Zespół guillaina-barrégo
Etiologia i przyczyny
Zespół Guillaina-Barrégo (GBS) jest rzadkim, autoimmunologicznym zaburzeniem neurologicznym, w którym układ odpornościowy atakuje nerwy obwodowe, najczęściej po infekcjach układu oddechowego lub przewodu pokarmowego. Około 50-70% pacjentów zgłasza infekcję w okresie 1-6 tygodni przed wystąpieniem objawów neurologicznych. Najważniejsze patogeny wywołujące GBS to Campylobacter jejuni (30-40% przypadków), CMV, EBV, Mycoplasma pneumoniae, wirus grypy, wirus Zika, SARS-CoV-2 oraz wirusy zapalenia wątroby i HIV. Patogeneza opiera się na mimikrze molekularnej, gdzie przeciwciała przeciwko patogenom reagują krzyżowo z gangliozydami nerwów obwodowych, prowadząc do uszkodzenia osłonki mielinowej (AIDP) lub aksonów (AMAN, AMSAN). Rzadko GBS może być związany ze szczepieniami, np. szczepionką przeciw grypie A/H1N1 z 1976 roku (ryzyko 1 dodatkowego przypadku na 100 000 szczepień) oraz szczepionkami przeciw COVID-19, choć związek przyczynowy nie jest jednoznaczny.
- Etiologia zespołu Guillaina-Barrégo
- Infekcje poprzedzające jako najczęstszy czynnik wyzwalający
- Mechanizm autoimmunologiczny GBS
- Szczepienia jako czynnik ryzyka
- Inne czynniki wyzwalające
- Predyspozycje genetyczne i indywidualne
- Zróżnicowanie podtypów GBS i ich etiologia
- Czynniki środowiskowe i geograficzne
- Podsumowanie etiologii zespołu Guillaina-Barrégo
Etiologia zespołu Guillaina-Barrégo
Zespół Guillaina-Barrégo (Guillain-Barré Syndrome, GBS) jest rzadkim zaburzeniem neurologicznym, w którym układ odpornościowy organizmu atakuje nerwy obwodowe. Chociaż dokładna przyczyna GBS pozostaje nieznana, istnieje wiele czynników, które mogą wywołać tę chorobę autoimmunologiczną12. Charakterystyczną cechą zespołu Guillaina-Barrégo jest fakt, że około dwóch trzecich pacjentów zgłasza objawy infekcji w okresie od jednego do sześciu tygodni przed wystąpieniem objawów neurologicznych34.
Infekcje poprzedzające jako najczęstszy czynnik wyzwalający
Najczęstszym mechanizmem wyzwalającym GBS są przebyte infekcje, zarówno układu oddechowego, jak i przewodu pokarmowego. Około 50-70% pacjentów z zespołem Guillaina-Barrégo doświadczyło infekcji w okresie od 1 do 6 tygodni przed wystąpieniem objawów neurologicznych45. Wśród najważniejszych patogenów związanych z GBS wymienia się:
- Campylobacter jejuni – najczęściej identyfikowany patogen u pacjentów z GBS, odpowiedzialny za około 30-40% przypadków. Jest to bakteria powszechnie znajdowana w niedogotowanym drobiu i będąca częstą przyczyną zatruć pokarmowych67.
- Cytomegalowirus (CMV) – drugi najczęściej raportowany czynnik zakaźny poprzedzający GBS6.
- Wirus Epsteina-Barr (EBV) – często związany z mononukleozą zakaźną6.
- Mycoplasma pneumoniae – bakteria powodująca atypowe zapalenie płuc8.
- Wirus grypy – infekcje grypowe mogą poprzedzać wystąpienie GBS9.
- Wirus Zika – podczas epidemii wirusa Zika w Polinezji Francuskiej w 2013 roku oraz w Ameryce Łacińskiej i na Karaibach w latach 2015-2016 zaobserwowano zwiększoną liczbę przypadków GBS10.
- SARS-CoV-2 (COVID-19) – istnieją dowody na związek między COVID-19 a rozwojem powikłań neurologicznych, w tym zespołu Guillaina-Barrégo6.
- Wirusy zapalenia wątroby (A, B, C i E) – mogą być także związane z GBS11.
- HIV – choć rzadko, również infekcja HIV może poprzedzać GBS9.
Mechanizm autoimmunologiczny GBS
Zespół Guillaina-Barrégo jest uważany za chorobę autoimmunologiczną, w której układ odpornościowy błędnie atakuje własne tkanki organizmu. W przypadku GBS, celem ataku są nerwy obwodowe, a dokładniej ich osłonka mielinowa lub aksony911. Główny mechanizm patofizjologiczny obejmuje:
- Mimikrę molekularną – występuje, gdy antygeny patogenów (np. lipooligosacharydy w błonie zewnętrznej Campylobacter jejuni) są strukturalnie podobne do gangliozydów znajdujących się w nerwach obwodowych. To strukturalne podobieństwo powoduje, że przeciwciała wytwarzane przeciwko patogenowi reagują krzyżowo z własnymi nerwami, powodując uszkodzenie312.
