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Xu L, Zhao C, Bao Y, Liu Y, Liang Y, Wei J, Liu G, Wang J, Zhan S, Wang S, Fan D. Variation in worldwide incidence of Guillain-Barré syndrome: a population-based study in urban China and existing global evidence. Front Immunol 2024; 15:1415986. [PMID: 39318625 PMCID: PMC11420027 DOI: 10.3389/fimmu.2024.1415986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 08/23/2024] [Indexed: 09/26/2024] Open
Abstract
Background and objectives Geographical variation existed in the incidences of Guillain-Barré syndrome (GBS), but no national population-based study has evaluated the incidences of GBS in China. This study aimed to estimate the incidence of GBS in urban China and evaluate the worldwide variation in the incidence of GBS. Methods Firstly, we did a population-based study to calculate the incidence of GBS in urban China based on the National Urban Medical Insurance database from 2013 to 2017. To identify GBS cases, natural language processing was used first for handling the lengthy and unstructured diagnostic information and then checked by prestigious neurologists. Secondly, a systematic review and meta-analysis were performed to analyze the incidence of GBS worldwide. Up to July 4, 2022, Medline, Embase, and Web of Science were retrieved to identify the population-based studies regarding the incidence of GBS. The basic information and the statistics regarding incidence were extracted. Quality assessment considered sample representativeness, condition assessment, and statistical methods. Results A total of 1.44 billion person-years in insurance data was covered, with 3,534 GBS cases identified. The annual incidences of GBS in urban China between 2013 and 2017 ranged from 0.41 (95% CI: 0.27 to 0.58) to 0.58 (95% CI: 0.38 to 0.82) per 100,000 person-years. The incidence was the highest in Northwest China and the lowest in Northeast China. The meta-analysis included 122 articles. The quality assessment showed that the quality scores of 43.3% of studies were ≥ 0.75 (the total score is 1). The global incidence of GBS was 1.12 (95% CI: 0.98 to 1.27) per 100,000 person-years. The incidences in West Europe, South Asia, and North Europe were higher, while the incidences in Australia and New Zealand, Southeast Asia, and North Africa were lower. The incidence of enteric infections was positively associated with the incidence of GBS (coefficient=0.0000185, P=0.007). The incidence in Europe, Australia, and America rose significantly from 1960 to 2020 (coefficient=0.01, t=2.52, P=0.015). Discussion There is a clear regional variation of the GBS incidence at both national and global levels. Careful control of enteric infections should be conducted to reduce the disease burden.
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Affiliation(s)
- Lu Xu
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
| | - Chen Zhao
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Yutong Bao
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Yuchen Liu
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Yuqing Liang
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Jiyu Wei
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Guozhen Liu
- Department of Research & Development, Peking University Health Information Technology Co., Ltd., Beijing, China
| | - Jinxi Wang
- Department of Strategic Planning, Shanghai Songsheng Business Consulting Co., Ltd., Beijing, China
| | - Siyan Zhan
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China
| | - Shengfeng Wang
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Key Laboratory for Neuroscience, National Health Commission/Ministry of Education, Peking University, Beijing, China
- Beijing Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
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Dutta D, Debnath M, Nagappa M, Das SK, Wahatule R, Sinha S, Taly AB, Ravi V. Antecedent infections in Guillain-Barré syndrome patients from south India. J Peripher Nerv Syst 2021; 26:298-306. [PMID: 34254392 DOI: 10.1111/jns.12459] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/23/2021] [Accepted: 07/06/2021] [Indexed: 12/16/2022]
Abstract
Guillain-Barré syndrome (GBS) is the commonest post-infectious inflammatory peripheral neuropathy with undiscerned aetiology. The commonly reported antecedent infections implicated in India include Campylobacter jejuni, chikungunya, dengue, and Japanese encephalitis (JE). In this study from south India, we investigated the role of these four agents in triggering GBS. This case-control study was performed on 150 treatment-naive patients with GBS and 150 age and sex-matched controls from the same community. IgM immunoreactivity for C. jejuni, chikungunya, and dengue was detected by enzyme-linked immunosorbent assay (ELISA) in serum of patients with GBS and control subjects. Immunoreactivity against JE was detected in serum as well as cerebrospinal fluid (CSF) from patients (n = 150) and orthopaedic control (n = 45) subjects. The immunoreactivity against infections was compared between demyelinating and axonal subtypes of GBS. Overall, 119/150 patients with GBS had serological evidence of antecedent infection. Amongst those with evidence of antecedent infection, 24 (16%), 8 (5%), and 9 (6%) patients were exclusively immunoreactive to chikungunya, JE, and C. jejuni, respectively. In the remaining patients (78/119), immunoreactivity to multiple pathogens was noted. Immunoreactivity to C. jejuni infection was found in 32% of GBS patients compared to 2.7% controls (P < .001), whereas to chikungunya virus was reported in 66.7% of patients with GBS compared to 44.7% controls (P = .006). Anti-dengue immunoreactivity was significantly associated with the demyelinating subtype of GBS. Patients positive for JE IgM (CSF) manifested demyelinating electrophysiology. In this large case-control study, immunoreactivity against multiple infectious agents was observed in a subset of patients. Chikungunya was the commonest antecedent infection, followed by C. jejuni.
