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1.
Kurume Med J ; 66(2): 127-133, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34135199

RESUMO

A 38-year old immunocompetent male presented to us with chicken pox complicated by development of Guillain-Barre syndrome (GBS) and left-sided native valve endocarditis due to methicillin resistant Staphylococcus aureus (MRSA). This was further complicated by embolization to various vital organs including the brain. The patient was treated with vancomycin for four weeks but did not respond to the treatment. We present this case to highlight the rare complications associated with chicken pox and the challenges faced in management of such a case.


Assuntos
Varicela/complicações , Endocardite/diagnóstico , Síndrome de Guillain-Barré/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Endocardite/tratamento farmacológico , Endocardite/microbiologia , Síndrome de Guillain-Barré/diagnóstico , Humanos , Masculino , Vancomicina/uso terapêutico
2.
mBio ; 13(1): e0385221, 2021 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-35100875

RESUMO

Early in life, commensal bacteria play a major role in immune development, helping to guide the host response toward harmful stimuli while tolerating harmless antigens to prevent autoimmunity. Guillain-Barré syndrome (GBS) is an autoimmune disease caused by errant immune attack of antibody-bound ganglioside receptors on host nerve cells, resulting in paralysis. Lipooligosaccharides enveloping the prevalent enteric pathogen, Campylobacter jejuni, frequently mimic human gangliosides and can trigger GBS by stimulating the autoimmune response. In low- to middle-income countries, young children are consistently exposed to C. jejuni, and it is not known if this impacts GBS susceptibility later in life. Using a macrophage model, we examined the effect of training these cells with low doses of ganglioside-mimicking bacteria prior to challenge with GBS-associated antigens. This training caused decreased production of proinflammatory cytokines, suggesting tolerance induction. We then screened Campylobacter isolates from 154 infant fecal samples for GM1 ganglioside mimicry, finding that 23.4% of strains from both symptomatic and asymptomatic infants displayed GM1-like structures. Training macrophages with one of these asymptomatic carrier isolates also induced tolerance against GBS-associated antigens, supporting that children can be exposed to the tolerizing antigen early in life. RNA interference of Toll-like receptor 2 (TLR2) and TLR4 suggests that these receptors are not involved in tolerance associated with decreases in tumor necrosis factor (TNF), interleukin-6 (IL-6), or IL-1ß levels. The results of this study suggest that exposure to ganglioside-mimicking bacteria early in life occurs naturally and impacts host susceptibility to GBS development. IMPORTANCE In this study, we demonstrated that it is possible to tolerize immune cells to potentially dampen the autoreactive proinflammatory immune response against Guillain-Barré syndrome (GBS)-associated antigens. The innate immune response functions to arm the host against bacterial attack, but it can be tricked into recognizing the host's own cells when infectious bacteria display sugar structures that mimic human glycans. It is this errant response that leads to the autoimmunity and paralysis associated with GBS. By presenting immune cells with small amounts of the bacterial glycan mimic, we were able to suppress the proinflammatory immune response upon subsequent high exposure to glycan-mimicking bacteria. This suggests that individuals who have already been exposed to the glycan mimics in small amounts are less sensitive to autoimmune reactions against these glycans, and this could be a factor in determining susceptibility to GBS.


Assuntos
Infecções por Campylobacter , Campylobacter jejuni , Síndrome de Guillain-Barré , Criança , Humanos , Pré-Escolar , Síndrome de Guillain-Barré/microbiologia , Gangliosídeos , Infecções por Campylobacter/microbiologia , Mimetismo Molecular , Gangliosídeo G(M1) , Lipopolissacarídeos , Macrófagos , Bactérias , Paralisia/complicações
3.
Infection ; 48(3): 471-475, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32128685

RESUMO

BACKGROUND: While Campylobacter jejuni represents the most common cause of bacterial gastroenteritis, Yersinia pseudotuberculosis infections are very rarely diagnosed in adults. CASE: We report on a previously healthy patient who presented several times at our hospital with fever, Guillain-Barré syndrome, recurrent abdominal symptoms and distinct mesenteric lymphadenopathy, respectively. This complicated and diagnostically challenging course of disease was caused by a C. jejuni and Y. pseudotuberculosis coinfection. Antibiotic treatment with doxycycline was effective. CONCLUSION: Broad serology testing was crucial to discover that two concomitant infections were causing the symptoms. This case demonstrates that when a clinical picture is not fully explained by one known infection, another infection with the same underlying risk factor has to be considered, hence "a horse and a zebra".


