Role ofCampylobacter jejuniInfection in the Pathogenesis of Guillain-Barré Syndrome: An Update

Abstract

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.

Detection of Campylobacter species in stool specimens from patients with symptoms of acute flaccid paralysis in South Africa

“…With polio almost eradicated globally, GBS has now become the most common cause of acute flaccid paralysis (AFP) with an annual incidence of 0.6-4.0 cases per 100000 population [4,5]. Campylobacter spp., particularly Campylobacter jejuni, have been described as one of the leading causes of human gastroenteritis [1][2][3][4][5].…”

“…With polio almost eradicated globally, GBS has now become the most common cause of acute flaccid paralysis (AFP) with an annual incidence of 0.6-4.0 cases per 100000 population [4,5]. Campylobacter spp., particularly Campylobacter jejuni, have been described as one of the leading causes of human gastroenteritis [1][2][3][4][5]. Pathogenic features of C. jejuni influencing the development of GBS have been described, with C. jejuni infections reportedly constituting the majority of GBS cases [1][2][3][4][5].…”

“…Campylobacter spp., particularly Campylobacter jejuni, have been described as one of the leading causes of human gastroenteritis [1][2][3][4][5]. Pathogenic features of C. jejuni influencing the development of GBS have been described, with C. jejuni infections reportedly constituting the majority of GBS cases [1][2][3][4][5]. GBS, which develops after C. jejuni infection, has been investigated and reported in a number of studies, rendering characteristics of C. jejuni strains subject to renewed interest in association with the pathogenesis of GBS [4,[6][7][8][9].…”

“…jejuni-induced GBS is the most common and severe sequela of Campylobacter gastroenteritis, that is characterized by acute or subacute symmetrical ascending motor weakness, areflexia, and mild-tomoderate sensory abnormalities [4,8,[10][11][12]. The disease is attributed to sialylated surface polysaccharide structures and flagella of some C. jejuni strains, which are thought to be responsible for the ganglioside mimicry and antibody formation leading to GBS [13][14][15][16].…”

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

“…It is reported that the GBS is associated with various types of infection (such as Campylobacter jejuni , Cytomegalovirus, Epstein‐Barr virus, Mycoplasma pneumoniae , and hepatitis E virus) which lead to a cross‐reaction with nervous system, demyelination of neurons, and finally initiation of nervous signs and symptoms by stimulating immune system (van Doorn & Jacobs, 2016; Taheraghdam et al., 2014). Simultaneously, accumulating evidence has indicated that the antecedent infection with C. jejuni enteritis may trigger the generation of AGA (Nyati & Nyati, 2013). Moreover, previous studies have shown that Cytomegalovirus (CMV), a member of the β herpes family may lead to the incidence of GBS and is second only to C. jejuni enteritis (Orlikowski et al., 2011; Taheraghdam et al., 2014).…”