Guillain-Barr&amp;eacute; Syndrome Following Bee Venom Acupuncture

Lee, Hyun Jo; Park, In Seok; Lee, Jon-In; Kim, Joong‐Seok

doi:10.2169/internalmedicine.54.2238

Cited by 16 publications

(10 citation statements)

References 15 publications

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“…It is noteworthy that GBS patients after discharge may be left with psychiatric sequelae including stress, anxiety, depression, fatigue, sleep abnormalities, and visual hallucinations, which may need a multidisciplinary team approach to facilitate both physical and psychiatric recovery ( Hillyar and Nibber, 2020 ). Although early rehabilitation is necessary for preventing ICUAW and facilitating the recovery of axonal GBS, it remains unclear, however, whether exercise-based rehabilitation, neurotrophic therapies, or acupuncture in general wards and after hospital discharge is beneficial ( Lee et al, 2015 ; Shang et al, 2020a ; Fan et al, 2020 ).…”

Section: Supportive Care and Treatment In The Intensive Care Unitmentioning

confidence: 99%

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Shang

Feng

et al. 2021

Front. Pharmacol.

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Guillain–Barré syndrome (GBS) is an acute polyneuropathy mostly characterized by acute flaccid paralysis with or without sensory/autonomous nerve dysfunction. Current immuno therapies including intravenous immunoglobulin (IVIg), plasma exchange (PE), and newly developed biological drugs benefit patients by alleviating hyperreactive immune responses. Up to 30% of patients develop respiratory failure during hospitalization and require mechanical ventilation and intensive care. Immunotherapies, mechanical ventilation, supportive care, and complication management during the intensive care unit (ICU) stay are equally emphasized. The most important aspect of intensive care and treatment of severe GBS, that is, mechanical ventilation, has been extensively reviewed elsewhere. In contrast to immunotherapies, care and treatment of GBS in the ICU setting are largely empirical. In this review, we intend to stress the importance of intensive care and treatment, other than mechanical ventilation in patients with severe GBS. We summarize the up-to-date knowledge of pharmacological therapies and ICU management of patients with severe GBS. We aim to answer some key clinical questions related to the management of severe GBS patients including but not limited to: Is IVIg better than PE or vice versa? Whether combinations of immune therapies benefit more? How about the emerging therapies promising for GBS? When to perform tracheal intubation or tracheostomy? How to provide multidisciplinary supportive care for severe cases? How to avert life-threatening complications in severe cases?

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Section: Supportive Care and Treatment In The Intensive Care Unitmentioning

confidence: 99%

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Shang

Feng

et al. 2021

Front. Pharmacol.

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“…Last but not the least, it is essential to ensure the safety and quality of the BV: before use, a battery of physicochemical and microbiological analysis must be performed. Attention must be paid also on the storage conditions: BV may be stored up to 12 months at room temperature or up to 24 months if kept in a cool place (2-8°C), in the original container, unopened, in a dry place and away from strong light (Lee et al, 2015a).…”

Section: Bee Venom: Safety and Practical Considerationsmentioning

confidence: 99%

An overview of the bioactive compounds, therapeutic properties and toxic effects of apitoxin

Pascoal

Estevinho

Choupina

et al. 2019

Food and Chemical Toxicology

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Melittin (MLT), also known as allergen Api m4 (Hossen et al., 2017), is the main compound of BV, comprising approximately 40-60% of its dry weight. MLT (together with apamin) has been reported to be found only in bee venom produced by the genus Apis (Moreno and Giralt, 2015). It is a linear, amphipathic, cationic and a-helical polypeptide molecule composed of 26 amino acid residues and is soluble in water (Silva et al., 2015; Kachel et al., 2018). Recent studies provided evidence on several biological properties of MLT (Table 1). MLT has been reported to be a very potent anti-inflammatory agent, being 100 times more potent than hydro-cortisol in animal models (Vick and Shipman, 1972; Eze et al., 2016). The antiinflammatory activity of this compound has been explored in several settings, including acne vulgaris, neuro inflammation, atherosclerosis, arthritis and liver inflammation (Lee and Bae, 2016).

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“…In the past decade, some traditional Chinese medicines have been found to be effective for treating GBS (8,9). These studies have highlighted the unique clinical e cacies of traditional medicine.…”

Section: Introductionmentioning

confidence: 99%

Celastrol ameliorates experimental autoimmune neuritis by shifting the polarization of M1/M2 macrophages via the hypoxic response pathway

Qian¹,

Tang²,

Min-hai³

et al. 2020

Preprint

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BackgroundGBS is an autoimmune disease characterized by inflammatory infiltration and demyelination of peripheral nerves. Macrophage polarization is involved in different stages of GBS. Altering the polarization of macrophages may be an effective therapeutic strategy for GBS. Celastrol was previously shown to contribute to anti-neuroinflammation. However, the mechanism underlying the effect of celastrol in GBS animal model experimental autoimmune neuritis (EAN) is unclear. We hypothesized that celastrol may shift the polarization of macrophages through the NRF /HIF-1αpathway.MethodsClinical scores, weight and histological changes were assessed to investigate the effects of celastrol on EAN. To detect the polarization state of macrophages, flow cytometry and immunofluorescence staining were applied. Inflammation cytokines were evaluated by ELISA. The expression of NRF2 and HIF-1α were detected by western-blot and immunofluorescence staining.ResultsCelastrol treatment significantly ameliorates the severity and neuroinflammation of EAN. The polarization state of macrophages from M1 to M2 was observed upon celastrol application. Consistently, pro-inflammatory cytokines were decreased, whereas anti-inflammatory cytokines were increased upon celastrol treatment. Furthermore, we found that celastrol treatment may increase expression of Nrf2 and decrease the expression of HIF-1α. ConclusionTaken together, these data demonstrate that celastrol may ameliorate the severity and neuroinflammation of EAN via promoting the polarization state of macrophages into M2, likely by modulating the hypoxic response. Celastrol may therefore serve as a novel therapeutic agent for GBS.

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Guillain-Barré Syndrome Following Bee Venom Acupuncture

Cited by 16 publications

References 15 publications

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

An overview of the bioactive compounds, therapeutic properties and toxic effects of apitoxin

Celastrol ameliorates experimental autoimmune neuritis by shifting the polarization of M1/M2 macrophages via the hypoxic response pathway

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