scholarly journals IL-17 and IL-22 in Cerebrospinal Fluid and Plasma Are Elevated in Guillain-Barré Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Shujuan Li ◽  
Ming Yu ◽  
Haifeng Li ◽  
Hongliang Zhang ◽  
Yanfang Jiang
Keyword(s):  
Demyelinating Disease ◽  
Preliminary Evidence ◽  
Guillain Barre Syndrome ◽  
Enzyme Linked Immunosorbent Assay ◽  
Pathogenic Potential ◽  
Th22 Cells ◽  
Disability Scale ◽  
Guillain Barré Syndrome ◽  
Scale Scores ◽  
Guillain Barré

Guillain-Barré syndrome (GBS) is an acute autoimmune-mediated inflammatory demyelinating disease that causes rapidly progressing paralysis and occasionally respiratory failure. We hypothesized that interleukin (IL)-17 and IL-22 are elevated in GBS and participate in the autoimmune inflammatory response of GBS. We used sandwich enzyme-linked immunosorbent assay (ELISA) to measure the IL-17 and IL-22 levels in the CSF, and plasma from 22 GBS patients at the acute phase and 18 healthy controls (HC). The results show that CSF and plasma levels of IL-17 and IL-22 are elevated in GBS patients compared with HC. IL-17 and IL-22 levels in CSF, respectively, are correlated with GBS disability scale scores (GDSs). Meanwhile, IL-17 and IL-22 levels in CSF, IL-22 in CSF, and plasma of GBS patients have positive correlation, respectively. The increased levels of IL-17 and IL-22 in CSF may be explained by the disruption of blood-brain barrier (BBB) and peripheral nervous system (PNS) local inflammation in GBS. Meanwhile, the elevated levels of these two cytokines in plasma suggest the activation of Th17 and Th22 cells in the systemic immune response of GBS. Our data provide preliminary evidence that GBS is associated with high levels of IL-17 and IL-22 in CSF and plasma. These cytokines display pathogenic potential and may serve as useful biomarkers for GBS.

scholarly journals Elevated Levels of Cerebrospinal Fluid and Plasma Interleukin-37 in Patients with Guillain-Barré Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Cong Li ◽  
Pingwei Zhao ◽  
Xiguang Sun ◽  
Yuanyuan Che ◽  
Yanfang Jiang
Keyword(s):  
Cerebrospinal Fluid ◽  
Inflammatory Cytokine ◽  
Guillain Barre Syndrome ◽  
Flow Cytometric ◽  
Disability Scale ◽  
Guillain Barré Syndrome ◽  
Scale Scores ◽  
Guillain Barré ◽  
Cytometric Bead Array Assay ◽  
Anti Inflammatory Cytokine

Aims. Interleukin-37 (IL-37) is an anti-inflammatory cytokine. This study aims to investigate the concentrations of plasma and cerebrospinal fluid (CSF) IL-37 in patients with Guillain-Barré Syndrome (GBS).Methods. The levels of plasma and CSF IL-37, IL-17A, IFN-γ, and TNF-αin 25 GBS patients and 20 healthy controls (HC) were determined by enzyme-linked immunoabsorbent assay and flow cytometric bead array assay, respectively. The values of clinical parameters in the patients were also measured.Results. The concentrations of plasma IL-37, IL-17A, IFN-γ, and TNF-αand CSF IL-37 and IL-17A in patients at the acute phase of GBS were significantly higher than those in the HC. The levels of plasma IL-37, IL-17A, IFN-γ, and TNF-αwere positively correlated in those patients, and the levels of CSF IL-37 and IL-17A as well as the levels of plasma TNF-αwere correlated positively with the GBS disability scale scores (GDSs) in those patients. Treatment with intravenous immunoglobulin significantly reduced the levels of plasma IL-37, IL-17A, IFN-γ, and TNF-αin the drug-responding patients.Conclusions. Our findings indicate higher levels of plasma and CSF IL-37 and IL-17A and other proinflammatory cytokines in patients with GBS.