- Uszkodzenie osłonki mielinowej – w najczęstszej postaci GBS, ostrej zapalnej poliradikuloneuropatii demielinizacyjnej (AIDP), układ odpornościowy atakuje osłonkę mielinową nerwów. Uszkodzenie mieliny uniemożliwia prawidłowe przewodzenie impulsów nerwowych, co prowadzi do osłabienia, drętwienia lub porażenia1.
- Uszkodzenie aksonów – w niektórych formach GBS (np. ostra aksonalna neuropatia ruchowa – AMAN) dochodzi do bezpośredniego uszkodzenia aksonów, co powoduje zatrzymanie przekazywania sygnałów nerwowych9.
Badania na modelach zwierzęcych potwierdziły kluczową rolę mimikry molekularnej w patogenezie GBS. Reakcja immunologiczna, która początkowo jest skierowana przeciwko patogenowi, prowadzi do wytworzenia przeciwciał skierowanych przeciwko gangliozytom, które są składnikami nerwów obwodowych3.
Szczepienia jako czynnik ryzyka
W bardzo rzadkich przypadkach GBS może być związany czasowo z niektórymi szczepieniami. Najlepiej udokumentowany związek dotyczy szczepionki przeciwko grypie A/H1N1 z 1976 roku, kiedy to zaobserwowano zwiększoną częstość występowania GBS, z ryzykiem około jednego dodatkowego przypadku GBS na 100 000 zaszczepionych osób1314.
Jednak późniejsze dane z nadzoru nad szczepieniami przeciwko grypie w kolejnych latach wykazały znacznie niższe ryzyko, wynoszące około jeden dodatkowy przypadek GBS na 1 milion szczepień3. Co istotne, badania szacują, że ryzyko rozwoju GBS po zakażeniu grypą jest nawet 7 razy wyższe niż po szczepieniu311.
W kontekście pandemii COVID-19, FDA (Amerykańska Agencja ds. Żywności i Leków) ogłosiła w lipcu 2021 roku, że szczepionka przeciwko COVID-19 firmy Johnson & Johnson może zwiększać ryzyko rozwoju GBS, dodając to ostrzeżenie do ulotki produktu6. Podobne obawy dotyczyły szczepionki Oxford-AstraZeneca14. Należy jednak podkreślić, że częstość występowania GBS w populacji ogólnej USA pozostaje podobna, a związek przyczynowy między szczepionkami przeciwko COVID-19 a GBS nie został jednoznacznie ustalony15.
Inne czynniki wyzwalające
Poza infekcjami i szczepieniami, zidentyfikowano również inne potencjalne czynniki wyzwalające zespół Guillaina-Barrégo:
- Operacje chirurgiczne – w niektórych przypadkach GBS może wystąpić po zabiegach chirurgicznych2. Stres i reakcja immunologiczna wywołana operacją mogą przyczynić się do wystąpienia GBS16.
- Urazy – rzadko, ale urazy mogą być czynnikiem wyzwalającym GBS11.
- Choroby autoimmunologiczne – GBS może wystąpić w powiązaniu z innymi chorobami autoimmunologicznymi, takimi jak toczeń rumieniowaty układowy9.
- Chłoniak Hodgkina – nowotwór układu limfatycznego może zwiększać ryzyko wystąpienia GBS9.
- Ciąża – choć rzadko, ciąża również była zgłaszana jako możliwy czynnik wyzwalający GBS6.
- Leki immunobiologiczne – antagoniści czynnika martwicy nowotworów, inhibitory punktów kontrolnych układu immunologicznego czy interferony typu I były zgłaszane jako potencjalnie związane z GBS10.
Predyspozycje genetyczne i indywidualne
Chociaż zespół Guillaina-Barrégo nie jest dziedziczny, badania sugerują możliwość istnienia predyspozycji genetycznych do rozwoju tej choroby17. Fakt, że mniej niż 1 na 1000 pacjentów z infekcją Campylobacter jejuni rozwija GBS, wskazuje na istotną rolę czynników gospodarza w procesie patologicznym8.
Ponadto zaobserwowano, że GBS częściej występuje u:
- Osób starszych – częstość występowania GBS wzrasta z wiekiem, a osoby powyżej 50 roku życia są najbardziej narażone9.
- Mężczyzn – GBS dotyka nieco częściej mężczyzn niż kobiety18.
Interesujące jest również, że u pacjentów z nawracającym GBS mogą występować podobne objawy kliniczne w kolejnych epizodach, mimo występowania takich samych lub różnych czynników wyzwalających. Sugeruje to, że czynniki genetyczne lub immunologiczne gospodarza mogą odgrywać ważną rolę w nawrotowym GBS19.
