TY - JOUR
T1 - Antecedent infections in Guillain-Barré syndrome in endemic areas of arbovirus transmission
T2 - A multinational case-control study
AU - Leonhard, Sonja E.
AU - Tan, Cheng Yin
AU - van der Eijk, Annemiek A.
AU - Reisin, Ricardo R.
AU - Franken, Suzanne C.
AU - Huizinga, Ruth
AU - Arends, Samuel
AU - Batstra, Manou R.
AU - Bezerra Jeronimo, Selma M.
AU - Drenthen, Judith
AU - de Koning, Laura
AU - Leon Cejas, Luciana
AU - Marchesoni, Cintia
AU - Marques, Wilson
AU - Shahrizaila, Nortina
AU - Casas, Dardo F.
AU - Sotelo, Andrea
AU - Tillard, Belen
AU - Dourado, Mario Emilio
AU - Jacobs, Bart C.
N1 - Funding Information:
The IGOS‐Zika project was funded by the European Union (Horizon 2020, ZikaPLAN Grant Agreement No. 734584). The automatic TLC sampler (ATS4) was funded via financial support from Stichting GBS. Funding information
Publisher Copyright:
© 2021 The Authors. Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society.
PY - 2021/12
Y1 - 2021/12
N2 - Half of the world's population is at risk of arthropod-borne virus (arbovirus) infections. Several arbovirus infections have been associated with Guillain-Barré syndrome (GBS). We investigated whether arboviruses are driving GBS beyond epidemic phases of transmission and studied the antibody response to glycolipids. The protocol of the International Guillain-Barré syndrome Outcome Study (IGOS), an observational prospective cohort study, was adapted to a case-control design. Serum samples were tested for a recent infection with Zika virus (ZIKV), dengue virus (DENV), chikungunya (CHIKV) virus, hepatitis E virus, Epstein-Barr virus (EBV), cytomegalovirus (CMV), Campylobacter jejuni, and Mycoplasma pneumoniae, and for antibodies to glycolipids. Forty-nine patients were included from Brazil (63%), Argentina (14%), and Malaysia (22%). Evidence of a recent infection was found in 27/49 (55%) patients: C jejuni (n = 15, 31%), M pneumoniae (n = 5, 10%), CHIKV (n = 2, 4%), EBV (n = 1, 2%), C jejuni and M pneumoniae (n = 2, 4%), CMV and DENV (n = 1, 2%), and C jejuni and DENV (n = 1, 2%). In 22 patients, 35 paired controls were collected. Odds ratio for recent infections did not significantly differ between cases and controls. No typical anti-ganglioside antibody binding was associated with recent arbovirus infection. We conclude that arbovirus infections occur in GBS patients outside of epidemic viral transmission, although not significantly more than in controls. Broad infection and anti-ganglioside antibody serology are important to establish the most likely pathogenic trigger in GBS patients. Larger studies are necessary to determine the association between arboviruses and GBS.
AB - Half of the world's population is at risk of arthropod-borne virus (arbovirus) infections. Several arbovirus infections have been associated with Guillain-Barré syndrome (GBS). We investigated whether arboviruses are driving GBS beyond epidemic phases of transmission and studied the antibody response to glycolipids. The protocol of the International Guillain-Barré syndrome Outcome Study (IGOS), an observational prospective cohort study, was adapted to a case-control design. Serum samples were tested for a recent infection with Zika virus (ZIKV), dengue virus (DENV), chikungunya (CHIKV) virus, hepatitis E virus, Epstein-Barr virus (EBV), cytomegalovirus (CMV), Campylobacter jejuni, and Mycoplasma pneumoniae, and for antibodies to glycolipids. Forty-nine patients were included from Brazil (63%), Argentina (14%), and Malaysia (22%). Evidence of a recent infection was found in 27/49 (55%) patients: C jejuni (n = 15, 31%), M pneumoniae (n = 5, 10%), CHIKV (n = 2, 4%), EBV (n = 1, 2%), C jejuni and M pneumoniae (n = 2, 4%), CMV and DENV (n = 1, 2%), and C jejuni and DENV (n = 1, 2%). In 22 patients, 35 paired controls were collected. Odds ratio for recent infections did not significantly differ between cases and controls. No typical anti-ganglioside antibody binding was associated with recent arbovirus infection. We conclude that arbovirus infections occur in GBS patients outside of epidemic viral transmission, although not significantly more than in controls. Broad infection and anti-ganglioside antibody serology are important to establish the most likely pathogenic trigger in GBS patients. Larger studies are necessary to determine the association between arboviruses and GBS.
UR - http://www.scopus.com/inward/record.url?scp=85115986267&partnerID=8YFLogxK
U2 - 10.1111/jns.12469
DO - 10.1111/jns.12469
M3 - Article
C2 - 34549484
AN - SCOPUS:85115986267
VL - 26
SP - 449
EP - 460
JO - Journal of the Peripheral Nervous System
JF - Journal of the Peripheral Nervous System
SN - 1085-9489
IS - 4
ER -
