Mycoplasma pneumoniae triggering the Guillain-Barré syndrome: A case-control study

Objective Guillain‐Barré syndrome (GBS) is an acute postinfectious immune‐mediated polyneuropathy. Although preceding respiratory tract infections with Mycoplasma pneumoniae have been reported in some cases, the role of M. pneumoniae in the pathogenesis of GBS remains unclear. We here cultured, for...

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Vydáno v:Annals of neurology Ročník 80; číslo 4; s. 566 - 580
Hlavní autoři: Meyer Sauteur, Patrick M., Huizinga, Ruth, Tio-Gillen, Anne P., Roodbol, Joyce, Hoogenboezem, Theo, Jacobs, Enno, van Rijn, Monique, van der Eijk, Annemiek A., Vink, Cornelis, de Wit, Marie-Claire Y., van Rossum, Annemarie M.C., Jacobs, Bart C.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Blackwell Publishing Ltd 01.10.2016
Wiley Subscription Services, Inc
Témata:
Adolescent
Adult
Aged
Antibodies, Bacterial - immunology
Autoantibodies - immunology
Case-Control Studies
Child
Cross Reactions
Female
Galactosylceramides - immunology
Guillain-Barre Syndrome - etiology
Guillain-Barre Syndrome - immunology
Humans
Immunoglobulin G
Immunoglobulin M
Male
Middle Aged
Mycoplasma Infections - complications
Mycoplasma Infections - immunology
Mycoplasma pneumoniae
Mycoplasma pneumoniae - immunology
Young Adult
ISSN:0364-5134, 1531-8249, 1531-8249
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Shrnutí:Objective Guillain‐Barré syndrome (GBS) is an acute postinfectious immune‐mediated polyneuropathy. Although preceding respiratory tract infections with Mycoplasma pneumoniae have been reported in some cases, the role of M. pneumoniae in the pathogenesis of GBS remains unclear. We here cultured, for the first time, M. pneumoniae from a GBS patient with antibodies against galactocerebroside (GalC), which cross‐reacted with the isolate. This case prompted us to unravel the role of M. pneumoniae in GBS in a case‐control study. Methods We included 189 adults and 24 children with GBS and compared them to control cohorts for analysis of serum antibodies against M. pneumoniae (n = 479) and GalC (n = 198). Results Anti–M. pneumoniae immunoglobulin (Ig) M antibodies were detected in GBS patients and healthy controls in 3% and 0% of adults (p = 0.16) and 21% and 7% of children (p = 0.03), respectively. Anti‐GalC antibodies (IgM and/or IgG) were found in 4% of adults and 25% of children with GBS (p = 0.001). Anti‐GalC‐positive patients showed more‐frequent preceding respiratory symptoms, cranial nerve involvement, and a better outcome. Anti‐GalC antibodies correlated with anti–M. pneumoniae antibodies (p < 0.001) and cross‐reacted with different M. pneumoniae strains. Anti‐GalC IgM antibodies were not only found in GBS patients with M. pneumoniae infection, but also in patients without neurological disease (8% vs 9%; p = 0.87), whereas anti‐GalC IgG was exclusively found in patients with GBS (9% vs 0%; p = 0.006). Interpretation M. pneumoniae infection is associated with GBS, more frequently in children than adults, and elicits anti‐GalC antibodies, of which specifically anti‐GalC IgG may contribute to the pathogenesis of GBS. Ann Neurol 2016;80:566–580
Bibliografie:MRace research grant from the Erasmus MC
Fellowship Award of the European Society for Paediatric Infectious Diseases (ESPID)
Prinses Beatrix Spierfonds
Thrasher Foundation
ArticleID:ANA24755
Sophia Scientific Research Foundation - No. SSWO 2014-150/WO
Promedica Foundation
Swiss National Science Foundation - No. PBZHP3_147290
ark:/67375/WNG-HRJ9MX18-7
NuthsOhra Foundation
istex:57AD4A182CD2A656FBB8A7F14C4FC2E753FD163F
Stichting Spieren voor Spieren - No. W.OR 12-04
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0364-5134
1531-8249
1531-8249
DOI:10.1002/ana.24755