Zróżnicowanie podtypów GBS i ich etiologia
Zespół Guillaina-Barrégo obejmuje kilka podtypów, które różnią się patogenezą, objawami klinicznymi i związkami z określonymi patogenami. Główne podtypy to:
- Ostra zapalna poliradikuloneuropatia demielinizacyjna (AIDP) – najczęstsza forma w krajach zachodnich, stanowiąca około 95% przypadków GBS. Charakteryzuje się demielinizacją nerwów obwodowych20.
- Ostra aksonalna neuropatia ruchowa (AMAN) – związana z przeciwciałami przeciwko gangliozytom GM1, GM1b, GD1a i GalNac-GD1a. Często występuje po infekcji Campylobacter jejuni20.
- Ostra aksonalna neuropatia ruchowa i czuciowa (AMSAN) – związana z przeciwciałami przeciwko gangliozytom GM1, GM1b i GD1a20.
- Zespół Millera Fishera (MFS) – wariant GBS charakteryzujący się oftalmoplegią, ataksją i arefleksją. Prawie wszyscy pacjenci z MFS mają przeciwciała anty-GQ1b19.
Specyficzne przeciwciała przeciwko gangliozytom (np. anty-GM1, anty-GQ1B) są odpowiedzialne za atakowanie i uszkadzanie złączy nerwowo-mięśniowych lub nerwów obwodowych. Na przykład, przeciwciała anty-GD1a u pacjentów wiążą się ze złączem nerwowo-mięśniowym oraz węzłami Ranviera nerwów obwodowych i myelin paranodal dotkniętych nerwów21.
Czynniki środowiskowe i geograficzne
Interesujące jest, że częstość występowania zespołu Guillaina-Barrégo może się różnić w zależności od regionu geograficznego. Najwyższy standaryzowany wskaźnik rozpowszechnienia GBS odnotowano w Japonii, prawdopodobnie ze względu na wysoką częstość występowania infekcji Campylobacter jejuni oraz przypuszczalnie również ze względu na predyspozycje genetyczne i środowiskowe22.
Ponadto, zwiększona ekspozycja na potencjalne przyczyny GBS, takie jak infekcje Campylobacter jejuni, Haemophilus influenzae, cytomegalowirus, wirus Zika i niektóre inne infekcje układu oddechowego lub przewodu pokarmowego, może być kolejnym powodem obserwowanego wzrostu zachorowań w niektórych regionach22.
Czynniki środowiskowe, takie jak wzrastające zanieczyszczenie powietrza, złe warunki higieniczne, ekspozycja na pewne toksyny i zmiany klimatyczne, mogą również odgrywać rolę w dysregulacji układu odpornościowego, potencjalnie wyzwalając reakcje autoimmunologiczne, takie jak GBS23.
Podsumowanie etiologii zespołu Guillaina-Barrégo
Zespół Guillaina-Barrégo jest rzadkim, ale potencjalnie zagrażającym życiu zaburzeniem autoimmunologicznym, którego dokładna przyczyna pozostaje nieznana. Najczęściej występuje po infekcjach bakteryjnych lub wirusowych, szczególnie ukierunkowanych na układ oddechowy lub przewód pokarmowy. Mimikra molekularna jest prawdopodobnie kluczowym mechanizmem patofizjologicznym, gdzie przeciwciała skierowane przeciwko patogenom reagują krzyżowo z składnikami nerwów obwodowych, prowadząc do ich uszkodzenia.
Inne rzadkie czynniki wyzwalające obejmują szczepienia, operacje, urazy i choroby współistniejące. Chociaż GBS nie jest dziedziczny, czynniki genetyczne i immunologiczne gospodarza prawdopodobnie odgrywają rolę w określaniu podatności na tę chorobę oraz jej podtypu i ciężkości. Zrozumienie różnych czynników etiologicznych i mechanizmów patogenetycznych jest kluczowe dla opracowania lepszych metod diagnostycznych i terapeutycznych dla pacjentów z zespołem Guillaina-Barrégo123.
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Materiały źródłowe
- #1 Guillain-Barre syndrome – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793
Guillain-Barre syndrome is rare, and the exact cause is not known. But two-thirds of people have symptoms of an infection in the six weeks before Guillain-Barre symptoms begin. Infections can include a respiratory or a gastrointestinal infection, including COVID-19. Guillain-Barre also can be caused by the Zika virus. […] The exact cause of Guillain-Barre syndrome isn’t known. It usually appears days or weeks after a respiratory or digestive tract infection. Rarely, recent surgery or vaccination can trigger Guillain-Barre syndrome. […] In Guillain-Barre syndrome, your immune system which usually attacks only invading organisms begins attacking the nerves. In AIDP, the nerves’ protective covering, known as the myelin sheath, is damaged. The damage prevents nerves from transmitting signals to your brain, causing weakness, numbness or paralysis. […] Guillain-Barre syndrome may be triggered by: Most commonly, an infection with campylobacter, a type of bacteria often found in undercooked poultry. […] COVID-19 virus.