Functional outcomes following inpatient rehabilitation of guillain-barré syndrome patients: Intravenous immunoglobulins versus plasma exchange

2021 ◽  
pp. 1-9
Author(s):  
Moshe Bondi ◽  
Einat Engel-Haber ◽  
Julie Wolff ◽  
Liza Grosman-Rimon ◽  
Ayala Bloch ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Plasma Exchange ◽  
Functional Outcomes ◽  
Daily Living ◽  
Functional Independence ◽  
Assessment Tools ◽  
Guillain Barre Syndrome ◽  
Disability Scale ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

BACKGROUND: Treatment with either Intravenous immunoglobulin (IVIg) or plasma exchange (PE) in patients with Guillain-Barré Syndrome (GBS) showed equivalent efficacy as attested by a commonly used disability scale. However, it has been suggested that this scale may not be sensitive enough to detect subtle functional changes between the two treatments since it mainly focuses on walking capability and respiratory function. OBJECTIVE: To evaluate functional outcomes following treatment with IVIg or PE using comprehensive scales that incorporate parameters of basic activities of daily living. METHODS: A retrospective cohort study was conducted between 2007 and 2013 in an inpatient neurologic rehabilitation department. The study group included 70 individuals with GBS: 39 were treated with PE and 31 with IVIg. A comparison of functional outcomes was performed using Functional Independence Measure (FIM), rehabilitation efficiency (REy), rehabilitation effectiveness (REs), and the GBS disability scale (GDS). RESULTS: Both treatments had a comparable effect on the various functional outcomes. Patients showed a significant increase in total FIM scores (30 points on average) during rehabilitation mainly as a result of an increase in motor sub-scores. A mean improvement of 1.23 (SD 0.9) in GDS was also observed. On average, individuals with GBS spent 20 days combined in the acute departments and 61 days in the rehabilitation department, with length of stay being similar for both treatments. CONCLUSIONS: IVIg and PE treatments have similar basic activities of daily living (ADL) functional outcomes. Nevertheless, due to the different mechanism of actions of these treatments and the multitude of GBS variants, it is possible that further comprehensive assessment tools may demonstrate differences in activity and participation of individuals with GBS.

scholarly journals Treatment-related fluctuation in Guillain-Barre syndrome

2011 ◽  
Vol 02 (02) ◽  
pp. 168-170 ◽  
Author(s):  
Thirunavukkarasu Thivakaran ◽  
Ranjanie Gamage ◽  
Inuka Kishara Gooneratne
Keyword(s):  
Immune Activation ◽  
Early Treatment ◽  
Disease Onset ◽  
Immunoglobulin Therapy ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Guillain Barre Syndrome ◽  
Disability Scale ◽  
Guillain Barré Syndrome ◽  
Immunoglobulin Treatment ◽  
Guillain Barré

ABSTRACTGuillain-Barre syndrome (GBS) is usually a monophasic illness but relapses occur. A 55-year-old female with hypertension and vitiligo presented with acute inflammatory demyelinating polyradiculoneuropathy. She improved with immunoglobulin treatment started on day 6 of illness, but relapsed on day 14 warranting repeat immunoglobulin therapy. Thereafter recovery was complete. Her relapse was due to treatment-related fluctuation (TRF). TRF is improvement in the GBS disability scale of at least one grade after completion of immunotherapy followed by worsening of the disability scale of at least one grade within the first 2 months after disease onset. Recurrent GBS and chronic inflammatory demyelinating polyradiculoneuropathy were excluded. During the peak of the illness ANA titres were transiently high. The presence of other medical conditions, predominant proximal weakness and the absence of preceding diarrhea are predictors for TRF seen in this patient. Early treatment and evidence of ongoing immune activation have contributed toward TRF.

