HLA alleles in patients with Guillain Barre syndrome

To determine whether genetic factors may work in concert with autoimmune factors in the pathogenesis of Guillain Barre syndrome (GBS) Methods We determined the differences in the distribution of HLA alleles between GBS patients and normal controls HLA DQA, DQB and DRB alleles were typed by the sequence specific primer polymerase chain reaction (PCR SSP) methods in 47 GBS, 7 patients with Campylobacter jejuni (CJ) enteritis and 50 normal controls Results There were no differences in the frequency of HLA DQA, DQB and DRB among GBS group, CJ group, normal controls and GBS subgroups with respect to recent CJ infection, GM1 IgG and GM1 IgM antibodies ( P >0 05) There was an increasing tendency of DQA1*0301 ( P =0 056, RR =2 991) in the subgroup with GM1 IgG antibodies and DQA1 *0302 ( P =0 087, RR =3 587) in the subgroup with recent CJ infection No difference was found among GBS, CJ enteritis patients and normal controls Conclusions The increasing tendency of the two alleles suggests that there may be some relation between genetic factors and immunological factors, but a definite conclusion waits for more cases

Relationship between pathogenesis of Guillain Barre syndrome and Penner’s serotypes of Cam pylobacter jejuni

Objective To investigate the relationship between the pathogenesis of Guillain Barre syndrome (GBS) and Campylobacter jejuni (C jejuni) in China Methods C jejuni strains were isolated from fresh stools of 47 GBS patients in Beijing area from 1995 to 1997 by modified Skirrow’s method Serotyping of C jejuni was performed with Penner’s method in 47 GBS patients and 171 patients with C jejuni enteritis in our hospital during the same period The stools from which no C jejuni strains could be isolated were typed by PCR RFLP (restriction fragment length polymorphism) method Results Six C jejuni strains were isolated by Skirrow’s method, including 3 strains of Penner serotype 2, 1 Penner serotype 4, 1 Penner serotype 19 and 1 Penner serotype 26 Three strains of DNA Ⅰ, which was equal to the same type of Penner serotype 19, were found by PCR RFLP method Conclusion C jejuni isolated from Beijing area are similar to those reported in literature, which once more confirms the molecular mimicry pathogenetic theory of GBS caused by C jejuni infection in China The similarities of serotypes between C jejuni strains from GBS patients and those from C jejuni enteritis patients may explain the high incidence of GBS following C jejuni infection in China

Acute motor axonal neuropathy following anti-rabies human diploid cell vaccine:A rare case and review

Rationale:Guillain Barre syndrome(GBS)is an acute neurological illness leading to quadriparesis with respiratory involvement.It can be triggered by infections,vaccinations,surgery,trauma,transplantation and drugs.Anti-rabies cell culture vaccines introduced to overcome the high rate of neurological complications associated with tissue based rabies vaccine,can be very rarely associated with GBS.Patient concerns:A 50-year-old female presented with acute severe upper back pain evolving into pure motor quadriparesis following administration of human diploid cell vaccine for rabies.Diagnosis:Acute motor axonal neuropathy variant of GBS following anti-rabies human diploid cell vaccine.Interventions:Intravenous high dose steroids.Outcomes:Patient recovered completely within 1 month.Lessons:Although anti-rabies cell culture vaccines are highly immunogenic and safe,they are rarely associated with GBS.Clinicians should be aware of this link because prompt diagnosis and treatment can result in complete recovery and avoid complications.

Zika Virus and Its Association with Neurological Disorders

Zika virus (ZIKV) is a flavivirus that can be identified as a small envelope with a positive-stranded RNA and an important medical pathogen, which causes deadly human diseases. The virus is carried by Aedes aegypti mosquitoes through a blood meal and it is also spread through body fluids. ZIKV infection may present with symptoms like fever, myalgia, maculopapular rash as well as neurological sequelae, which include, microcephaly, epilepsy, and Guillain Barré syndrome (GBS). This put the virus on a scale of the public health burden of almost 87 countries. The potential threat of ZIKV infection is not completely eradicated in many countries in Africa, America, and the Western Pacific regions. There are no vaccines and treatments available to date. Since ZIKV causes microcephaly in utero by targeting neural progenitor cells, inducing apoptosis, and impairing neurodevelopment, this article hopes to evaluate the neurological disorders associated with the Zika virus infection while elucidating the current trends in the development of vaccines and drugs.

Miller Fisher syndrome: toward a more comprehensive understanding

Purpose To review recent knowledge on the clinical features, pathology and pathophysiology, diagnosis and treatment of Miller Fisher syndrome (MFS) Data sources Clinical and laboratory studies on MFS in the past 10 years were included Results A viral infection preceded neurological symptoms in 71 8% of MFS patients Typical MFS consists of the triad of ataxia, areflexia and ophthalmoplegia Other cranial nerves are also involved, which may overlap with limb weakness in typical Guillain Barre syndrome (GBS) Lower cranial nerve variants of GBS, atypical MFS and ataxic neuropathies may overlap, and are thought of as variant forms of MFS Recurrence and CNS involvement is found more frequently in MFS than in GBS Antibody to GQ1b, a tetrasyaloganglioside (GQ1b antibody) which is found in close relation to ophthalmoplegia in MFS, is also associated with Campylobacter jejuni (C jejuni) serotype Penner 2 This suggests that C jejuni may induce MFS via the GQ1b structure The GQ1b antibody may lead to the failure of acetylcholine release from motor nerve terminals, which has been confirmed by clinical neurophysiological results Conclusions Many studies have shown similarities in the pathogenesis of MFS and GBS However, there are still some differences between them, especially in the areas of sensory and CNS involvement The GQ1b antibody is thought of as one of the key factors in the pathogenesis of MFS, especially with ophthalmoplegia, and it may prove a useful clinical marker in the diagnosis of MFS

Therapeutics of Integrative Medicine Ameliorate Immunological Disorders of the Nervous System: A Meta-Analysis

Objective: The objective of the study is to evaluate the therapeutic efficacy of integrative medicine in the treatment of immunological disorders of the nervous system. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were adopted to conduct this study, which included randomized controlled trials with a confirmed diagnosis of multiple sclerosis(MS), myasthenia gravis(MG), and Guillain–Barre syndrome(GBS), all of which were treated with integrative medicine. The effective rate, recurrent frequency, and disease score were used as the markers of outcome variables for the meta-analysis. Results: A total of 48 randomized control trials were included. The effective rates of treatment with integrative medicine were noticeably higher than those with Western medicine alone for the three diseases. The recurrence frequency for MS and the recurrence rate for MG treated with integrative medicine were reduced more than those with Western medicine alone. The Extended Disability Status Scale, acetylcholine receptor antibody, and Hughes scores for MS, MG, and GBS, respectively, treated with integrative medicine were significantly lower than those with Western medicine alone. The risks of bias in the literature evaluation showed that the quality of the included studies was not high. Conclusions: Compared to treatment with Western medicine alone, integrative medicine might ameliorate immunological disorders of the nervous system.