- #2 Guillain-Barré Syndrome | National Institute of Neurological Disorders and Strokehttps://www.ninds.nih.gov/health-information/disorders/guillain-barre-syndrome
Guillain-Barr syndrome (GBS) is a rare neurological disorder in which a person’s immune system mistakenly attacks part of their peripheral nervous system. […] GBS is not contagious or inherited and the exact cause is unknown. […] Since the body’s own immune system does the damage, GBS is called an autoimmune disease. […] In GBS, however, the immune system mistakenly attacks the healthy nerves. This attack may start as a fight against an infection. […] GBS usually starts a few days or weeks following a respiratory or gastrointestinal bacterial or viral infection. […] One of the most common risk factors for GBS is infection with the bacteria Campylobacter jejuni, which causes gastroenteritis. […] Sometimes, surgery will trigger the syndrome. […] In very rare cases certain vaccinations may increase the risk of GBS. […] Some countries worldwide reported an increased incidence of GBS following infection with the COVID-19, Zika, cytomegalovirus, or Epstein-Barr viruses.
- #3 Guillain-Barre Syndrome – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK532254/
Guillain-Barr syndrome (GBS) and its variants are considered post-infectious, immune-mediated neuropathies. Evidence from animal models suggests a key role of molecular mimicry. In Campylobacter jejuni gastrointestinal infections, a lipooligosaccharide present in the outer membrane of the bacteria is similar to gangliosides which are components of the peripheral nerves. Therefore, an immune response triggered to fight infection can lead to a cross-reaction on host nerves. […] Many infections have been linked with GBS. The most common are gastrointestinal or respiratory illnesses. Up to 70% of patients have reported an antecedent illness in the 1 to 6 weeks before the presentation of GBS. […] During the Zika virus outbreak, many GBS cases were described. […] Case reports detail many other possible etiologies linked to GBS, including medications and surgeries. In 1976, flu vaccination against the influenza A/H1N1 antigen led to a well-documented, increased incidence of cases of GBS; however, further surveillance data of flu vaccinations in subsequent years have described only one additional case of GBS for every 1 million vaccines. Subsequent studies estimate that developing GBS after a flu infection is up to 7 times more likely than developing GBS after a vaccination.
- #4 Guillain-Barré Syndrome (GBS): Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/15838-guillain-barre-syndrome
Guillain-Barr syndrome is a post-infectious, immune-mediated neuropathy. This means: […] The condition typically develops after you’ve had some type of infection (post- means after). In up to 70% of people who’ve had GBS, their symptoms started within one to six weeks of an illness. Researchers don’t know why GBS affects some people after they get sick and not others. […] An immune-mediated condition results from an abnormal immune system response. For some people, after they get sick, their immune system responds abnormally and attacks and damages their peripheral nerves, leading to GBS. This is another way of saying it’s an autoimmune condition. But unlike most autoimmune conditions, GBS isn’t chronic (lifelong). […] Researchers have identified some infections and other immune system-related factors that can trigger Guillain-Barr syndrome, including:
- #4 Guillain-Barré Syndrome (GBS): Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/15838-guillain-barre-syndrome
About 2 in 3 people with GBS had diarrhea or a respiratory infection weeks before developing GBS symptoms. Infection with the bacteria Campylobacter jejuni, which causes diarrhea, is one of the most common triggers of GBS. […] Some people with GBS have had the flu or infections with cytomegalovirus, Epstein-Barr virus, Zika virus or other viruses. […] In very rare cases, people have developed GBS in the days or weeks after getting certain vaccines. It’s important to know that the benefits of vaccination far outweigh the possible risks. Studies show that you have a greater chance of getting GBS after getting the flu than you do after getting vaccinated against the flu. […] Very rarely, GBS can develop after any surgery.
- #5 Guillain-Barré Syndrome | Campylobacter | CDChttps://www.cdc.gov/campylobacter/signs-symptoms/guillain-barre-syndrome.html
Guillain-Barr syndrome (GBS) is a rare condition that causes nerve damage. […] Campylobacter infection is one of the most common causes of GBS in the United States. […] About 1 in every 1,000 people with Campylobacter infection gets GBS. […] At least 1 in every 20 people with GBS had a recent Campylobacter infection. […] Some studies found as many as 8 in every 20 people with GBS had a recent Campylobacter infection. […] About 2 in every 3 people had diarrhea or a respiratory illness before developing GBS. […] Some people with GBS had the flu or infection with cytomegalovirus, Epstein Barr virus, Zika virus, or other viruses. […] Very rarely, people have developed GBS after getting certain vaccines.