Assuntos
Infecções por Campylobacter/diagnóstico , Coinfecção/diagnóstico , Gastroenteropatias/diagnóstico , Síndrome de Guillain-Barré/diagnóstico , Infecções por Yersinia pseudotuberculosis/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Infecções por Campylobacter/diagnóstico por imagem , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/microbiologia , Campylobacter jejuni/isolamento & purificação , Coinfecção/diagnóstico por imagem , Coinfecção/tratamento farmacológico , Coinfecção/microbiologia , Doxiciclina/uso terapêutico , Febre/microbiologia , Gastroenteropatias/diagnóstico por imagem , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/microbiologia , Alemanha , Síndrome de Guillain-Barré/diagnóstico por imagem , Síndrome de Guillain-Barré/microbiologia , Humanos , Linfadenopatia/diagnóstico , Linfadenopatia/microbiologia , Masculino , Recidiva , Resultado do Tratamento , Yersinia pseudotuberculosis/isolamento & purificação , Infecções por Yersinia pseudotuberculosis/diagnóstico por imagem , Infecções por Yersinia pseudotuberculosis/tratamento farmacológico , Infecções por Yersinia pseudotuberculosis/microbiologia
4.
Rev Peru Med Exp Salud Publica ; 37(4): 681-688, 2020.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-33566907

RESUMO

OBJECTIVE: To describe the results of laboratory tests performed on biological samples from patients with Guillain-Barré syndrome (GBS) submitted to the Instituto Nacional de Salud (INS) between 2018 and 2019. MATERIALS AND METHODS: We conducted an observational study on patients with GBS, by using data from the epidemiological surveillance system. Biological samples, previously analyzed at the INS, were obtained to study arboviruses, respiratory viruses, enteroviruses and enterobacteria, among others. RESULTS: A total of 2,051 specimens were obtained from 906 patients with GBS. Three patients tested positive for dengue and three for Zika. In 19 patients, the stool culture was positive for Campylobacter jejuni. Phylogenetic analysis of 10 Campylobacter jejuni strains classified them as genotype ST2993, which was previously reported in China and associated to a GBS outbreak. Twelve cerebrospinal fluid samples tested positive for enterovirus by PCR in 2018, but none could be verified by culture or complete genome sequencing during the study. One patient was positive for influenza A, two for influenza B, two for adenovirus, five for respiratory syncytial virus, and ten for rinovirus. CONCLUSION: Several pathogens were found in samples from patients with GBS. However, we found that the genotype ST2993 of Campylobacter jejuni was the most likely causal agent, a pathogen that is related to GBS outbreaks in different continents. It is necessary to confirm this hypothesis with additional analytical studies and it is important to describe the transmission mechanism of C. jejuni genotype ST2993 in order to implement prevention and control measures.


OBJETIVO: Describir los resultados de los exámenes de laboratorio realizados en muestras biológicas de pacientes con síndrome de Guillain-Barré (SGB), recibidas en el Instituto Nacional de Salud (INS) entre los años 2018 y 2019. MATERIALES Y MÉTODOS: Se realizó un estudio observacional en pacientes con SGB notificados en el sistema de vigilancia epidemiológica. Se obtuvieron muestras biológicas analizadas en el INS para investigar arbovirus, virus respiratorios, enterovirus y enterobacterias, entre otros. RESULTADOS: Se recibió un total de 2051 especímenes clínicos de 906 pacientes con SGB. Tres pacientes dieron positivo al dengue y tres pacientes al Zika. En 19 pacientes, el cultivo en heces fue positivo para Campylobacter jejuni. El análisis filogenético de diez cepas de Campylobacter jejuni las clasificó como genotipo ST2993, reportado previamente en China y asociado a un brote de SGB. En 2018, hubo 12 muestras que habían dado positivo al PCR para enterovirus en el líquido cefalorraquídeo, pero ninguna pudo corroborarse con el cultivo respectivo ni con secuenciamiento de genoma completo. Un paciente dio positivo por virus de la influenza A, dos por virus de la influenza B, dos por adenovirus, cinco por virus respiratorio sincicial, y diez por rinovirus. CONCLUSIÓN: Se han encontrado diversos agentes patógenos en especímenes de pacientes con SGB, sin embargo, la presencia de Campylobacter jejuni genotipo ST2993, un patógeno relacionado a brotes de SGB en varios continentes, sería el probable agente causal. Es necesario confirmar esta hipótesis con estudios analíticos y determinar la cadena de transmisión de este agente para implementar las medidas de prevención y control.


