Correlations between cytomegalovirus, Epstein-Barr virus, anti-ganglioside antibodies, electrodiagnostic findings and functional status in Guillain-Barré syndrome.

  • Aliakbar Taheraghdam Mail Department of Neurology, Neurosciences Research Center (NSRC), School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
  • Peyman Pourkhanjar Neurologist, Department of Neurology, Neurosciences Research Center (NSRC), School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
  • Mahnaz Talebi Department of Neurology, Neurosciences Research Center (NSRC), School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
  • Mohammadreza Bonyadi Department of Neurology, Neurosciences Research Center (NSRC), School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
  • Ali Pashapour Department of Neurology, Neurosciences Research Center (NSRC), School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
  • Ehsan Sharifipour Department of Neurology, Neurosciences Research Center (NSRC), Student Research Committee, School of Medicine, Tabriz University of Medical Sciences, Imam Reza Hospital, Tabriz, Iran.
  • Reza Rikhtegar Neurologist, Department of Neurology, Neurosciences Research Center (NSRC), School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Keywords:
Anti-Ganglioside Antibodies, Cytomegalovirus, Electrodiagnostic Findings, Epstein-Barr Virus, Guillain-Barré Syndrome

Abstract

Background: Due to underlying autoimmune background of Guillain-Barré syndrome (GBS), the possible role of infectious agents cytomegalovirus  (CMV) and  Epstein-Barr virus (EBV) and also due to association  of anti-ganglioside antibodies with GBS, the present study aimed to investigate the  associations   between serum anti-ganglioside antibodies (AGA) level,  type  of  infection  and electrodiagnostic (ED) findings with the severity and three- month functional outcome  of patients with GBS.
Methods: In a prospective study, 30 patients with GBS were selected  and before starting the treatment, baseline serum samples of patients were obtained for measuring the serum AGA including  the  antibodies  against  GQ1b, GT1b, GD1a, GD1b, GM1, GM2, GM3 and strains of CMV and EBV. All the patients  were  precisely examined  for ED findings. Functional   status   of  patients on  admission and three months  after admission were recorded  according to the modified Rankin scale (mRS).
Results: The  results of patients' serum  assessment revealed that CMV IgM was positive in one patient (3.3%), CMV IgG in 29 patients  (96.7%) and EBV IgG in 27 patients (90%). Anti-GM1 was found in 3 patients  (10%) and anti- GM3 was found only in one patient  (3.3%). However, no statistical significant association  was found  between the AGA and strain of the disease and ED findings.
Conclusion: Despite the coexistence  of AGA and serum antibodies  against  CMV and  EBV in some GBS patients, there  was not clear association  in this regard. However, the  AGA was  positive  in  patients   who  suffered  from severe phase of the disease.

