Abstract
Guillain-Barré syndrome (GBS), a neurologic disease that produces ascending paralysis, affects people all over the world. Acute infectious illness precedes 50%-75% of the GBS cases. Although many infectious agents have been associated with GBS, the strongest documented association is with Campylobacter infection. The first line of evidence supporting Campylobacter infection as a trigger of GBS is anecdotal reports. The second line of evidence is serological surveys, which have demonstrated that sera from GBS patients contain anti Campylobacter jejuni antibodies, consistent with recent infection. Finally, culture studies have proven that a high proportion of GBS patients have C. jejuni in their stools at the time of onset of neurological symptoms. One of every 1058 Campylobacter infections results in GBS. Sialic acid containing lipooligosaccharides (LOS) biosynthesis gene locus are associated with GBS and the expression of ganglioside mimicking structures. GM1a was the most prevalent ganglioside mimic in GBS associated strains. Molecular mimicry between C. jejuni LOS and gangliosides in human peripheral nerves, and cross-reactive serum antibody precipitate the majority of GBS cases in Bangladesh, like worldwide. DOI: http://dx.doi.org/10.3329/dmcj.v2i1.17794 Delta Med Col J. Jan 2014; 2(1): 28-35
Highlights
Guillain-Barré syndrome (GBS) is a nervous system disorder, usually triggered by an acute respiratory (22-53%) or gastrointestinal (6-26%) infections.[1,2] GBS is an autoimmune disease, results from nerve damage frequently becomes severe with a mortality of 2-7% and different morbidity
The association between GBS and C. jejuni infection has been demonstrated by case reports and case series, many of which have been described in this article
The development of these autoimmune neuropathies after C. jejuni infection is primarily related to sialylated lipooligosaccharides (LOS) on the cell surface of C. jejuni These exhibit significant molecular mimicry with gangliosides on human peripheral nerves.[48,70,71]
Summary
Guillain-Barré syndrome (GBS) is a nervous system disorder, usually triggered by an acute respiratory (22-53%) or gastrointestinal (6-26%) infections.[1,2] GBS is an autoimmune disease, results from nerve damage frequently becomes severe with a mortality of 2-7% and different morbidity. GBS, the most common cause of acute neuromuscular paralysis is clinically defined by Asbury and Cornblath, as a progressive motor weakness of more than one limb with low or absence of reflexes and no other identifiable causes.[4,5] The global incidence of GBS ranges from 0.4 to 4.0 (median 1.3) cases per 100,000 people annually, occurring more often in adolescents and young adults than in children.[5,6] Guillain-Barré syndrome is the most frequent cause of non polio acute flaccid paralysis (AFP) in Bangladesh which has an incidence rate of 3.25 cases per 100,000 children of
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