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Affiliation(s)
- Debprasad Dutta
- Department of Human Genetics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Madhu Nagappa
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sumit Kumar Das
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Rahul Wahatule
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sanjib Sinha
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Arun B Taly
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Vasanthapuram Ravi
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Martinez-Anton L, Marenda M, Firestone SM, Bushell RN, Child G, Hamilton AI, Long SN, Le Chevoir MAR. Investigation of the Role of Campylobacter Infection in Suspected Acute Polyradiculoneuritis in Dogs. J Vet Intern Med 2018; 32:352-360. [PMID: 29356096 PMCID: PMC5787210 DOI: 10.1111/jvim.15030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/20/2017] [Accepted: 11/29/2017] [Indexed: 01/12/2023] Open
Abstract
Background Acute polyradiculoneuritis (APN) is an immune‐mediated peripheral nerve disorder in dogs that shares many similarities with Guillain‐Barré syndrome (GBS) in humans, in which the bacterial pathogen Campylobacter spp. now is considered to be a major triggering agent. Little information is available concerning the relationship between APN and Campylobacter spp. in dogs. Hypothesis/Objectives To estimate the association between Campylobacter spp. infection and APN. Associations with additional potential risk factors also were investigated, particularly consumption of raw chicken. Animals Twenty‐seven client‐owned dogs suffering from suspected APN and 47 healthy dogs, client‐owned or owned by staff members. Methods Case‐control study with incidence density‐based sampling. Fecal samples were collected from each enrolled animal to perform direct culture, DNA extraction, and polymerase chain reaction (PCR) for detection of Campylobacter spp. In some cases, species identification was performed by sequence analysis of the amplicon. Data were obtained from the medical records and owner questionnaires in both groups. Results In cases in which the fecal sample was collected within 7 days from onset of clinical signs, APN cases were 9.4 times more likely to be positive for Campylobacter spp compared to control dogs (P < 0.001). In addition, a significant association was detected between dogs affected by APN and the consumption of raw chicken (96% of APN cases; 26% of control dogs). The most common Campylobacter spp. identified was Campylobacter upsaliensis. Conclusions and Clinical Importance Raw chicken consumption is a risk factor in dogs for the development of APN, which potentially is mediated by infection with Campylobacter spp.