Assuntos
Síndrome de Guillain-Barré , Campylobacter jejuni/genética , Campylobacter jejuni/isolamento & purificação , Vírus da Dengue/isolamento & purificação , Fezes/microbiologia , Síndrome de Guillain-Barré/epidemiologia , Síndrome de Guillain-Barré/microbiologia , Síndrome de Guillain-Barré/terapia , Síndrome de Guillain-Barré/virologia , Humanos , Peru/epidemiologia , Filogenia , Zika virus/isolamento & purificação
5.
Rev Neurol ; 67(6): 203-209, 2018 Sep 16.
Artigo em Espanhol | MEDLINE | ID: mdl-30183060

RESUMO

INTRODUCTION: After Zika virus outbreak and the increase in the incidence of Guillain-Barre syndrome (GBS), the causal relationship has been studied, however a full etiological correlation has not been found. PATIENTS AND METHODS: From January 1 to December 31, 2017, patients with GBS were included. In addition to the basic serologies, enterovirus, herpes, Campylobacter, hepatitis B and C, TORCH, HIV, Brucella and Salmonella were requested. RESULTS: Cohort of seven male patients. Five patients analyzed cerebrospinal fluid reporting normal; all of them underwent brain scan, reporting normal. Neuroconduction was performed, resulting in acute inflammatory demyelinating polyneuropathy in four cases and acute motor axonal neuropathy in one case. All received intravenous immunoglobulins, five cases had a good prognosis and two deaths. No positive cases were reported to Zika virus. A positive case was reported to dengue and another to chikungunya. Five positive cases were reported to Campylobacter. One case positive to enterovirus. Dengue + Campylobacter coinfections were reported in one case and chikungunya + Campylobacter in another case. CONCLUSIONS: The present cohort shows that it was not possible to establish a causal relationship between GBS and Zika virus, but other viral and bacterial causal agents were identified, such as dengue, chikungunya and enterovirus, with the identification of Campylobacter cases even more remarkable.


TITLE: Agentes causales mas frecuentes del sindrome de Guillain-Barre en un hospital de Veracruz, Mexico.Introduccion. Con posterioridad a la oleada del virus del Zika y el incremento en la incidencia de sindrome de Guillain-Barre (SGB), se ha estudiado la relacion causal, pero no se ha encontrado una plena correlacion etiologica. Pacientes y metodos. Del 1 de enero al 31 de diciembre de 2017, se incluyeron pacientes con SGB. Ademas de las serologias basicas, se solicitaron determinaciones de enterovirus, virus del herpes, Campylobacter, hepatitis B y C, TORCH, virus de la inmunodeficiencia humana, Brucella y Salmonella. Resultados. Cohorte de siete pacientes de sexo masculino. A cinco pacientes se les analizo el liquido cefalorraquideo, que era normal. A todos se les realizo una tomografia encefalica, tambien normal, y se realizo neuroconduccion, que mostro polineuropatia inflamatoria desmielinizante aguda en cuatro casos y neuropatia motora axonal aguda en uno. Todos recibieron inmunoglobulinas intravenosas; tuvieron buen pronostico cinco casos y hubo dos defunciones. No se informo de casos positivos al virus del Zika. Hubo un caso positivo al dengue, uno al chikungunya, cinco a Campylobacter y uno a enterovirus. Se informo de coinfecciones de dengue + Campylobacter en un caso y de chikungunya + Campylobacter en otro. Conclusiones. La presente cohorte demuestra que no fue posible establecer una relacion causal entre el SGB y el virus del Zika, pero se identificaron otros agentes causales viricos y bacterianos, como dengue, chikungunya y enterovirus, y fue aun mas destacable la identificacion de los casos de Campylobacter.


Assuntos
Síndrome de Guillain-Barré/microbiologia , Adulto , Idoso de 80 Anos ou mais , Estudos Transversais , Síndrome de Guillain-Barré/diagnóstico , Hospitais Gerais , Humanos , Masculino , México , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
6.
BMJ Case Rep ; 20182018 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-30262531

RESUMO

Syringomyelia is the development of a fluid-filled cavity or syrinx within the spinal cord that can cause loss of sensation and muscle spasticity. Guillain-Barre syndrome (GBS) is a postinfection autoimmune disease, classified as an acute polyneuropathy. This report describes the emergency admission of a 6-year-old girl presenting with sudden pallor and pain in both lower limbs. The patient's reflexes were normal, as were the results of her sonography, radiography and biochemical tests; however, spinal MRI revealed extensive compartmentalised syringomyelia extending from C2 to T3. A sensory and motor nerve conduction study revealed a demyelinating type motor polyneuropathy which, along with positive Mycoplasma pneumoniae test, was suggestive of GBS. Intravenous immunoglobulin infusion showed excellent results. In conclusion, we report a rare paediatric case of syringomyelia coexisting with GBS. It is important to bear in mind the possibility of other coexisting diseases even if MRI reveals definitive characteristics of another condition.


