P-PN035. TH17 pathway-related cytokine abnormalities in the plasma and cerebrospinal fluid in Guillain Barré Syndrome (GBS): A correlation analysis

Abstract

Introduction . Guillain Barré Syndrome (GBS) is a monophasic immune-mediated disease of the peripheral nervous system, often triggered by antecedent gastrointestinal or respiratory infection. Compelling evidence suggests inflammatory cytokines as the critical drivers of the onset and progression in GBS. Elevated levels of pro-inflammatory cytokines were reported both in the plasma and cerebrospinal fluid (CSF) of patients with GBS. However, whether there exists a correlation between the levels of proinflammatory cytokines in plasma and CSF is inadequately explored. Methods . In this study, we recruited 37 (21 male and 16 female) patients with GBS from the emergency services of the National Institute of Mental Health and Neurosciences, Bangalore, India. Mean age of the patients was 36.65 ± 12.2 years. We analysed the levels of four Th17- pathway related cytokines, IL-6, IL-17A, IL-22 and IL-23, in both the plasma and CSF of patients with GBS by Multiplex Suspension Assay. The levels of these cytokines were correlated between plasma and CSF and also with various clinical features and electrophysiological subtypes. Results . Spearman’s correlation analysis suggests that there was no correlation in the levels of the Th17-pathway related cytokines, IL-6 (p = 0.11), IL-17A (p = 0.85), IL-22 (p = 0.45) and IL-23 (p = 0.76) between plasma and CSF in patients of GBS. Conclusion . Elevated levels of Th17 pathway related cytokines were observed both in the plasma and CSF in our earlier studies. Immune molecules in the CSF play pathogenic roles in various nervous system disorders. CSF analysis also plays important role in establishing the diagnosis of GBS. Though Th17 pathway-related cytokines are upregulated in both the plasma and CSF, however, they do not show any correlation. This may suggest that immune molecules in plasma and CSF may drive pathogenetic processes in GBS independently.