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Affiliation(s)
- L Martinez-Anton
- Faculty of Veterinary & Agricultural Sciences, Department of Neurology & Neurosurgery, University of Melbourne, Melbourne, Vic., Australia
| | - M Marenda
- Faculty of Veterinary & Agricultural Sciences, Department of Microbiology, University of Melbourne, Melbourne, Vic., Australia
| | - S M Firestone
- Asia-Pacific Centre for Animal Health, Faculty of Veterinary & Agricultural Sciences, University of Melbourne, Parkville, Vic., Australia
| | - R N Bushell
- Faculty of Veterinary & Agricultural Sciences, Department of Microbiology, University of Melbourne, Melbourne, Vic., Australia
| | - G Child
- Small Animal Specialist Hospital, Sydney, NSW, Australia
| | - A I Hamilton
- Small Animal Specialist Hospital, Sydney, NSW, Australia
| | - S N Long
- Centre for Animal Referral & Emergency, Melbourne, Vic., Australia
| | - M A R Le Chevoir
- Faculty of Veterinary & Agricultural Sciences, Department of Neurology & Neurosurgery, University of Melbourne, Melbourne, Vic., Australia
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Nyati KK, Prasad KN, Agrawal V, Husain N. Matrix metalloproteinases-2 and -9 in Campylobacter jejuni-induced paralytic neuropathy resembling Guillain-Barré syndrome in chickens. Microb Pathog 2017; 111:395-401. [PMID: 28916318 DOI: 10.1016/j.micpath.2017.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 09/10/2017] [Accepted: 09/11/2017] [Indexed: 11/19/2022]
Abstract
Inflammation in Guillain-Barré syndrome (GBS) is manifested by changes in matrix metalloproteinase (MMP) and pro-inflammatory cytokine expression. We investigated the expression of MMP-2, -9 and TNF-α and correlated it with pathological changes in sciatic nerve tissue from Campylobacter jejuni-induced chicken model for GBS. Campylobacter jejuni and placebo were fed to chickens and assessed for disease symptoms. Sciatic nerves were examined by histopathology and immunohistochemistry. Expressions of MMPs and TNF-α, were determined by real-time PCR, and activities of MMPs by zymography. Diarrhea developed in 73.3% chickens after infection and 60.0% of them developed GBS like neuropathy. Pathology in sciatic nerves showed perinodal and/or patchy demyelination, perivascular focal lymphocytic infiltration and myelin swelling on 10th- 20th post infection day (PID). MMP-2, -9 and TNF-α were up-regulated in progressive phase of the disease. Enhanced MMP-2, -9 and TNF-α production in progressive phase correlated with sciatic nerve pathology in C. jejuni-induced GBS chicken model.
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Affiliation(s)
- Kishan Kumar Nyati
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India.
| | - Kashi Nath Prasad
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India.
| | - Vinita Agrawal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India
| | - Nuzhat Husain
- Department of Pathology, Dr. RML Institute of Medical Sciences, Lucknow 226 010, India
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Comparative Analysis of Cultural and PCR Based Assays for Detection of Campylobacter spp. in Human Stool Samples. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40011-015-0565-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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CampylobacterSpecies. Food Microbiol 2014. [DOI: 10.1128/9781555818463.ch11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Role of Campylobacter jejuni infection in the pathogenesis of Guillain-Barré syndrome: an update. BIOMED RESEARCH INTERNATIONAL 2013; 2013:852195. [PMID: 24000328 PMCID: PMC3755430 DOI: 10.1155/2013/852195] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 07/03/2013] [Indexed: 01/25/2023]
Abstract
Our current knowledge on Campylobacter jejuni infections in humans has progressively increased over the past few decades. Infection with C. jejuni is the most common cause of bacterial gastroenteritis, sometimes surpassing other infections due to Salmonella, Shigella, and Escherichia coli. Most infections are acquired due to consumption of raw or undercooked poultry, unpasteurized milk, and contaminated water. After developing the diagnostic methods to detect C. jejuni, the possibility to identify the association of its infection with new diseases has been increased. After the successful isolation of C. jejuni, reports have been published citing the occurrence of GBS following C. jejuni infection. Thus, C. jejuni is now considered as a major triggering agent of GBS. Molecular mimicry between sialylated lipooligosaccharide structures on the cell envelope of these bacteria and ganglioside epitopes on the human nerves that generates cross-reactive immune response results in autoimmune-driven nerve damage. Though C. jejuni is associated with several pathologic forms of GBS, axonal subtypes following C. jejuni infection may be more severe. Ample amount of existing data covers a large spectrum of GBS; however, the studies on C. jejuni-associated GBS are still inconclusive. Therefore, this review provides an update on the C. jejuni infections engaged in the pathogenesis of GBS.
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Rajendran P, Babji S, George AT, Rajan DP, Kang G, Ajjampur SS. Detection and species identification of Campylobacter in stool samples of children and animals from Vellore, south India. Indian J Med Microbiol 2012; 30:85-8. [PMID: 22361767 DOI: 10.4103/0255-0857.93049] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Campylobacter spp. are an important cause of bacterial gastroenteritis frequently isolated from animal, poultry and environmental samples. In this study, we investigated the zoonotic potential of Campylobacter spp. by comparing prevalence rates and species in 394 children with diarrhoea and 652 animals in Vellore using PCR-based tools. Eighteen children (4.5%) had campylobacteriosis, a majority of whom had co-pathogens (15/18) and most were infected with Campylobacter jejuni (16/18). A few C. coli and mixed infections with both species were also seen. Among the animal samples, 16/25 chicken samples (64%) were positive and all were found to be C. jejuni.