- #6 Guillain-Barre Syndrome: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/315632-overview
GBS is considered to be a postinfectious, immune-mediated disease targeting peripheral nerves. Up to two thirds of patients report an antecedent bacterial or viral illness prior to the onset of neurologic symptoms. […] In several studies, C jejuni was the most commonly isolated pathogen in GBS. […] The virulence of C jejuni is thought to result from the presence of specific antigens in its capsule that are shared with nerves. […] Cytomegalovirus (CMV) infections are the second most commonly reported infections preceding GBS, with CMV being the most common viral trigger of GBS. […] Evidence exists that coronavirus disease 2019 (COVID-19) is linked to the development of neurologic complications, including GBS. […] Other significant, although less frequently identified, infectious agents in GBS patients include Epstein-Barr virus (EBV), Mycoplasma pneumoniae, and varicella-zoster virus.
- #6 Guillain-Barre Syndrome: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/315632-overview
Vaccinations have been linked to GBS by temporal association. […] In July 2021, the US Food and Drug Administration (FDA) announced that the Janssen (Johnson Johnson) COVID-19 vaccine may increase the risk of developing GBS, adding the warning to the vaccines label. […] In a case-controlled study, patients with GBS reported more frequent penicillin and antimotility drug use and less frequent oral contraceptive use. However, no definite cause-effect relationships have been established. […] Various events, such as surgery, trauma, and pregnancy, have been reported as possible triggers of GBS, but these associations remain mostly anecdotal.
- #7 What Causes Guillain-Barre Syndrome? – AmeriPharma® Specialty Carehttps://ameripharmaspecialty.com/guillain-barre-syndrome/what-causes-guillain-barre-syndrome/
Infections and certain medical conditions can often serve as precursors to autoimmune responses and cause the onset of Guillain-Barre syndrome. The following are the most common triggering causes of GBS. […] Studies show that infections with this bacterium can trigger autoimmune responses. Approximately 30-40% of GBS cases are related to this bacterial infection. […] CMV is one of the potential triggering causes of Guillain-Barre syndrome in 0.6 â 2.2 per 1000 cases. It can provoke a strong immune response, particularly in immunocompromised individuals, and contribute to disease development. […] What causes GBS following an EBV infection is the immune systemâs attempt to eliminate the virus, but inadvertently damaging the myelin sheath of nerves. […] Emerging evidence shows that infections with this virus may sometimes trigger Guillain-Barre syndrome.
- #8 Guillain-Barré Syndrome | AAFPhttps://www.aafp.org/pubs/afp/issues/2013/0201/p191.html
Several infections have been implicated in the development of GBS. About two-thirds of patients with the disease report respiratory or gastrointestinal symptoms in the three weeks before the onset of GBS symptoms. The strongest evidence implicates Campylobacter jejuni infection, but GBS also has been reported following infection with Mycoplasma pneumoniae, Haemophilus influenzae, cytomegalovirus, and Epstein-Barr virus.
- #8 Guillain-Barré Syndrome | AAFPhttps://www.aafp.org/pubs/afp/issues/2013/0201/p191.html
Guillain-Barr syndrome is believed to result from an aberrant immune response that attacks nerve tissue. This response may be triggered by surgery, immunizations, or infections. […] The mechanism of GBS is believed to be an inflammatory neuropathy due to cross reactivity between neural antigens and antibodies that is induced by specific infections. Infectious organisms, such as C. jejuni, express lipooligosaccharides in the bacterial wall similar to gangliosides. This molecular mimicry creates antiganglioside antibodies that attack nerves. The specific antibody that is stimulated and its target area in the nerve may explain the different subtypes of GBS. Fewer than one per 1,000 patients with C. jejuni infection develops GBS, suggesting that host factors play a significant role in the pathologic process. However, research has not yet identified factors that increase an individual’s risk of developing GBS.
- #9 Guillain-Barre syndrome: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000684.htm
Guillain-Barré syndrome (GBS) is a serious health problem that occurs when the body’s defense (immune) system mistakenly attacks part of the peripheral nervous system. This leads to nerve inflammation that causes muscle weakness or paralysis and other symptoms. […] The exact cause of GBS is unknown. It is thought that GBS is an autoimmune disorder. With an autoimmune disorder, the body’s immune system attacks itself by mistake. The incidence of GBS increases with aging, but can occur at any age. People older than 50 years are at the greatest risk. […] GBS may occur following infections from viruses or bacteria, such as: Influenza, Some gastrointestinal illnesses, Mycoplasma pneumonia, HIV, the virus that causes HIV/AIDS (very rare), Herpes simplex, Mononucleosis, COVID-19. […] GBS may also occur with other medical conditions, such as: Systemic lupus erythematosus, Hodgkin disease, After surgery.
- #9 Guillain-Barre syndrome: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000684.htm
GBS damages parts of nerves. This nerve damage causes tingling, muscle weakness, loss of balance, and paralysis. GBS most often affects the nerve covering (myelin sheath). This damage is called demyelination. It causes nerve signals to move more slowly. Damage to other parts of the nerve can cause the nerve to stop working.