Assuntos
Síndrome de Guillain-Barré/complicações , Pneumonia por Mycoplasma/complicações , Siringomielia/complicações , Criança , Feminino , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/tratamento farmacológico , Síndrome de Guillain-Barré/microbiologia , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Imageamento por Ressonância Magnética , Mycoplasma pneumoniae/isolamento & purificação , Medula Espinal/diagnóstico por imagem , Siringomielia/diagnóstico por imagem
7.
Emerg Infect Dis ; 24(9): 1754-1755, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30124417

RESUMO

We describe a case of coexisting transverse myelitis and Guillain-Barré syndrome related to infection with Bartonella henselae proteobacterium and review similar serology-proven cases. B. henselae infection might be emerging as a cause of myelitis and Guillain-Barré syndrome and should be considered as an etiologic factor in patients with such clinical presentations.


Assuntos
Bartonella henselae/isolamento & purificação , Doença da Arranhadura de Gato/diagnóstico , Síndrome de Guillain-Barré/diagnóstico , Mielite Transversa/diagnóstico , Bartonella henselae/imunologia , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/microbiologia , Criança , Diagnóstico Diferencial , Feminino , Síndrome de Guillain-Barré/complicações , Síndrome de Guillain-Barré/microbiologia , Humanos , Imageamento por Ressonância Magnética , Mielite Transversa/complicações , Mielite Transversa/diagnóstico por imagem , Mielite Transversa/microbiologia , Texas
8.
Epidemiol Infect ; 146(13): 1740-1745, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29986777

RESUMO

Guillain Barré syndrome (GBS), which is triggered by autoantibodies produced in response to antigenic stimuli such as certain infections and vaccinations, is the most common cause of acute flaccid paralysis worldwide. Campylobacter, the most common bacterial enteric infection in the USA, is reported to be the most commonly diagnosed antecedent of GBS, yet little information is available about the risk of post-Campylobacter GBS. Data collected through active, population-based surveillance in the Emerging Infections Program during the 2009-2010 novel Influenza A (H1N1) vaccination campaign allowed us to compare confirmed and probable GBS cases to non-cases to determine whether antecedent Campylobacter infection (or a diarrhoeal illness consistent with campylobacteriosis) was more common among cases and to assess the risk of GBS following Campylobacter infection. We estimate that 8-12% of GBS cases in the USA are attributable to Campylobacter infection (or a diarrhoeal illness consistent with campylobacteriosis), with 434-650 cases of post-diarrhoeal GBS annually and about 49 cases of GBS per 100 000 Campylobacter infections. These results provide updated estimates for post-Campylobacter GBS incidence in the USA and highlight an important benefit of effective measures to prevent Campylobacter infections.


Assuntos
Infecções por Campylobacter/epidemiologia , Campylobacter/isolamento & purificação , Síndrome de Guillain-Barré/epidemiologia , Programas de Imunização , Influenza Humana/prevenção & controle , Vigilância da População , Infecções por Campylobacter/complicações , Diarreia/epidemiologia , Diarreia/microbiologia , Síndrome de Guillain-Barré/microbiologia , Humanos , Incidência , Vírus da Influenza A Subtipo H1N1/fisiologia , Estados Unidos/epidemiologia
9.
Brain Dev ; 40(5): 439-442, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29429558

RESUMO

We report the case of a 12-year-old girl who developed Guillain-Barré syndrome (GBS) and optic neuritis (ON) following Mycoplasma pneumoniae infection. Her symptoms, including bilateral vision impairment and tingling in her hands and right foot, were resolved after methylprednisolone pulse therapy. Serum anti-galactocerebroside (Gal-C) IgM antibodies were detected in our patient. This is the first report of a child with GBS and ON associated with M. pneumoniae infection.