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Affiliation(s)
- P Rajendran
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore - 632 004, Tamil Nadu, India
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Quetz JDS, Lima IFN, Havt A, Prata MMG, Cavalcante PA, Medeiros PHQS, Cid DAC, Moraes ML, Rey LC, Soares AM, Mota RMS, Weigl BH, Guerrant RL, Lima AAM. Campylobacter jejuni infection and virulence-associated genes in children with moderate to severe diarrhoea admitted to emergency rooms in northeastern Brazil. J Med Microbiol 2011; 61:507-513. [PMID: 22174372 DOI: 10.1099/jmm.0.040600-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Campylobacter is an important cause of foodborne gastroenteritis. We determined the occurrence of Campylobacter jejuni and Campylobacter coli, using culture-based methods and PCRs targeting virulence-associated genes (VAGs) among children aged ≤14 years who were treated for diarrhoea at emergency rooms in northeastern Brazil. Genomic DNA was extracted directly from stool samples collected from 366 children. A questionnaire was also applied to qualify the clinical conditions presented by each child at the time of admission. C. jejuni and C. coli were detected in 16.4 % (60/366) and 1.4 % (5/366) of the diarrhoeal samples, respectively, by PCR, a much higher proportion than that detected by conventional methods. C. jejuni VAGs were detected in the following proportions of hipO-positive samples: ciaB, 95 % (57/60); dnaJ, 86.7 % (52/60); racR, 98.3 % (59/60); flaA, 80 % (48/60); pldA, 45 % (27/60); cdtABC, 95 % (57/60); and pVir 0 % (0/60). Particular symptoms, such as blood in faeces, vomiting, fever, and/or abdominal pain, were not associated with detection of C. jejuni nor were they associated with any particular VAG or combination of VAGs (P>0.05). C. jejuni and its VAGs were detected in a substantial proportion of the children admitted. Further efforts shall be directed towards elucidating whether these genetic factors or their expressed proteins play a role in Campylobacter pathogenesis.
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Affiliation(s)
- Josiane da S Quetz
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Ila F N Lima
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Alexandre Havt
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Mara M G Prata
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Paloma A Cavalcante
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Pedro H Q S Medeiros
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - David A C Cid
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Milena L Moraes
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Luís Carlos Rey
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Alberto M Soares
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
| | - Rosa M S Mota
- Science Center/Unit of Statistics, Federal University of Ceara, Fortaleza, CE 60455-760, Brazil
| | - Bernhard H Weigl
- Program for Appropriate Technology in Health (PATH), Seattle, Washington, WA 98107, USA
| | - Richard L Guerrant
- Center for Global Health, University of Virginia, Charlottesville, VA 22908, USA
| | - Aldo A M Lima
- Institute of Biomedicine for Brazilian Semi-Arid/Clinical Research Unit, Federal University of Ceara, Fortaleza, CE 60430-270, Brazil
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Nyati KK, Prasad KN, Kharwar NK, Soni P, Husain N, Agrawal V, Jain AK. Immunopathology and Th1/Th2 immune response of Campylobacter jejuni-induced paralysis resembling Guillain-Barré syndrome in chicken. Med Microbiol Immunol 2011; 201:177-87. [PMID: 22102098 DOI: 10.1007/s00430-011-0220-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Indexed: 01/08/2023]
Abstract
Immunopathogenesis of Campylobacter jejuni-associated Guillain-Barré syndrome (GBS) is not yet well established probably due to lack of experimental model. Therefore, we studied the Th1/Th2 immune response and pathological changes in C. jejuni-induced chicken model for GBS. C. jejuni (5 × 10(9) CFU/ml) and placebo were fed to 30 chickens each. Stools of all birds were negative for C. jejuni by culture and PCR before experiment. The birds were regularly assessed for disease symptoms up to 30 days. Sciatic nerves from all chickens were examined at 5 days intervals by histopathology and immunohistochemistry, and also for the expression of Th1/Th2 cytokines. Twenty-two chickens (73.3%) developed diarrhea after C. jejuni infection; 18 (60.0%) experimental chickens developed GBS-like paralytic neuropathy. Pathology in the sciatic nerves of these chickens included perinodal and/or patchy demyelination, perivascular focal lymphocytic infiltration, myelin swelling and presence of macrophages within the nerve fibers on 10th-20th post-infection day (PID). Cytokines (IFN-γ, IL-1β, TNF-α, IL-6 and IL-2) were elevated in early phase (5th-15th PID) and TGF-β2, IL-10 and IL-4 in the recovery phase (25th-30th PID) of the disease. The study provides evidence that C. jejuni infection in the chicken can provide an experimental animal model of GBS.
