Cerebrospinal fluid biomarkers in Guillain-Barré syndrome – Where do we stand?

Brettschneider, Johannes; Petzold, Axel; Süßmuth, Sigurd D.; Tumani, Hayrettin

doi:10.1007/s00415-009-0097-x

Cited by 61 publications

(43 citation statements)

References 78 publications

(122 reference statements)

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“…Previous studies demonstrated oligosaccharide structures of GD3, GD1a, GM1 and LPS similar to GT1a in other stubs of C. jejuni isolated from GBS patients using similar methods [30]. The capability of C. jejuni LPS in producing antiganglioside IgM and IgG antibodies in rats refers to the immunological importance of this imitation [31]. The same results were obtained for mice and rabbits [32].…”

Section: Discussionsupporting

confidence: 67%

Evaluating the Status of Antiganglioside Antibodies in Children with Guillain-Barré Syndrome

Hashemilar

Barzegar²,

Nikanfar³

et al. 2013

Neuroimmunomodulation

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Objective: Antiganglioside antibodies have been reported to play a role in the pathophysiology of Guillain-Barré syndrome (GBS). Methods: This case-control study was designed to evaluate the status of antiganglioside antibodies in children with GBS. The study included 50 patients suffering from GBS as the case group and 30 children as the control group. Clinical information such as demographic data and recent digestive or respiratory infection (within the last month) was collected for all patients, and paraclinical studies including cerebrospinal fluid examination and electrophysiology were conducted by a subspecialized physician. Anti-GM1, anti-GQ1 and anti-GD1a antibodies were measured with ELISA and the EUROLINE method. Results: The mean age of patients in the case and control groups was 5.3 ± 3.8 and 5.4 ± 3.4 years, respectively. With the EUROLINE method, the results obtained for anti-GM1 were significant (p = 0.007); however, the p values for anti-GQ1a and anti-GQ1b were not significant (0.051 vs. 0.94), while with ELISA, comparing all three antibodies in both the case and control groups showed statistically significant results, with a p < 0.05. Conclusion: EUROLINE is a new method used to evaluate antibodies in immune system diseases, but it is not useful for all antibodies specific to GBS, as the analysis was significant with a p value of 0.007 for anti-GM2.

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Section: Discussionsupporting

confidence: 67%

Evaluating the Status of Antiganglioside Antibodies in Children with Guillain-Barré Syndrome

Hashemilar

Barzegar²,

Nikanfar³

et al. 2013

Neuroimmunomodulation

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“…10 These distinct mechanisms are in line with current serologic testing, with anti-glycan antibodies more closely associated with non-AIDP subtypes of GBS. 1 As would be predicted, anti-GM1, GD1b, and GQ1b were not detected in our patient's serum.…”

Section: Go To Section 4 Sectionsupporting

confidence: 62%

Clinical Reasoning: A middle-aged woman with progressive symmetric weakness and a CSF pleocytosis

Marks¹,

Jann²,

DeAngelis³

2012

Neurology

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A 54-year-old Ecuadorian American woman presented with 4 days of progressive bilateral extremity weakness, which began in the upper extremities but quickly spread to the lower extremities. The patient also reported reduced gait stability, bilateral distal paresthesias, and patchy decreased sensation with pain over her lower abdomen and pelvis. At presentation, she denied symptoms of dysautonomia or bulbar dysfunction. Past medical history included longstanding rheumatoid arthritis treated with chronic methylprednisolone, hypertension, left sciatic radiculopathy, scoliosis, uterine prolapse, and thyroid disease.On examination, the patient's vitals were stable. Mental status and cranial nerves were normal. Motor strength was decreased symmetrically in the upper and lower extremities (4/5) with areflexia and absent plantar reflexes. The patient had decreased pinprick sensation over the T6 -T8 dermatomes and diminished vibratory sense distally. Joint position sense was preserved bilaterally. The patient demonstrated a paraparetic slow gait with assistance.

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“…Sharief et al (1993) did not observe upregulation in TNF-␣ levels in cerebrospinal fluid (CSF), but serum TNF-␣ levels were significantly elevated and concluded that TNF-␣ played important role in the pathogenesis of GBS [6]. While studying CSF biomarkers in GBS, Brettschneider et al (2009) reported significant increase of TNF receptor and TNF-␣ mRNA in GBS; however TNF-␣ protein was increased only in a few patients [35]. Sivieri et al (1997) did not find significant levels of TNF-␣ in serum as well as in CSF, and commented that cytokines could not be easily detected in the biologic fluids like CSF because of their short half-life [36].…”

Section: Discussionmentioning

confidence: 96%