Assuntos
Síndrome de Guillain-Barré/complicações , Neurite Óptica/complicações , Autoanticorpos/sangue , Criança , Feminino , Galactosilceramidas/análise , Galactosilceramidas/sangue , Síndrome de Guillain-Barré/microbiologia , Humanos , Metilprednisolona/farmacologia , Mycoplasma pneumoniae/patogenicidade , Neurite Óptica/tratamento farmacológico , Neurite Óptica/microbiologia
10.
Cell Mol Immunol ; 15(6): 547-562, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29375121

RESUMO

Guillain-Barré syndrome (GBS) and transverse myelitis (TM) both represent immunologically mediated polyneuropathies of major clinical importance. Both are thought to have a genetic predisposition, but as of yet no specific genetic risk loci have been clearly defined. Both are considered autoimmune, but again the etiologies remain enigmatic. Both may be induced via molecular mimicry, particularly from infectious agents and vaccines, but clearly host factor and co-founding host responses will modulate disease susceptibility and natural history. GBS is an acute inflammatory immune-mediated polyradiculoneuropathy characterized by tingling, progressive weakness, autonomic dysfunction, and pain. Immune injury specifically takes place at the myelin sheath and related Schwann-cell components in acute inflammatory demyelinating polyneuropathy, whereas in acute motor axonal neuropathy membranes on the nerve axon (the axolemma) are the primary target for immune-related injury. Outbreaks of GBS have been reported, most frequently related to Campylobacter jejuni infection, however, other agents such as Zika Virus have been strongly associated. Patients with GBS related to infections frequently produce antibodies against human peripheral nerve gangliosides. In contrast, TM is an inflammatory disorder characterized by acute or subacute motor, sensory, and autonomic spinal cord dysfunction. There is interruption of ascending and descending neuroanatomical pathways on the transverse plane of the spinal cord similar to GBS. It has been suggested to be triggered by infectious agents and molecular mimicry. In this review, we will focus on the putative role of infectious agents as triggering factors of GBS and TM.


Assuntos
Doenças Transmissíveis/patologia , Síndrome de Guillain-Barré/patologia , Mielite Transversa/patologia , Doenças Transmissíveis/imunologia , Doenças Transmissíveis/microbiologia , Doenças Transmissíveis/virologia , Síndrome de Guillain-Barré/imunologia , Síndrome de Guillain-Barré/microbiologia , Síndrome de Guillain-Barré/virologia , Humanos , Imunidade , Mielite Transversa/imunologia , Mielite Transversa/microbiologia , Mielite Transversa/virologia
11.
J Neuroimmunol ; 314: 13-16, 2018 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-29301655

RESUMO

Mycoplasma pneumoniae (Mp) triggers Guillain-Barré syndrome (GBS) and elicits anti-galactocerebroside (GalC) antibodies. Specifically anti-GalC IgG is associated with Mp-GBS, possibly because of its better ability to cross the blood-nerve barrier (BNB). We here investigated CSF for the presence of anti-GalC in GBS. Intrathecal anti-GalC was found in 46% of Mp-GBS patients (n=6/13), in contrast to 16% of GBS controls (n=4/25) and 0% of non-GBS controls (n=0/7). The antibodies most likely originated from increased BNB permeability and/or intrathecal synthesis. Intrathecal anti-GalC IgG was specifically associated with Mp-GBS, further supporting that anti-GalC IgG contributes to the pathogenesis of GBS.


Assuntos
Autoanticorpos/líquido cefalorraquidiano , Galactosilceramidas/líquido cefalorraquidiano , Síndrome de Guillain-Barré/imunologia , Mycoplasma pneumoniae/imunologia , Adolescente , Adulto , Autoanticorpos/imunologia , Autoantígenos/imunologia , Feminino , Galactosilceramidas/imunologia , Síndrome de Guillain-Barré/líquido cefalorraquidiano , Síndrome de Guillain-Barré/microbiologia , Humanos , Imunoglobulina G/líquido cefalorraquidiano , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-Idade , Pneumonia por Mycoplasma/complicações , Adulto Jovem
12.
Microb Pathog ; 111: 395-401, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28916318

RESUMO

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.