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Affiliation(s)
- Kishan K Nyati
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India
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Biasi RS, Freitas de Macedo RE, Scaranello Malaquias MA, Franchin PR. Prevalence, strain identification and antimicrobial resistance of Campylobacter spp. isolated from slaughtered pig carcasses in Brazil. Food Control 2011. [DOI: 10.1016/j.foodcont.2010.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sinha S, Prasad KN, Jain D, Nyati KK, Pradhan S, Agrawal S. Immunoglobulin IgG Fc-receptor polymorphisms and HLA class II molecules in Guillain-Barré syndrome. Acta Neurol Scand 2010; 122:21-6. [PMID: 20105138 DOI: 10.1111/j.1600-0404.2009.01229.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To analyze host genetic factors immunoglobulin G Fc receptors (FcgammaRs) and human leukocyte antigen (HLA) class II in GBS patients. METHODS FcgammaRIIA, IIIA and IIIB polymorphisms were studied in 80 each GBS patients and healthy controls by allele specific PCR. HLA class II DRbeta1 and DQbeta1 typing was performed at the two-digit level by PCR in randomly selected 54 GBS patients and 202 controls. RESULTS FcgammaRIIA-H/H (56% vs 9%; P < 0.0001) and FcgammaRIIIA-V/V (40% vs 13%; P < 0.0001) genotypes, H131 allele frequencies (0.73 vs 0.26, P < 0.0001) and HLA DQbeta1*060x (OR, 1.96; 95% CI, 1.26-3.04; P < 0.01) were significantly increased in GBS than controls. DRbeta1*0701 alone (OR, 10; 95% CI, 45.90-2.25; P < 0.001) and together with FcgammaRIIA-H/H (OR, 11.03; 95% CI, 2.63-46.20; P < 0.001) was significantly associated with GBS patients having microbiological evidence of recent infection. CONCLUSIONS The study indicates that homozygous FcgammaRIIA and FcgammaRIIIA genotypes and FcgammaRIIA H131 allele are associated with GBS. HLA class II molecule DRbeta1*0701 is identified as novel genetic risk factor for development of GBS in patients with preceding infection.
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Affiliation(s)
- S Sinha
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Detection of Campylobacter jejuni by culture and real-time PCR in a French cohort of patients with Guillain-Barre syndrome. J Clin Microbiol 2010; 48:2278-81. [PMID: 20410350 DOI: 10.1128/jcm.00381-10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bacteriological culture and real-time PCR (RT-PCR) were used to detect Campylobacter jejuni in fecal samples from a French cohort of 237 patients with Guillain-Barré syndrome (GBS). We provide evidence that diverse serotypes and genotypes of C. jejuni are a major trigger of GBS in France.
