Comprehensive analysis of bacterial risk factors for the development of Guillain-Barre syndrome after Campylobacter jejuni enteritis

J Infect Dis. 2006 Feb 15;193(4):547-55. doi: 10.1086/499969. Epub 2006 Jan 19.

Abstract

Background: Guillain-Barre syndrome (GBS), a postinfectious autoimmune-mediated neuropathy, is a serious complication after Campylobacter jejuni enteritis.

Methods: To investigate the bacterial risk factors for developing GBS, genotypes, serotypes, and ganglioside mimics on lipo-oligosaccharide (LOS) were analyzed in C. jejuni strains from Japanese patients.

Results: Strains from patients with GBS had LOS biosynthesis locus class A more frequently (72/106; 68%) than did strains from patients with enteritis (17/103; 17%). Class A strains predominantly were serotype HS:19 and had the cstII (Thr51) genotype; the latter is responsible for biosynthesis of GM1-like and GD1a-like LOSs. Both anti-GM1 and anti-GD1a monoclonal antibodies regularly bound to class A LOSs, whereas no or either antibody bound to other LOS locus classes. Mass-spectrometric analysis showed that a class A strain carried GD1a-like LOS as well as GM1-like LOS. Logistic regression analysis showed that serotype HS:19 and the class A locus were predictive of the development of GBS.

Conclusions: The high frequency of the class A locus in GBS-associated strains, which was recently reported in Europe, provides the first GBS-related C. jejuni characteristic that is common to strains from Asia and Europe. The class A locus and serotype HS:19 seem to be linked to cstII polymorphism, resulting in promotion of both GM1-like and GD1a-like structure synthesis on LOS and, consequently, an increase in the risk of producing antiganglioside autoantibodies and developing GBS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Bacterial / immunology
  • Campylobacter Infections / complications*
  • Campylobacter Infections / microbiology
  • Campylobacter jejuni*
  • Enteritis / complications
  • Enteritis / microbiology*
  • G(M1) Ganglioside / chemistry
  • G(M1) Ganglioside / immunology*
  • Guillain-Barre Syndrome / epidemiology
  • Guillain-Barre Syndrome / etiology*
  • Guillain-Barre Syndrome / microbiology
  • Humans
  • Lipopolysaccharides / chemistry
  • Lipopolysaccharides / immunology
  • Lipopolysaccharides / metabolism*
  • Risk Factors

Substances

  • Antibodies, Bacterial
  • Lipopolysaccharides
  • G(M1) Ganglioside