- #10 Diagnosis and management of GuillainâBarré syndrome in ten steps | Nature Reviews Neurologyhttps://www.nature.com/articles/s41582-019-0250-9
GuillainBarr syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. […] GBS is thought to be caused by an aberrant immune response to infections that results in damage to peripheral nerves, although the pathogenesis is not fully understood. In a subgroup of patients with GBS, serum antibodies are found against gangliosides, which reside at high densities in the axolemma and other components of the peripheral nerves. […] The incidence of GBS can increase during outbreaks of infectious illnesses that trigger the disease. Most recently, the Zika virus epidemics in French Polynesia in 2013 and in Latin America and the Caribbean in 20152016 were linked to an increase in individuals being diagnosed with GBS.
- #10 Diagnosis and management of GuillainâBarré syndrome in ten steps | Nature Reviews Neurologyhttps://www.nature.com/articles/s41582-019-0250-9
Six pathogens have been temporally associated with GBS in casecontrol studies: Campylobacter jejuni, cytomegalovirus, hepatitis E virus, Mycoplasma pneumoniae, EpsteinBarr virus and Zika virus. […] Vaccines were first linked to GBS in 1976 when a 7.3-fold increase in the risk of GBS was observed among nonmilitary individuals in the United States who had received the swine influenza vaccine. […] A relationship between administration of immunobiologicals (for example, tumour necrosis factor antagonists, immune checkpoint inhibitors or type I interferons) and GBS has been reported on the basis of case series information and biological plausibility.
- #11 Guillain-Barré Syndrome: Causes, Symptoms, and Treatmenthttps://www.webmd.com/brain/what-is-guillain-barre
It’s most often associated with a recent digestive or respiratory infection, and less often with other illnesses, surgery, trauma, or vaccines. About two-thirds of people who develop Guillain-Barr have diarrhea or respiratory symptoms in the days or weeks before nervous system symptoms start. […] Some potential GBS triggers include: Campylobacter, a type of bacteria found in undercooked poultry and thought to be the most common trigger; Influenza virus; COVID-19 virus; Cytomegalovirus; Epstein-Barr virus; Zika virus; Hepatitis A, B, C and E; HIV, the virus that causes AIDS; Mycoplasma pneumonia; Surgery; Trauma; Hodgkin’s lymphoma; COVID-19 vaccines from Johnson Johnson and AstraZeneca. […] While Guillain-Barr is more common after exposure to these things, it’s not clear why these triggers are linked to this condition and why some people, but not most, get GBS after an infection or other medical event.
- #11 Guillain-Barré Syndrome: Causes, Symptoms, and Treatmenthttps://www.webmd.com/brain/what-is-guillain-barre
Guillain-Barr Syndrome (GBS) is a rare disorder in which your immune system suddenly attacks your nerves, often after you’ve had a stomach or respiratory bug. […] Doctors know GBS is not inherited or contagious. But it is linked to several infections, illnesses, and traumas. They don’t know the exact cause. […] It could be that some illnesses alter your nerve cells, so your immune system starts to view them as threats. Some scientists think your immune system forgets which cells it should and shouldn’t attack. […] When you have it, your immune system begins attacking your nerves. In AIDP, which is the most common type of GBS, the nerves’ protective covering (myelin sheath) is damaged. Sometimes, the core of the nerve, called an axon, is also damaged. The damage prevents nerves from sending signals between your brain and muscles. That means your muscles can’t respond to your brain’s commands, and your brain may get abnormal sensations from the damaged areas.
- #12 Guillain-Barré Syndrome â Zero To Finalshttps://zerotofinals.com/medicine/neurology/guillainbarre/
Guillain-Barré syndrome is usually triggered by an infection and is particularly associated with to Campylobacter jejuni, cytomegalovirus (CMV) and Epstein-Barr virus (EBV). […] Guillain-Barré is thought to occur due to a process called molecular mimicry. The B cells of the immune system create antibodies against the antigens on the triggering pathogen. These antibodies also match proteins on the peripheral neurones. They may target proteins on the myelin sheath or the nerve axon itself.
- #13 Guillain-Barré Syndrome (GBS) and Vaccines | Vaccine Safety | CDChttps://www.cdc.gov/vaccine-safety/about/guillain-barre.html
Guillain-Barr syndrome (GBS) is a rare disorder where the bodys immune system damages nerve. […] While its cause is not fully understood, the syndrome often follows infection with a virus or bacteria. […] Those who received the 1976 swine flu vaccine had a slight increased risk for developing GBS of approximately one additional case of GBS for every 100,000 people who got the swine flu vaccine. Scientists have several theories about the cause, but the exact reason for this link remains unknown. […] Recent CDC studies based on data from the Vaccine Safety Datalink (VSD) and the Vaccine Adverse Event Reporting System (VAERS) have found evidence suggesting an increased risk of GBS among adults 18 years and older after JJ/Janssen COVID-19 vaccination but not after Pfizer-BioNTech or Moderna COVID-19 vaccination.