References

1. Jacobs BC, Meulstee J, van Doorn PA, van der Meche FG. Electrodiagnostic findings related to anti-GM1 and anti-GQ1b antibodies in Guillain-Barre syndrome. Muscle Nerve 1997; 20(4): 446-52.
2. van der Meche FG, Meulstee J, Vermeulen M, Kievit A. Patterns of conduction failure in the Guillain-Barre syndrome. Brain 1988; 111(Pt 2): 405-16.
3. Rajabally YA, Uncini A. Outcome and its predictors in Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 2012; 83(7): 711-8.
4. Seneviratne U. Guillain-Barre syndrome. Postgrad Med J 2000; 76(902): 774-82.
5. Esteghamati A, Keshtkar A, Gooya M, Zahraee M, Dadras M, Moosavi T. Relationship between Occurrence of Guillan-Barre Syndrome and Mass Campaign of Measles and Rubella Immunization in Iranian 5-14 Years Old Children. Iran J Pediatr 2007; 17(Suppl 2): 217-23.
6. Hughes RA, Rees JH. Clinical and epidemiologic features of Guillain-Barre syndrome. J Infect Dis 1997; 176(Suppl 2): S92-S98.
7. van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barre syndrome. Lancet Neurol 2008; 7(10): 939-50.
8. Uncini A, Manzoli C, Notturno F, Capasso M. Pitfalls in electrodiagnosis of Guillain- Barre syndrome subtypes. J Neurol Neurosurg Psychiatry 2010; 81(10): 1157-63.
9. Capasso M, Notturno F, Manzoli C, Uncini A. Involvement of sensory fibres in axonal subtypes of Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 2011; 82(6): 664-70.
10. Semchenko EA, Day CJ, Wilson JC, Grice ID, Moran AP, Korolik V. Temperature- dependent phenotypic variation of Campylobacter jejuni lipooligosaccharides. BMC Microbiol 2010; 10: 305.
11. Ledeen RW, Yu RK. Gangliosides: structure, isolation, and analysis. Methods Enzymol 1982; 83: 139-91.
12. Prendergast MM, Moran AP. Lipopolysaccharides in the development of the Guillain-Barre syndrome and Miller Fisher syndrome forms of acute inflammatory peripheral neuropathies. J Endotoxin Res 2000; 6(5): 341-59.
13. Ang CW, Jacobs BC, Laman JD. The Guillain-Barre syndrome: a true case of molecular mimicry. Trends Immunol 2004; 25(2): 61-6.
14. Nachamkin I, Shadomy SV, Moran AP, Cox N, Fitzgerald C, Ung H, et al. Anti- ganglioside antibody induction by swine (A/NJ/1976/H1N1) and other influenza vaccines: insights into vaccine-associated Guillain-Barre syndrome. J Infect Dis 2008; 198(2): 226-33.
15. Willison HJ. The immunobiology of Guillain-Barre syndromes. J Peripher Nerv Syst 2005; 10(2): 94-112.
16. Jacobs BC, van Doorn PA, Groeneveld JH, Tio-Gillen AP, van der Meche FG. Cytomegalovirus infections and anti-GM2 antibodies in Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 1997; 62(6): 641-3.
17. Irie S, Saito T, Nakamura K, Kanazawa N, Ogino M, Nukazawa T, et al. Association of anti-GM2 antibodies in Guillain-Barre syndrome with acute cytomegalovirus infection. J Neuroimmunol 1996; 68(1-2): 19-26.
18. Khalili-Shirazi A, Gregson N, Gray I, Rees J, Winer J, Hughes R. Antiganglioside antibodies in Guillain-Barre syndrome after a recent cytomegalovirus infection. J Neurol Neurosurg Psychiatry 1999; 66(3): 376-9.
19. Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 1990; 27(Suppl): S21-S24.
20. Meulstee J, van der Meche FG. Electrodiagnostic criteria for polyneuropathy and demyelination: application in 135 patients with Guillain- Barre syndrome. Dutch Guillain-Barre Study Group. J Neurol Neurosurg Psychiatry 1995; 59(5): 482-6.
21. Hao Q, Saida T, Kuroki S, Nishimura M, Nukina M, Obayashi H, et al. Antibodies to gangliosides and galactocerebroside in patients with Guillain-Barre syndrome with preceding Campylobacter jejuni and other identified infections. J Neuroimmunol 1998; 81(1-2): 116-26.
22. Kornberg AJ, Pestronk A, Bieser K, Ho TW, McKhann GM, Wu HS, et al. The clinical correlates of high-titer IgG anti-GM1 antibodies. Ann Neurol 1994; 35(2): 234-7.
23. Yuki N, Yoshino H, Sato S, Miyatake T. Acute axonal polyneuropathy associated with anti-GM1 antibodies following Campylobacter enteritis. Neurology 1990; 40(12): 1900-2.
24. Ogawara K, Kuwabara S, Mori M, Hattori T, Koga M, Yuki N. Axonal Guillain-Barre syndrome: relation to anti-ganglioside antibodies and Campylobacter jejuni infection in Japan. Ann Neurol 2000; 48(4): 624-31.
25. Sivadon V, Orlikowski D, Rozenberg F, Quincampoix JC, Caudie C, Durand MC, et al. Prevalence and characteristics of Guillain-Barre syndromes associated with Campylobacter jejuni and cytomegalovirus in greater Paris. Pathol Biol (Paris) 2005; 53(8-9): 536-8. [In French].
26. Caudie C, Vial C, Bancel J, Petiot P, Antoine JC, Gonnaud PM. Antiganglioside autoantibody profiles in Guillain-Barre syndrome. Ann Biol Clin (Paris) 2002;
27. Nafissi S, Vahabi Z, Sadeghi GM, Amirzargar AA, Naderi S. The role of cytomegalovirus, Haemophilus influenzae and Epstein Barr virus in Guillain Barre syndrome. Acta Med Iran 2013; 51(6): 372-6.
How to Cite
1.
Taheraghdam A, Pourkhanjar P, Talebi M, Bonyadi M, Pashapour A, Sharifipour E, Rikhtegar R. Correlations between cytomegalovirus, Epstein-Barr virus, anti-ganglioside antibodies, electrodiagnostic findings and functional status in Guillain-Barré syndrome. Curr J Neurol. 13(1):7-12.
Section
Special Articles