Comprehensive analysis of bacterial risk factors for the development of Guillain-Barre syndrome after Campylobacter jejuni enteritis
Comprehensive analysis of bacterial risk factors for the development of Guillain-Barre syndrome after Campylobacter jejuni enteritis
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DOI：
10.1086/499969
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发表时间：
2006-02-15
影响因子：
6.4
通讯作者：
Yuki, N
中科院分区：
文献类型：
--
作者：
Koga, M;Gilbert, M;Yuki, N
背景格林-巴利综合征（GBS）是空肠弯曲菌感染后的严重并发症，是一种感染后自身免疫介导的神经病变。为了研究发生GBS的细菌危险因素，分析了C.日本患者的空肠菌株。GBS患者的菌株具有LOS生物合成位点A类的频率（72/106; 68%）高于肠炎患者的菌株（17/103; 17%）。A类菌株主要是血清型HS：19，具有cst II（Thr 51）基因型;后者负责GM 1样和GD 1a样LOS的生物合成。抗-GM 1和抗-GD 1a单克隆抗体都有规律地与A类LOS结合，而没有或任一抗体与其他LOS基因座类别结合。质谱分析表明，A类菌株携带GD 1a样LOS以及GM 1样LOS。Logistic回归分析显示，血清型HS：19和A类基因座对GBS的发生有预测作用。最近在欧洲报道的GBS相关菌株中A类基因座的高频率，提供了第一个GBS相关的C。空肠特征是来自亚洲和欧洲的菌株所共有的。A类基因座和血清型HS：19似乎与cst II多态性有关，导致LOS上GM 1样和GD 1a样结构合成的促进，因此，产生抗神经节苷脂自身抗体和发展GBS的风险增加。
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.