- #14 GuillainâBarré syndrome – Wikipediahttps://en.wikipedia.org/wiki/Guillain%E2%80%93Barr%C3%A9_syndrome
GBS is known to occur after influenza and influenza vaccination has been demonstrated to be associated with a reduced risk. […] An increased incidence of GuillainBarr syndrome followed influenza immunization that followed the 1976 swine flu outbreak; 8.8 cases per million recipients developed it as a complication. […] GBS has been reported in association with COVID-19, and may be a potential neurological complication of the disease. […] GBS has been reported as a very rare side effect of the Janssen and OxfordAstraZeneca COVID-19 vaccines. […] Zimelidine, an antidepressant, had a very favorable safety profile but as a result of rare case reports of GuillainBarr syndrome was withdrawn from the market.
- #15 Guillain-Barré Syndrome > Fact Sheets > Yale Medicinehttps://www.yalemedicine.org/conditions/guillain-barre-syndrome
However, the annual incidence of GBS in the general U.S. population is about the same. Therefore, at this time it is unclear if suspected GBS cases following the Johnson Johnson COVID vaccines are caused by the vaccine or simply a coincidence. […] It is thought that in GBS, some of the antibodies targeting bacterial or viral invaders mistakenly target nerve cells. This compromises nerve function, causing the symptoms of GBS.
- #16 What is Guillain-Barré Syndrome?: Symptoms and Causes Explained | Brain And Spine Specialistshttps://brainandspinecenterllc.com/2024/07/23/what-is-guillain-barre-syndrome-symptoms-and-causes-explained/
Guillain-Barré Syndrome is a rare but serious autoimmune disorder. In GBS, the bodyâs immune system mistakenly attacks the protective sheath surrounding the peripheral nerves. […] You might be surprised to learn that the exact cause of GBS is still not fully understood. While it is known that GBS is caused by the immune system mistakenly attacking the peripheral nerves, experts are not entirely sure why this occurs. It is believed to involve a combination of genetic and environmental factors, and some common triggers have been identified. […] Many cases of GBS occur after a person has had a respiratory or gastrointestinal infection. Common infectious triggers include the bacteria Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, and Zika virus. […] Some individuals develop GBS after undergoing surgery. The stress and immune response triggered by surgery might contribute to the onset of GBS. […] Although extremely rare, some vaccines have been associated with the onset of GBS. Itâs important to note that the benefits of vaccination far outweigh these rare risks.
- #17 Guillain-Barré Syndrome | The Foundation for Peripheral Neuropathyhttps://www.foundationforpn.org/causes/guillain-barre-syndrome/
Guillain-Barré (ghee-yan bah-ray) syndrome (GBS) is a rare inflammatory disorder in which the bodyâs immune system attacks the protective covering of the peripheral nerves (myelin sheath), preventing the nerves from sending signals to the muscles. […] GBS can strike anyone, regardless of age or sex. GBS is not contagious, but it may follow a bacterial or viral infection, such as campylobacterial infection (caused by a bacteria found in undercooked food, especially poultry) or Epstein-Barr virus (EBV). […] Although GBS is not inherited, there may be a genetic predisposition to the disease. […] It is called a syndrome rather than a disease because it is not clear that a specific disease-causing agent is involved. No one yet knows why GBS strikes some people and not others, or what sets the disease in motion.
- #18 Guillain-Barre Syndrome Risk Factors – AmeriPharma® Specialty Carehttps://ameripharmaspecialty.com/guillain-barre-syndrome/guillain-barre-syndrome-risk-factors/
Some studies suggest that the risk may increase after influenza vaccination. […] GBS affects slightly more men than women. […] Surgery-induced GBS, also called post-surgical GBS, may affect 5 â 9% of adults. […] In 2021, a team of Indian researchers shared five case reports, suggesting a possible link between COVID-19 and GBS. […] A higher risk of GBS is anticipated in those receiving vector-based COVID-19 vaccines. […] As with other vaccines, the increase in GBS risk following COVID-19 vaccination is insignificant. […] Some studies have linked COVID-19 and other vaccines to this disease. But the risk is insignificant.
- #19 Recurrent GuillainâBarré syndrome | Journal of Neurology, Neurosurgery & Psychiatryhttps://jnnp.bmj.com/content/80/1/56
GuillainBarr syndrome (GBS) is generally considered to be monophasic, but recurrences do occur in a presently undefined subgroup of patients. […] It is suggested that recurrent GBS patients may have similar clinical symptoms in subsequent episodes, while having the same or different triggering events. […] Genetic or immunological host factors may play an important role in recurrent GBS, since these patients can develop similar symptoms after different preceding infections. […] Although GBS is considered to be monophasic, recurrences are reported in 25% of patients. […] The recurrent patients were younger and more often had MFS and a milder course of disease, which suggests that a distinct subgroup of patients has a higher susceptibility of recurring. […] Our observations identify a trend towards shorter intervals between subsequent recurrences, and a more severe deficit with each recurrence.