Gene Polymorphisms of Interleukin-27 Correlate with the Susceptibility, Severity, and Clinical Outcomes of Elderly People with Guillain-Barré Syndrome

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Huifang Zhang ◽  
Hongying Zhao ◽  
Guotao Yang ◽  
Ying Li ◽  
Yunfeng Liu
Keyword(s):  
Clinical Outcomes ◽  
Elderly People ◽  
Gene Polymorphisms ◽  
Healthy Subjects ◽  
Serum Levels ◽  
Guillain Barre Syndrome ◽  
Enzyme Linked Immunosorbent Assay ◽  
Nucleotide Polymorphisms ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

<b><i>Introduction:</i></b> Guillain-Barré syndrome (GBS) is a common autoimmune disease in the peripheral nervous system. This study aimed to elucidate the role of IL-27 gene polymorphisms in elderly people with GBS. <b><i>Methods:</i></b> A total of 395 healthy subjects and 422 GBS patients with an average age of 63 years old were included in this study. Peripheral blood samples were collected. The 2 single-nucleotide polymorphisms (SNPs) of IL-27, namely, rs153109 and rs785575, of GBS patients were analyzed using the PCR method and compared with those of the healthy controls. The correlations of IL-27 SNPs with disease severity, disease outcome, level of anti-GM1 antibodies, and <i>Campylobacter jejuni</i> infection were assessed. Serum levels of IL-27 of healthy subjects and GBS patients were analyzed using enzyme-linked immunosorbent assay. <b><i>Results:</i></b> No significant differences in the frequencies of rs785575 SNPs between GBS and healthy subjects were observed. In analyzing rs153109 SNPs, the G allele was found to be more prevalent in the GBS patients (<i>p</i> = 0.012). More alleles show GG genotype in GBS patients (<i>p</i> = 0.023). The −964A&#x3e;G allele has a higher prevalence in severely affected and anti-GM1-Ab-positive GBS patients. GBS patients with the rs153109 SNP showed a poor clinical outcome than those without rs153109 SNP (<i>p</i> = 0.012). GBS patients showed higher serum IL-27 levels than healthy subjects (<i>p</i> &#x3c; 0.001). The levels of IL-27 were also higher in GBS patients with genotypes of AG and GG, and those with GG genotypes showed the highest IL-27 levels. <b><i>Conclusion:</i></b> The rs153109 SNP is more prevalent in GBS patients with the GG and G allele and is associated with severer GBS, poorer clinical outcomes, and higher IL-27 levels.

scholarly journals Gamunex® in Guillain-Barré Syndrome: A Postmarketing, Retrospective, Observational Study

2017 ◽  
Vol 44 (6) ◽  
pp. 711-717 ◽  
Author(s):  
Zaeem A. Siddiqi ◽  
Kecia Courtney ◽  
Kim Hanna ◽  
Elsa Mondou ◽  
Vera Bril
Keyword(s):  
Treatment Success ◽  
Guillain Barre Syndrome ◽  
Medical Chart Review ◽  
Disability Scale ◽  
Guillain Barré Syndrome ◽  
Evaluable Population ◽  
Study Population ◽  
Guillain Barré ◽  
Health Canada ◽  
Effectiveness Threshold

AbstractBackground: The objective of this retrospective study was to evaluate the effectiveness and safety of Gamunex® (immune globulin [human] 10%; hereinafter “Gamunex”) when administered intravenously in the initial treatment of Guillain-Barré syndrome (GBS). The study was conducted as a postapproval commitment for Health Canada. Methods: A medical chart review for hospitalized patients diagnosed with GBS and treated with Gamunex (Gamunex 10% and IGIVnex® 10%; N=109; n=69 evaluable) was conducted at seven Canadian study centers in reverse chronological order. The primary endpoint for assessing effectiveness was the proportion of patients with treatment success compared with a prospectively defined historical effectiveness threshold for plasma exchange (PE) treatment (55.05%). Treatment success was assessed as ≥1 point improvement from baseline on the GBS Disability Scale or abbreviated GBS Disability Scale. Cases were not evaluable if treatment success, relapse, or treatment failure could not be determined by the available chart data. Results: Applying a conservative estimate with all nonevaluable patients (n= 40) classified as treatment failures, Gamunex treatment success was estimated at 57.8% (63 of 109 patients), which exceeded the predefined historical PE effectiveness threshold. In the evaluable population of this study, Gamunex treatment was successful in 91.3% of patients (63/69). Some 23 (21.1%) of 109 Gamunex-treated patients experienced ≥1 adverse event; the profile and frequency were consistent with the adverse events reported for Gamunex in the product’s labeling and with the natural clinical course of GBS. Conclusions: The effectiveness of Gamunex for treatment of GBS was comparable to PE therapy. Gamunex was observed to have an acceptable safety profile in this study population.