Assuntos
Infecções por Campylobacter/enzimologia , Campylobacter jejuni/fisiologia , Síndrome de Guillain-Barré/enzimologia , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Paralisia/enzimologia , Animais , Infecções por Campylobacter/genética , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/patologia , Campylobacter jejuni/genética , Galinhas , Modelos Animais de Doenças , Síndrome de Guillain-Barré/genética , Síndrome de Guillain-Barré/microbiologia , Síndrome de Guillain-Barré/patologia , Humanos , Metaloproteinase 2 da Matriz/genética , Metaloproteinase 9 da Matriz/genética , Paralisia/genética , Paralisia/microbiologia , Nervo Isquiático/enzimologia , Nervo Isquiático/microbiologia , Nervo Isquiático/patologia , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo
13.
Microbiome ; 5(1): 92, 2017 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-28789710

RESUMO

BACKGROUND: Campylobacter jejuni is the leading antecedent infection to the autoimmune neuropathy Guillain-Barré syndrome (GBS), which is accompanied by an autoimmune anti-ganglioside antibody attack on peripheral nerves. Previously, we showed that contrasting immune responses mediate C. jejuni induced colitis and autoimmunity in interleukin-10 (IL-10)-deficient mice, dependent upon the infecting strain. Strains from colitis patients elicited T helper 1 (TH1)-dependent inflammatory responses while strains from GBS patients elicited TH2-dependent autoantibody production. Both syndromes were exacerbated by antibiotic depletion of the microbiota, but other factors controlling susceptibility to GBS are unknown. METHODS: Using 16S rRNA gene high-throughput sequencing, we examined whether structure of the gut microbial community alters host (1) gastrointestinal inflammation or (2) anti-ganglioside antibody responses after infection with C. jejuni strains from colitis or GBS patients. We compared these responses in C57BL/6 mice with either (1) stable human gut microbiota (Humicrobiota) transplants or (2) conventional mouse microbiota (Convmicrobiota). RESULTS: Inoculating germ-free C57BL/6 wild-type (WT) mice with a mixed human fecal slurry provided a murine model that stably passed its microbiota over >20 generations. Mice were housed in specific pathogen-free (SPF) facilities, while extra precautions of having caretakers wear sterile garb along with limited access ensured that no mouse pathogens were acquired. Humicrobiota conferred many changes upon the WT model in contrast to previous results, which showed only colonization with no disease after C. jejuni challenge. When compared to Convmicrobiota mice for susceptibility to C. jejuni enteric or GBS patient strains, infected Humicrobiota mice had (1) 10-100 fold increases in C. jejuni colonization of both strains, (2) pathologic change in draining lymph nodes but only mild changes in colon or cecal lamina propria, (3) significantly lower Th1/Th17-dependent anti-C. jejuni responses, (4) significantly higher IL-4 responses at 5 but not 7 weeks post infection (PI), (5) significantly higher Th2-dependent anti-C. jejuni responses, and (6) significantly elevated anti-ganglioside autoantibodies after C. jejuni infection. These responses in Humicrobiota mice were correlated with a dominant Bacteroidetes and Firmicutes microbiota. CONCLUSIONS: These data demonstrate that Humicrobiota altered host-pathogen interactions in infected mice, increasing colonization and Th-2 and autoimmune responses in a C. jejuni strain-dependent manner. Thus, microbiota composition is another factor controlling susceptibility to GBS.


Assuntos
Autoanticorpos/biossíntese , Infecções por Campylobacter/imunologia , Transplante de Microbiota Fecal , Síndrome de Guillain-Barré/imunologia , Síndrome de Guillain-Barré/microbiologia , Animais , Autoanticorpos/sangue , Autoanticorpos/imunologia , Autoimunidade , Infecções por Campylobacter/microbiologia , Campylobacter jejuni/imunologia , Colite/etiologia , Colite/imunologia , Colite/microbiologia , Modelos Animais de Doenças , Fezes/microbiologia , Interações Hospedeiro-Patógeno , Humanos , Inflamação , Interleucina-10/imunologia , Interleucina-4/imunologia , Camundongos , Camundongos Endogâmicos C57BL , RNA Ribossômico 16S
15.
Euro Surveill ; 21(4)2016.
Artigo em Inglês | MEDLINE | ID: mdl-26848143

RESUMO

We report a cluster of atypical Guillain-Barré syndrome in 10 adults temporally related to a cluster of four children with acute flaccid paralysis, over a 3-month period in South Wales, United Kingdom. All adult cases were male, aged between 24 and 77 years. Seven had prominent facial diplegia at onset. Available electrophysiological studies showed axonal involvement in five adults. Seven reported various forms of respiratory disease before onset of neurological symptoms. The ages of children ranged from one to 13 years, three of the four were two years old or younger. Enterovirus testing is available for three children; two had evidence of enterovirus D68 infection in stool or respiratory samples. We describe the clinical features, epidemiology and state of current investigations for these unusual clusters of illness.