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Lymphocyte transformation test detects a response to Campylobacter jejuni antigens in patients with Guillain-Barré syndrome. Med Microbiol Immunol 2010; 199:109-16. [DOI: 10.1007/s00430-010-0144-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Indexed: 10/19/2022]
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Nyati KK, Prasad KN, Verma A, Singh AK, Rizwan A, Sinha S, Paliwal VK, Pradhan S. Association of TLR4 Asp299Gly and Thr399Ile polymorphisms with Guillain-Barré syndrome in Northern Indian population. J Neuroimmunol 2009; 218:116-9. [PMID: 19913922 DOI: 10.1016/j.jneuroim.2009.10.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 10/21/2009] [Accepted: 10/23/2009] [Indexed: 11/29/2022]
Abstract
Molecular mimicry between Campylobacter jejuni lipopolysaccharide and host gangliosides induces an immune response leading to axonal damage and Guillain-Barré syndrome (GBS). TLR polymorphisms are associated with many autoimmune diseases. The role of the TLR4 gene in GBS susceptibility largely remains unknown. We investigated TLR4 polymorphism in GBS. One hundred and twenty GBS patients and 150 healthy controls were included. TLR4 (Asp299Gly and Thr399Ile) genes were studied by PCR-RFLP. TLR4 (Asp299Gly) polymorphism was significantly associated with GBS (p, 0.045; OR, 8.75; 95% CI, 1.05-72.88); only acute motor axonal neuropathy (AMAN) was associated with Gly299Gly homozygote (p, 0.027; OR, 12.40; 95% CI, 1.33-115.77) and Thr399Ile (p, 0.019; OR, 3.42; 95% CI, 1.22-9.54) heterozygote, and TLR4-399Ile allele (p, 0.045; OR, 2.63; 95% CI, 1.02-6.75) compared to controls. In conclusion, TLR4 (Asp299Gly) polymorphism is associated with an increased susceptibility to GBS. Besides Asp299Gly, AMAN subtype is also associated with Thr399Ile polymorphism.
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Affiliation(s)
- Kishan Kumar Nyati
- Department of Microbiology, Sanjay Gandhi Post-graduate Institute of Medical Sciences, Lucknow-226 014, Uttar Pradesh, India
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Kalra V, Chaudhry R, Dua T, Dhawan B, Sahu JK, Mridula B. Association of Campylobacter jejuni infection with childhood Guillain-Barré syndrome: a case-control study. J Child Neurol 2009; 24:664-8. [PMID: 19491112 DOI: 10.1177/0883073808325649] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A prospective case-control study was conducted to determine the association between Campylobacter jejuni infection and childhood Guillain-Barré syndrome in the Indian population. We found evidence of recent Campylobacter jejuni infection in 27.7% of patients with Guillain-Barré syndrome, as compared with 2.3% in neurological controls (P = .003) and 2.3% in nonneurological controls (P = .003). Of the 15 patients with Campylobacter jejuni infection, 8 (53.3%) reported having had diarrhea within 12 weeks before the onset of the neurologic illness. Our results suggest association between recent Campylobacter jejuni infection and bulbar weakness (P = .043). No statistical difference was observed between the Campylobacter jejuni positive and negative groups with respect to age, other clinical features, albuminocytological dissociation, and residual paralysis at follow-up. It is concluded that subclinical Campylobacter jejuni infection is an important antecedent illness in childhood Guillain-Barré syndrome in the Indian population.
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Affiliation(s)
- Veena Kalra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
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Al Amri A, Senok AC, Ismaeel AY, Al-Mahmeed AE, Botta GA. Multiplex PCR for direct identification of Campylobacter spp. in human and chicken stools. J Med Microbiol 2007; 56:1350-1355. [PMID: 17893173 DOI: 10.1099/jmm.0.47220-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Differentiation between Campylobacter jejuni and Campylobacter coli is problematic in clinical specimens due to fastidious growth requirements and limited biochemical tests. This study describes a rapid, multiplex PCR protocol for the direct detection and differentiation of C. jejuni and C. coli in stools. An evaluation was carried out of this multiplex protocol based on the detection of cadF (genus specific), and hipO (C. jejuni) and asp (C. coli) genes, using stool from patients with Campylobacter enteritis and chicken. Protocol sensitivity was assessed and specificity determined using a panel of enteric bacteria, and evaluation of 30 diarrhoeic stool specimens culture negative for Campylobacter. Of the 114 specimens (54 human and 60 chicken) evaluated by the protocol, 70 (61.4 %) were identified as C. jejuni, 35 (30.7 %) as C. coli and 9 (7.9 %) as a mixed infection/colonization with both species. All mixed infections were identified as C. jejuni by culture. Among the stool specimens that were culture negative for Campylobacter, two (6.7 %) were C. jejuni positive by multiplex PCR. The protocol sensitivity limit was 0.015-0.016 ng C. jejuni and C. coli DNA mul(-1) in the specimen. There was no cross-reaction with the reference strains assessed. Comparison of hippurate test and multiplex PCR demonstrated 17 isolates with false-positive hippurate enzymic activity and 7 with false-negative activity. This rapid protocol (turnaround time 6 h) is highly sensitive and specific for direct evaluation of stool for these pathogens. It has significant application for routine clinical diagnostic and epidemiological purposes.