scholarly journals COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports

2020 ◽  
Vol 5 ◽  
pp. 107 ◽  
Author(s):  
Rodrigo M. Carrillo-Larco ◽  
Carlos Altez-Fernandez ◽  
Sabrina Ravaglia ◽  
Joaquín A. Vizcarra
Keyword(s):  
Systematic Review ◽  
Cerebrospinal Fluid ◽  
Case Reports ◽  
Epidemiological Studies ◽  
Preliminary Evidence ◽  
Guillain Barre Syndrome ◽  
Protein Levels ◽  
Guillain Barré Syndrome ◽  
Successful Resolution ◽  
Guillain Barré

Background: Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death. Whether COVID-19 patients are at high risk of GBS is unknown. Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and COVID-19. Methods: Without any restrictions, we searched MEDLINE, Embase, Global Health, Scopus, Web of Science and MedXriv (April 23 rd, 2020). Two reviewers screened and studied titles, abstracts and reports. We extracted information to characterize sociodemographic variables, clinical presentation, laboratory results, treatments and outcomes. Results: Eight reports (n=12 patients) of GBS and COVID-19 were identified; one was a Miller Fisher case. The age ranged between 23 and 77 years, and there were more men (9/102). GBS symptoms started between 5 and 24 days after those of COVID-19. The protein levels in cerebrospinal fluid samples ranged between 40 and 193 mg/dl. None of the cerebrospinal fluid samples tested positive for COVID-19. Six patients debuted with ascendant weakness and three with facial weakness. Five patients had favourable evolution, four remained with relevant symptoms or required critical care and one died; the Miller Fisher case had successful resolution. Conclusions: GBS is emerging as a disease that may appear in COVID-19 patients. Although limited, preliminary evidence appears to suggest that GBS occurs after COVID-19 onset. Practitioners and investigators should have GBS in mind as they look after COVID-19 patients and conduct research on novel aspects of COVID-19. Comparison with GBS patients in the context of another viral outbreak (Zika), revealed similarities and differences that deserves further scrutiny and epidemiological studies.

COVID-19 and Neurology – An Emerging Association

2021 ◽  
Vol 21 ◽  
Author(s):  
Amit Gupta ◽  
Prakrati Yadav ◽  
Deepak Kumar
Keyword(s):  
Early Diagnosis ◽  
Literature Search ◽  
Demyelinating Disease ◽  
Transverse Myelitis ◽  
Guillain Barre Syndrome ◽  
Neurological Manifestations ◽  
Guillain Barré Syndrome ◽  
Neurological Features ◽  
Guillain Barré ◽  
Google Search

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, which is a cause of the ongoing pandemic, has the potential to infect the nervous system and causing neurological manifestations. However, patients with primarily neurological symptoms are often overlooked and tested later. Objective : We aim to summarise all the neurological manifestations which are reported so far to aid in early diagnosis and preventingze all the neurological manifestations that are reported so far to aid in early diagnosis and prevent further complication of the disease. Methods and Material: We did a literature search on the topic using Google search engine through Google Scholar, PubMed, and WHO resources by keywords including Coronavirus, SARS-CoV-2, COVID-19, Clinical features, Stroke, Transverse myelitis, Encephalitis, Encephalopathy, Guillain-Barre syndrome, Hypogeusia, Hyposmia, Anosmia, and Neurological manifestations. Discussion: SARS-CoV-2 can affect the neuronal cells by both direct and indirect mechanisms. This can lead to various neurological manifestations ranging from subtle symptoms of myalgia, headache, dizziness, hypogeusia, hyposmia to dreaded complications like stroke, encephalitis, demyelinating disease like Guillain-Barre syndrome. Conclusions: Presentation of COVID-19 with neurological features is not uncommon, and these patients should be tested earlier to help in the prevention of transmission, early diagnosis, and management.

