Guillain-Barré syndrome: expanding the concept of molecular mimicry

Jon D. Laman*, Ruth Huizinga, Geert Jan Boons, Bart C. Jacobs

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

23 Citations (Scopus)

Abstract

Guillain-Barré syndrome (GBS) is a rapidly progressive, monophasic, and potentially devastating immune-mediated neuropathy in humans. Preceding infections trigger the production of cross-reactive antibodies against gangliosides concentrated in human peripheral nerves. GBS is elicited by at least five distinct common bacterial and viral pathogens, speaking to the notion of polymicrobial disease causation. This opinion emphasizes that GBS is the best-supported example of true molecular mimicry at the B cell level. Moreover, we argue that mechanistically, single and multiplexed microbial carbohydrate epitopes induce IgM, IgA, and IgG subclasses in ways that challenge the classic concept of thymus-dependent (TD) versus thymus-independent (TI) antibody responses in GBS. Finally, we discuss how GBS can be exemplary for driving innovation in diagnostics and immunotherapy for other antibody-driven neurological diseases.

Original languageEnglish
Pages (from-to)296-308
Number of pages13
JournalTrends in Immunology
Volume43
Issue number4
DOIs
Publication statusPublished - Apr 2022

Bibliographical note

Acknowledgments
This work was supported by the Dutch MS Research Foundation (J.D.L.) and the Zabawas Foundation (J.D.L.). B.C.J. was
supported by Prinses Beatrix Spierfonds, GBS-CIDP Foundation International, Annexon, CSL-Behring, Grifols, and Hansa
Biopharma. R.H. was funded by GBS-CIDP Foundation International and the T2B collaboration project funded by a PPP
Allowance made available by Top Sector Life Sciences & Health to Samenwerkende Gezondheidsfondsen (SGF) under
project number LSHM18055-SGF to stimulate public-private partnerships and cofinancing by health foundations that are
part of the SGF. G.J.B. was funded by the National Institute of General Medical Sciences, National Institutes of Health (grant
U01GM120408). The authors thank Margot van der Maarel for a first version of Table 1 and Anna Sieben for artwork in several
figures.

Publisher Copyright:© 2022 Elsevier Ltd

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