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Affiliation(s)
- Aisha Al Amri
- Department of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, PO Box 22979, Manama, Kingdom of Bahrain
| | - Abiola C Senok
- Department of Clinical Sciences, College of Medicine, University of Sharjah, United Arab Emirates
| | - Abdulrahman Yusuf Ismaeel
- Department of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, PO Box 22979, Manama, Kingdom of Bahrain
| | - Ali E Al-Mahmeed
- Department of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, PO Box 22979, Manama, Kingdom of Bahrain
| | - Giuseppe A Botta
- Department of Medical and Morphological Sciences, Institute of Microbiology, Udine Medical School, Udine, Italy
- Department of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, PO Box 22979, Manama, Kingdom of Bahrain
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Sinha S, Prasad KN, Jain D, Pandey CM, Jha S, Pradhan S. Preceding infections and anti-ganglioside antibodies in patients with Guillain-Barré syndrome: a single centre prospective case-control study. Clin Microbiol Infect 2007; 13:334-7. [PMID: 17391394 DOI: 10.1111/j.1469-0691.2006.01636.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Preceding infections and anti-ganglioside antibodies were assessed among 80 Guillain-Barré syndrome (GBS) patients and 125 controls. Previous infections were more frequent among GBS patients than among controls (p <0.0001), and had a significant association with axonal subtype compared with acute inflammatory demyelinating polyneuropathy (AIDP) (29/46 vs. 10/34 patients; p <0.05). Campylobacter jejuni (26%) was the most common preceding infection among GBS patients, followed by Mycoplasma pneumoniae (15%). Anti-ganglioside antibodies were detected more frequently among GBS patients than among controls (65/80 vs. 13/125; p <0.001), and a higher proportion of axonal cases had these antibodies than did AIDP patients (43/46 vs. 22/34; p <0.01).
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Affiliation(s)
- S Sinha
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Humphrey T, O'Brien S, Madsen M. Campylobacters as zoonotic pathogens: a food production perspective. Int J Food Microbiol 2007; 117:237-57. [PMID: 17368847 DOI: 10.1016/j.ijfoodmicro.2007.01.006] [Citation(s) in RCA: 467] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Indexed: 11/30/2022]
Abstract
Campylobacters remain highly important zoonotic pathogens worldwide which infect an estimated 1% of the population of Western Europe each year. Certain campylobacters are also important in infections of animals, particularly of the reproductive tract, and some are involved in periodontal disease. This paper focuses, however, on the two species which are most important in food-borne infections of humans, Campylobacter (C.) jejuni and C. coli. Infection with these campylobacters is serious in its own right but can also have long-term sequelae such as reactive arthritis and Guillain-Barré syndrome. The pathogens are ubiquitous in nature and in domestic animals and, as a consequence, are found frequently in the environment and on many raw foods, of both plant and animal origin and bacterial numbers can be very high on certain key foods like raw poultry meat. Although all commercial poultry species can carry campylobacters, the risk is greater from chicken because of the high levels of consumption. Campylobacters are relatively 'new' zoonotic pathogens as routine culture from clinical specimens only became possible in the late 1970s. As a consequence there is much that still needs to be understood about the behaviour and pathogenicity of these highly important bacteria. In particular, and from a food industry/food safety perspective, it is important to better understand the behaviour of C. jejuni and C. coli in the food production environment, and how this affects their ability to survive certain food production processes. There is a belief that campylobacters are much more sensitive to hostile conditions than either salmonellas or Escherichia coli. Much of data to support this view have been derived from laboratory experiments and may not fully represent the natural situation. Studies are showing that campylobacters may be more robust than previously thought and thus may represent a greater challenge to food safety. We recommend that research is undertaken to better understand how campylobacters behave in the food chain and how responses to relevant conditions affect their ability to survive processing and their virulence. There is also a need to better understand the reasons why campylobacters are capable of frequent change, particularly in the expression of surface antigens.
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Affiliation(s)
- Tom Humphrey
- University of Bristol, Division of Veterinary Pathology, Infection & Immunity, School of Clinical Veterinary Sciences, The Churchill Building, Langford, Bristol BS40 5DU, United Kingdom
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Campylobacter infection and Guillain–Barré syndrome: public health concerns from a microbial food safety perspective. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.cair.2005.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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