scholarly journals COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports

2020 ◽  
Vol 5 ◽  
pp. 107 ◽  
Author(s):  
Rodrigo M. Carrillo-Larco ◽  
Carlos Altez-Fernandez ◽  
Sabrina Ravaglia ◽  
Joaquín A. Vizcarra
Keyword(s):  
Systematic Review ◽  
Cerebrospinal Fluid ◽  
Case Reports ◽  
Epidemiological Studies ◽  
Preliminary Evidence ◽  
Guillain Barre Syndrome ◽  
Protein Levels ◽  
Guillain Barré Syndrome ◽  
Successful Resolution ◽  
Guillain Barré

Background: Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death. Whether COVID-19 patients are at high risk of GBS is unknown. Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and COVID-19. Methods: Without any restrictions, we searched MEDLINE, Embase, Global Health, Scopus, Web of Science and MedXriv (April 23rd, 2020). Two reviewers screened and studied titles, abstracts and reports. We extracted information to characterize sociodemographic variables, clinical presentation, laboratory results, treatments and outcomes. Results: Eight reports (n=12 patients) of GBS and COVID-19 were identified; one was a Miller Fisher case. Overall, the median age was 62.5 (interquartile range (IQR)=54.5-70.5) years, and there were more men (9/102). GBS symptoms started between 5 and 24 days after those of COVID-19. The median protein levels in cerebrospinal fluid samples was 101.5 mg/dl (IQR=51-145). None of the cerebrospinal fluid samples tested positive for COVID-19. Six patients debuted with ascendant weakness and three with facial weakness. Five patients had favourable evolution, four remained with relevant symptoms or required critical care and one died; the Miller Fisher case had successful resolution. Conclusions: GBS is emerging as a disease that may appear in COVID-19 patients. Although limited, preliminary evidence appears to suggest that GBS occurs after COVID-19 onset. Practitioners and investigators should have GBS in mind as they look after COVID-19 patients and conduct research on novel aspects of COVID-19. Comparison with GBS patients in the context of another viral outbreak (Zika), revealed similarities and differences that deserves further scrutiny and epidemiological studies.

scholarly journals Antibody to human T-lymphotropic virus in a patient with Guillain-Barré syndrome (case report)

1991 ◽  
Vol 33 (4) ◽  
pp. 329-331 ◽  
Author(s):  
C.M. Nakauchi ◽  
A.C. Linhares ◽  
M.L.C. Gomes ◽  
K. Maruyama ◽  
L.I. Kanzaki ◽  
...  
Keyword(s):  
Guillain Barre Syndrome ◽  
Enzyme Linked Immunosorbent Assay ◽  
Epstein Barr Virus Infection ◽  
Serum Samples ◽  
T Lymphotropic Virus ◽  
Adult T Cell Leukemia ◽  
Barr Virus ◽  
Negative Results ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Serum sample obtained from a male, 12 year old patient suffering from Guillain-Barré syndrome (GBS) was positive for human T-lymphotropic virus (HTLV-I) antibody by the enzyme-linked immunosorbent assay (ELISA) and the Western Blot analysis (WB). Attempts to isolate enteroviruses (including poliovirus) from faecal material in both tissue culture and suckling mice were unsuccessful; in addition, acute and convalescent paired serum samples did not show any evidence of recent poliovirus infection when tested against the three serotypes. Specific tests for detection of Epstein-Barr virus infection were not performed; however, the Paul-Bunnel test yielded negative results. ELISA for detection of anti-cytomegalovirus IgM was also negative. The concomitant occurrence of either adult T cell leukemia (ATL) or lymphoma was not recorded in this case.

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