Assuntos
Enterovirus/isolamento & purificação , Síndrome de Guillain-Barré/epidemiologia , Paralisia/complicações , Paralisia/epidemiologia , Paralisia/etiologia , Adolescente , Adulto , Idoso , Surtos de Doenças , Enterovirus/classificação , Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/virologia , Feminino , Síndrome de Guillain-Barré/complicações , Síndrome de Guillain-Barré/microbiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores de Tempo , Reino Unido/epidemiologia , País de Gales/epidemiologia
16.
Eur J Paediatr Neurol ; 20(1): 196-9, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26371981

RESUMO

BACKGROUND: Paediatric Listeria meningitis is rare, especially in immuno-competent children, but associated with significant mortality and morbidity and frequent complications. METHODS: We report an unusual case of Listeria meningitis in a previously healthy 35 month-old girl with selective spinal grey matter involvement and demyelination in neurophysiological studies. Despite adequate antibiotic treatment, the case was initially complicated by ventriculitis, hydrocephalus and tonsillar herniation through the foramen magnum, requiring external ventricular drainage and subsequent ventriculoperitoneal shunt insertion. Paucity of movements, hypotonia, areflexia and bladder dysfunction then became evident. RESULTS: Electromyogram and nerve conduction studies showed acute inflammatory demyelinating polyneuropathy and the patient received intravenous immunoglobulin followed by corticosteroids. MRI scans with contrast revealed extensive whole cord selective grey matter signal changes. She required extensive neurorehabilitation, making gradual (but incomplete) recovery. CONCLUSION: Spinal cord involvement is rare in neuro-listeriosis and there no previous paediatric reports of Listeria-related myelitis or demyelinating polyneuropathy. The mechanism behind these presentations is unclear but an auto-immune response to the infection might be considered.


Assuntos
Substância Cinzenta/patologia , Meningite por Listeria/patologia , Doenças da Medula Espinal/microbiologia , Doenças da Medula Espinal/patologia , Pré-Escolar , Feminino , Síndrome de Guillain-Barré/microbiologia , Síndrome de Guillain-Barré/patologia , Humanos , Hidrocefalia/etiologia , Imageamento por Ressonância Magnética , Meningite por Listeria/complicações
17.
J Clin Apher ; 31(5): 476-8, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26356494

RESUMO

Lyme disease is a rare tick-borne multisystemic infection caused by Borrelia burgdorferi. Different neurological conditions were reported in the disease. In this article, we present a 15-year-old patient hospitalized with ataxia who was diagnosed with Lyme neuroborreliosis. Intravenous immunoglobulin and ceftriaxone treatment was applied to the patient for 4 weeks. However, ataxia did not recover, upper and lower muscle weakness developed, and deep tendon reflexes diminished during follow-up. The patient was diagnosed with Guillain-Barre syndrome arising from B. burgdorferi. Second dose of intravenous immunoglobulin treatment was started for 5 days but the patient didn't recover. Therefore administration of plasmapheresis was decided. All symptoms relieved following the plasmapheresis. The effect of plasmapheresis in pediatric neuroborreliosis has not been documented before. This study highlights that plasmapheresis could be a useful alternative for pediatric neuroborreliosis cases. J. Clin. Apheresis 31:476-478, 2016. © 2015 Wiley Periodicals, Inc.


Assuntos
Borrelia burgdorferi/patogenicidade , Neuroborreliose de Lyme/terapia , Plasmaferese , Adolescente , Ataxia , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/microbiologia , Síndrome de Guillain-Barré/terapia , Humanos , Imunoglobulinas/administração & dosagem , Masculino , Terapia de Salvação/métodos , Resultado do Tratamento
18.
Immunobiology ; 221(4): 535-43, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26709064

RESUMO

The Gram-negative bacterium Campylobacter jejuni causes gastroenteritis and Guillain-Barré syndrome in humans. Recent advances in the immunobiology of C. jejuni have been made. This review summarizes C. jejuni-binding innate receptors and highlights the role of innate immunity in autoimmune diseases. This human pathogen produces a variety of glycoconjugates, including human ganglioside-like determinants and multiple activators of Toll-like receptors (TLRs). Furthermore, C. jejuni targets MyD88, NLRP3 inflammasome, TIR-domain-containing adapter-inducing interferon-ß (TRIF), sialic acid-binding immunoglobulin-like lectins (Siglecs), macrophage galactose-type lectin (MGL), and immunoglobulin-like receptors (TREM2, LMIR5/CD300b). The roles of these innate receptors and signaling molecules have been extensively studied. MyD88-mediated TLR activation or inflammasome-dependent IL-1ß secretion is essential for autoimmune induction. TRIF mediates the production of type I interferons that promote humoral immune responses and immunoglobulin class-switching. Siglec-1 and Siglec-7 interact directly with gangliosides. Siglec-1 activation enhances phagocytosis and inflammatory responses. MGL internalizes GalNAc-containing glycoconjugates. TREM2 is well-known for its role in phagocytosis. LMIR5 recognizes C. jejuni components and endogenous sulfoglycolipids. Several lines of evidence from animal models of autoimmune diseases suggest that simultaneous activation of innate immunity in the presence of autoreactive lymphocytes or antigen mimicry may link C. jejuni to immunopathology.


