Guillain-Barre Syndrome following Primary Cytomegalovirus Infection: A Prospective Cohort Study

David, Olivier; Porcher, Raphaël; Sivadon-Tardy, Valérie; Quincampoix, J.-C.; Raphaël, Jean-Claude; Durand, Marie-Christine; Sharshar, Tarek; Roussi, J; Caudie, Christiane; Annane, Djillali; Rozenberg, Flore; Leruez‐Ville, Marianne; Gaillard, Jean‐Louis; Gault, Elyanne

doi:10.1093/cid/cir074

Cited by 132 publications

(116 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, although the crucial role of Campylobacter jejuni (48) is well established for AMAN, the link between pathogenesis and different viral infections such as CMV (49) or EBV (50) in AIDP patients remain questionable. Herpes viruses-such as cytomegalovirus (CMV), Epstein-Barr virus (EBV) (13,15), and the varicella-zoster virus (VZV-have often been mentioned as possible GBS promoters (58), whereas the herpes simplex virus (HSV-1 and HSV-2) is rarely associated with GBS (59,60). Our results again confirmed that none of the abovementioned viruses were strictly necessary for AIDP progression.…”

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

The Pathogenesis of the Demyelinating Form of Guillain-Barre Syndrome (GBS): Proteo-peptidomic and Immunological Profiling of Physiological Fluids

Ziganshin

Ivanova

Lomakin

et al. 2016

Molecular & Cellular Proteomics

View full text Add to dashboard Cite

Acute inflammatory demyelinating polyneuropathy (AIDP) -the main form of Guillain-Barre syndrome-is a rare and severe disorder of the peripheral nervous system with an unknown etiology. One of the hallmarks of the AIDP pathogenesis is a significantly elevated cerebrospinal fluid (CSF) protein level. In this paper CSF peptidome and proteome in AIDP were analyzed and compared with multiple sclerosis and control patients. A total protein concentration increase was shown to be because of even changes in all proteins rather than some specific response, supporting the hypothesis of protein leakage from blood through the blood-nerve barrier. The elevated CSF protein level in AIDP was complemented by activization of protein degradation and much higher peptidome diversity. Because of the studies of the acute motor axonal form, Guillain-Barre syndrome as a whole is thought to be associated with autoimmune response against neurospecific molecules. Thus, in AIDP, autoantibodies against cell adhesion proteins localized at Ranvier's nodes were suggested as possible targets in AIDP. Indeed, AIDP CSF peptidome analysis revealed cell adhesion proteins degradation, however no reliable dependence on the corresponding autoantibodies levels was found. Proteome analysis revealed overrepresentation of Gene Ontology groups related to responses to bacteria and virus infections, which were earlier suggested as possible AIDP triggers. Immunoglobulin blood serum analysis against most common neuronal viruses did not reveal any specific pathogen; however, AIDP patients were more immunopositive in average and often had polyinfections. Cytokine analysis of both AIDP CSF and blood did not show a systemic adaptive immune response or general inflammation, whereas innate immunity cytokines were up-regulated. To supplement the widely-accepted though still unproven autoimmunity-based AIDP mechanism we propose a hypothesis of the primary peripheral nervous system damaging initiated as an innate immunity-associated local inflammation following neurotropic viruses egress, whereas the autoantibody production might be an optional complementary secondary process. Molecular & Cellular

show abstract

Section: Discussionsupporting

confidence: 77%

“…Campylobacter jejuni (13,14), Epstein-Barr virus (EBV), cytomegalovirus (CMV) (13,15), and Mycoplasma pneumoniae (13) are among the most common infectious agents that are thought to be able to trigger GBS. Besides, the first strong evidence that Zika virus can cause GBS development was published recently (16).…”

mentioning

confidence: 99%

The Pathogenesis of the Demyelinating Form of Guillain-Barre Syndrome (GBS): Proteo-peptidomic and Immunological Profiling of Physiological Fluids

Ziganshin

Ivanova

Lomakin

et al. 2016

Molecular & Cellular Proteomics

View full text Add to dashboard Cite

show abstract

“…Campylobacter jejuni is the predominant infection triggering GBS worldwide,14 and is associated with severe acute motor axonal neuropathy (AMAN)‐type of GBS with a poor clinical outcome 15. Cytomegalovirus in contrast can cause severe senso‐motoric disorders and a GBS subtype described as acute inflammatory demyelinating polyneuropathy (AIDP) 16. The frequency of these GBS subtypes differs between geographical regions, which is in part explained by the local endemic infections.…”

Section: Introductionmentioning

confidence: 99%

Zika virus and Guillain–Barré syndrome in Bangladesh

GeurtsvanKessel

Islam

et al. 2018

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectivePrevious studies have associated Guillain–Barré syndrome (GBS) with Zika virus (ZIKV) outbreaks in South America and Oceania. In Asia, ZIKV is known to circulate widely, but the association with Guillain–Barré syndrome is unclear. We investigated whether endemic ZIKV infection is associated with the development of GBS.MethodsA prospective study was conducted from 2011 to 2015 in Bangladesh. A total of 418 patients and 418 healthy family controls were included in the study. Patients were diagnosed with GBS prior to inclusion according to established criteria. Detailed information on the epidemiology, clinical presentation, electrophysiology, diagnosis, disease severity, and clinical course were obtained during a follow‐up of 1 year using a predefined protocol.Results ZIKV‐neutralizing antibodies were detected in our study from 2013 onwards. The prevalence of ZIKV‐neutralizing antibodies was not significantly higher in patients with GBS compared to healthy controls (OR 2.23, P = 0.14, 95% CI 0.77–6.53). Serological evidence for prior ZIKV infection in patients with GBS was associated with more frequent cranial, sensory, and autonomic nerve involvement compared to GBS patients with Campylobacter jejuni, the predominant preceding infection in GBS worldwide. Nerve‐conduction studies revealed that ZIKV antibodies were associated with a demyelinating subtype of GBS, while C. jejuni infections were related to an axonal subtype.InterpretationNo significant association was found between ZIKV infection and GBS in Bangladesh, but GBS following ZIKV infection was characterized by a distinct clinical and electrophysiological subtype compared to C. jejuni infection. These findings indicate that ZIKV may precede a specific GBS subtype but the risk is low.

show abstract

“…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). Currently, although there are a number of studies on the AGA and a few studies of anti‐CMV antibodies in GBS, the association between them remains poorly documented (Annunziata, Figura, Galli, Mugnaini, & Lenzi, 2003; McCombe, Wilson, & Prentice, 1992; Taheraghdam et al., 2014).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

View full text Add to dashboard Cite

IntroductionNumerous 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.MethodsA 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.ResultsOf 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.ConclusionIn 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 CSF‐CMV‐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.

show abstract

Guillain-Barre Syndrome following Primary Cytomegalovirus Infection: A Prospective Cohort Study

Cited by 132 publications

References 37 publications

The Pathogenesis of the Demyelinating Form of Guillain-Barre Syndrome (GBS): Proteo-peptidomic and Immunological Profiling of Physiological Fluids

The Pathogenesis of the Demyelinating Form of Guillain-Barre Syndrome (GBS): Proteo-peptidomic and Immunological Profiling of Physiological Fluids

Zika virus and Guillain–Barré syndrome in Bangladesh

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

Contact Info

Product

Resources

About