Guillain-Barré syndrome.

Autor: Leonhard SE; Department of Clinical Microbiology and Infectious Disease, Erasmus MC, Rotterdam, The Netherlands., Papri N; Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh.; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands., Querol L; Neuromuscular Unit, Department of Neurology, Hospital de la Santa Creu i Santa Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red para Enfermedades Raras, CIBERER, Madrid, Spain., Rinaldi S; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.; Department of Neurology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK., Shahrizaila N; Neurology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Jacobs BC; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands. b.jacobs@erasmusmc.nl.; Department of Immunology, Erasmus MC, Rotterdam, The Netherlands. b.jacobs@erasmusmc.nl.; Erasmus MC Center of Expertise for Neuromuscular Diseases, Rotterdam, The Netherlands. b.jacobs@erasmusmc.nl.
Jazyk: angličtina
Zdroj: Nature reviews. Disease primers [Nat Rev Dis Primers] 2024 Dec 19; Vol. 10 (1), pp. 97. Date of Electronic Publication: 2024 Dec 19.
DOI: 10.1038/s41572-024-00580-4
Abstrakt: Guillain-Barré syndrome (GBS) is a rare immune-mediated polyradiculoneuropathy. Patients typically develop rapidly progressive weakness and sensory deficits that can result in complete paralysis requiring mechanical ventilation. GBS is usually a monophasic disease in which an aberrant immune response to an infection or other trigger damages the peripheral nerves. For example, in patients with preceding Campylobacter jejuni infection, molecular mimicry causes a cross-reactive antibody response to nerve gangliosides. Diagnosis is based on clinical features, supported by cerebrospinal fluid analysis and nerve conduction studies. Effective treatments include plasma exchange and intravenous immunoglobulins. However, ~20% of patients who received treatment are unable to walk after 6 months and ~5% die as a consequence of GBS. Important knowledge gaps in GBS include its pathogenesis, especially after viral infections. In addition, there is a lack of specific biomarkers to improve the diagnosis, monitor the disease activity, and predict the clinical course and outcome of GBS. Major challenges for the future include finding more effective and personalized treatments, which are affordable in low-income and middle-income countries, and preparation for outbreaks of infections as potential triggers for GBS.
Competing Interests: Competing interests: S.E.L. declares no competing interests. N.P. declares no competing interests. N.S. declares no competing interests. S.R. reports institutional funding for research related to Guillain–Barré syndrome (GBS) from the Wellcome Trust, Medical Research Council (UK) and GBS-CIDP Foundation International. He has undertaken consultancies for argenx, Hansa Biopharma, Dainthus and Annexon related to the treatment of inflammatory neuropathies. He is a member of the IGOS biobank committee and of the Medical Advisory Board of the GBS and related inflammatory neuropathies (GAIN) patient support group. L.Q. received research grants from Instituto de Salud Carlos III – Ministry of Economy and Innovation (Spain), CIBERER, Fundació La Marató, GBS-CIDP Foundation International, UCB, argenx and Grifols. L.Q. received speaker or expert testimony honoraria from CSL Behring, Novartis, Sanofi Genzyme, Merck, Annexon, Alnylam, Janssen, argenx, UCB, Dianthus, LFB, Avilar Therapeutics, Nuvig Therapeutics, Takeda and Roche. L.Q. serves at the Clinical Trial Steering Committees for Sanofi Genzyme and argenx, and was Principal Investigator for UCB’s CIDP01 trial. L.Q. is a member of the Steering Committee of IGOS. B.C.J. reports institutional funding for research related to GBS from Prinses Beatrix Spierfonds, Zon-MW, GBS-CIDP Foundation International, Horizon 2020, Grifols, CSL Behring, Annexon, Roche and Hansa Biopharma. B.C.J. is in the Clinical Trial Committee of Annexon. B.C.J. serves as the chair of the Steering Committee of IGOS and is a member of the Global Medical Advisory Board of the GBS-CIDP Foundation International.
(© 2024. Springer Nature Limited.)
Databáze: MEDLINE
Externí odkaz: