated lipooligosaccharide structures on the cell envelope of these bacteria and ganglioside epitopes on the human nerves that generates cross-reactive immune response results in autoimmune-driven nerve damage. Though C. jejuni is associated with several pathologic forms of GBS, axonal subtypes following C. jejuni infection may be more severe. Ample amount of existing data covers a large spectrum of GBS; however, the studies on C. jejuni-associated GBS are still inconclusive. Therefore, this review provides an update on the C. jejuni infections engaged in the pathogenesis of GBS.
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              Guillain-Barré syndrome following primary cytomegalovirus infection: a prospective cohort study.

              Little is known about the epidemiology and the prognostic factors of Guillain-Barré syndrome (GBS) following primary infection with cytomegalovirus (CMV-GBS). We prospectively followed up 506 patients with cases of GBS who were admitted to our center from 1996 through 2006. We diagnosed 63 (12.4%) CMV-GBS cases by immunoglobulin (Ig) M detection and IgG avidity. Plasma CMV DNA was detected at hospital admission. Patient subgroups were compared using Fisher's exact test and the Wilcoxon rank-sum test. Temporal variations were analyzed with time series methods. Patients with CMV-GBS were mostly young (median age, 32 years; sex ratio, 0.85), but we also identified a subpopulation of patients consisting of women aged >50 years. Sensory defects (in 72% of cases) and facial palsy (49%) were frequent, and test results positive for CMV DNA in plasma at hospital admission (found in 62% of cases) tended to be associated with objective sensory defect (P=.052). The main factors associated with long-term neurological sequelae (21%) were older age (P<.001) and assisted ventilation during hospitalization (P=.005). The number of CMV-GBS cases decreased between 1996 and 2006 (P=.019) and displayed an annual periodicity between the months of July and October. The incidence of CMV-GBS was estimated to be between 0.6 and 2.2 cases per 1000 cases of primary CMV infection (versus 0.25 to 0.65 cases per 1000 cases of Campylobacter jejuni infection). This study provides new insights about the epidemiology of CMV-GBS and shows that the risk of developing GBS is similar following primary CMV infection or C. jejuni infection. Our results also suggest a direct or indirect involvement of viral replication in the neuropathological processes of CMV-GBS. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
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                Author and article information

                Contributors
                tiantanzgj@163.com
                Journal
                Brain Behav
                Brain Behav
                10.1002/(ISSN)2157-9032
                BRB3
                Brain and Behavior
                John Wiley and Sons Inc. (Hoboken )
                2162-3279
                07 April 2017
                May 2017
                : 7
                : 5 ( doiID: 10.1002/brb3.2017.7.issue-5 )
                : e00690
                Affiliations
                [ 1 ] Department of Clinical Laboratory Beijing Tiantan HospitalCapital Medical University BeijingChina
                [ 2 ]China National Clinical Research Center for Neurological Diseases BeijingChina
                [ 3 ]Monogenic Disease Research Center for Neurological Disorder BeijingChina
                Author notes
                [*] [* ] Correspondence

                Guojun Zhang, Department of Clinical Laboratory, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

                Email: tiantanzgj@ 123456163.com

                Author information
                http://orcid.org/0000-0003-3946-3988
                Article
                BRB3690
                10.1002/brb3.690
                5434194
                28523231
                1f681a24-7659-47d8-9ef0-9a10da57c81e
                © 2017 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 September 2016
                : 10 February 2017
                : 28 February 2017
                Page count
                Figures: 3, Tables: 4, Pages: 6, Words: 4786
                Funding
                Funded by: Beijing Natural Science Foundation
                Award ID: 7142051
                Funded by: High Level Technical Talent Development of Beijing Health System
                Award ID: 2013‐3‐052
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                brb3690
                May 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.9 mode:remove_FC converted:17.05.2017

                Neurosciences
                anti‐gangliosides antibody,cytomegalovirus,guillain–barré syndrome
                Neurosciences
                anti‐gangliosides antibody, cytomegalovirus, guillain–barré syndrome

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