Assuntos
Infecções por Campylobacter/imunologia , Campylobacter jejuni/imunologia , Gastroenterite/imunologia , Síndrome de Guillain-Barré/imunologia , Interações Hospedeiro-Patógeno/imunologia , Imunidade Inata , Proteínas Adaptadoras de Transporte Vesicular/genética , Proteínas Adaptadoras de Transporte Vesicular/imunologia , Animais , Infecções por Campylobacter/genética , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/patologia , Campylobacter jejuni/patogenicidade , Proteínas de Transporte/genética , Proteínas de Transporte/imunologia , Gastroenterite/genética , Gastroenterite/microbiologia , Gastroenterite/patologia , Regulação da Expressão Gênica , Glicoconjugados/imunologia , Glicoconjugados/metabolismo , Síndrome de Guillain-Barré/genética , Síndrome de Guillain-Barré/microbiologia , Síndrome de Guillain-Barré/patologia , Humanos , Inflamassomos/imunologia , Lectinas Tipo C/genética , Lectinas Tipo C/imunologia , Glicoproteínas de Membrana/genética , Glicoproteínas de Membrana/imunologia , Mimetismo Molecular , Fator 88 de Diferenciação Mieloide/genética , Fator 88 de Diferenciação Mieloide/imunologia , Proteína 3 que Contém Domínio de Pirina da Família NLR , Receptores Imunológicos/genética , Receptores Imunológicos/imunologia , Lectinas Semelhantes a Imunoglobulina de Ligação ao Ácido Siálico/genética , Lectinas Semelhantes a Imunoglobulina de Ligação ao Ácido Siálico/imunologia
19.
Infez Med ; 23(4): 349-52, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26700086

RESUMO

In this report, we describe a case of acute motoral axonal neuropathy (AMAN) following septic shock due to Acinetobacter baumannii. The aetiology of AMAN is still not fully clarified. An association with a potential infection by Campylobacter jejuni, resulting in stimulation of autoimmune response against gangliosides mediated by a phenomenon of molecular mimicry, is believed to play a major role. Since the lipopolysaccharide of A. baumannii has a structure that is similar to that of C. jejuni, we hypothesise that the infection by A. baumannii in our patient may have had a pathogenic role in the development of the neurological picture via a mechanism of molecular mimicry.


Assuntos
Acinetobacter baumannii/isolamento & purificação , Cardiotônicos/administração & dosagem , Dopamina/administração & dosagem , Síndrome de Guillain-Barré/microbiologia , Síndrome de Guillain-Barré/terapia , Choque Séptico/complicações , Choque Séptico/terapia , Adulto , Antibacterianos/administração & dosagem , Quimioterapia Combinada , Emergências , Síndrome de Guillain-Barré/diagnóstico , Humanos , Unidades de Terapia Intensiva , Masculino , Respiração Artificial/métodos , Choque Séptico/diagnóstico , Choque Séptico/microbiologia , Resultado do Tratamento
20.
FEMS Microbiol Lett ; 362(4)2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25688069

RESUMO

This report describes a draft genome sequence of Campylobacter jejuni strain G1. The strain contains no plasmids, despite being resistant to tetracycline (Tet). Comparison of the genome of this strain with that of a reference strain NCTC 11168 (Tet sensitive) revealed the presence of a candidate gene that may be responsible for antibiotic resistance, as well as the genes involved in the synthesis of ganglioside-mimicking molecules responsible for the development of a neurodegenerative disorder, Guillain-Barré syndrome.


Assuntos
Campylobacter jejuni/genética , Genoma Bacteriano , Resistência a Tetraciclina/genética , Sequência de Bases , Campylobacter jejuni/efeitos dos fármacos , Farmacorresistência Bacteriana/genética , Gangliosídeos/metabolismo , Síndrome de Guillain-Barré/microbiologia , Humanos , Dados de Sequência Molecular , Plasmídeos , Análise de Sequência de DNA
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