- #19 Recurrent GuillainâBarré syndrome | Journal of Neurology, Neurosurgery & Psychiatryhttps://jnnp.bmj.com/content/80/1/56
Recurrent patients are more likely to have MFS than non-recurrent patients. The presence of anti-GQ1b antibodies in almost all MFS patients highlights the importance of immunological factors in this disorder. […] Individual patients developed either GBS during all episodes or MFS, never both. Because recurrent GBS patients were significantly younger, more mildly affected and more often had MFS, neurologists should be aware that these patients are more prone to recurrences. Since similar neurological symptoms can occur after different infections, this study further indicates that immunological and genetic host factors play a role in determining the clinical phenotype in recurrent GBS.
- #20 Guillain-Barré Syndrome: Causes, Symptoms, Treatmenthttps://patient.info/doctor/guillain-barre-syndrome-pro
History of acute viral or bacterial infectious illness from 1-3 weeks prior to the onset of weakness. […] Vaccinations: live and dead vaccines have been implicated. Although there have been case reports of GBS following COVID-19 vaccination, a causal link has not yet been established. […] Guillain-Barr syndrome consists of a number of subtypes, including: AIDP, Acute motor and sensory axonal neuropathy (AMSAN): associated with the antibodies GM1, GM1b and GD1a, Acute motor axonal neuropathy (AMAN): associated with the antibodies GM1, GM1b, GD1a and GalNac-GD1a, Acute sensory neuronopathy: associated with GD1b antibodies, Acute pandysautonomia. […] About 95% of cases of Guillain-Barr syndrome are AIDP.
- #21https://www.ijcmph.com/index.php/ijcmph/article/view/8242
GuillainBarr syndrome (GBS) is a polyradiculoneuropathy autoimmune disease that is characterized by significant inflammation that affects the peripheral nervous system in a rapidly progressive pattern that is mainly clinically presented by muscle weakness. […] Among the reported antibodies, anti-GM1 and anti-GQ1B have been reported to be responsible for attacking and damaging either the neuromuscular junctions or peripheral nerves. […] Moreover, it has been found that the anti-GD1a antibodies in patients bind to the neuromuscular junction and also bind to the nodes of Ranvier of the peripheral nerves and the paranodal myelin of the affected nerves. […] Reports have shown that this disease is identified as special forms of neuropathies that develop in immune-mediated, post-infection sequelae.
- #22 Global, regional, and national burden of GuillainâBarré syndrome and its underlying causes from 1990 to 2019 | Journal of Neuroinflammation | Full Texthttps://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-021-02319-4
GuillainBarr syndrome (GBS) is an acute immune-mediated polyneuropathy. It represents an aberrant autoimmune response to a preceding infection or other immune stimulation, which leads the immune system to attack the myelin sheaths or axons of the peripheral nerves and their spinal roots, due to molecular mimicry. […] Respiratory or gastrointestinal infection, infection with the Zika virus, and autoimmunity are some of the suggested etiologies for the development of GBS. […] The highest age-standardised prevalence rate of GBS was found in Japan, probably due to the high frequency of Campylobacter jejuni infections and presumably also due to genetic and environmental predispositions. […] Higher exposure to potential underlying causes of GBS, such as infection with Campylobacter jejuni, Haemophilus influenzae, Cytomegalovirus, Zika virus, and some other respiratory or gastrointestinal infections could be another reason for the observed increase. […] Although the proportion of the GBS YLDs attributable to the individual underlying causes differed by age group, globally upper respiratory infections and unknown causes accounted for most of the YLDs.
- #23 Guillain-Barré Syndrome (GBS) in India: Causes, Symptoms & Sudden Surge Explained | Asterhttps://www.asterhospitals.in/blogs-events-news/aster-cmi-bangalore/guillain-barre-syndrome-gbs-india-causes-symptoms-sudden-surge-explained
Guillain-Barr Syndrome (GBS) is an autoimmune disorder that affects the peripheral nervous system, often triggered by infections, including viral and bacterial illnesses. […] Many cases of GBS are associated with infections such as diarrhoea caused due to a bacteria named Campylobacter jejuni, viral infections such as dengue, chikungunya, Zika virus, and even COVID-19. […] While vaccines play a critical role in preventing infectious diseases, rare cases of GBS have been reported following certain vaccinations. […] Rising pollution levels, poor hygienic conditions, exposure to certain toxins, and climate changes may also play a role in immune system dysregulation, potentially triggering autoimmune responses like GBS. […] Some studies suggest that certain genetic factors may make individuals more prone to developing GBS, especially in populations with a high burden of infectious diseases.