Oomes P G, van der Meché F G, Markus-Silvis L, Meulstee J, Kleyweg R P
Department of Neurology, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Muscle Nerve. 1991 Oct;14(10):1013-20. doi: 10.1002/mus.880141013.
Serum from 20 patients with Guillain-Barré syndrome (GBS), 10 healthy controls and 10 patients with recent cytomegalovirus, Epstein-Barr virus, or Campylobacter jejuni/coli infections was injected into rat sciatic nerve. The 20 GBS patients consisted of 2 groups of 10 patients with different electrophysiological and clinical disease patterns. The main aim of the study was to investigate possible differences in humoral (auto)-immunity between these subgroups. We found no statistically significant differences in electrophysiological or histological parameters between nerves injected with sera from the 2 GBS groups. The sera of the GBS groups caused significantly more compound muscle action potential reduction at 3 to 5 days postinjection than the healthy control sera. No significant difference in nerve conduction was found between nerves injected with GBS serum and serum of patients with proven infections without GBS. Histological analysis of the same nerves that were studied electrophysiologically showed no significant differences in demyelination or other histological parameters between patients and controls at 5 days postinjection. Based on the findings in this study that sera of GBS groups with important differences in disease pattern and sera of patients with proven infection but without GBS show similar in vivo effects on rat nerves, we suggest it may be more likely that these effects are caused by aspecific serum factors associated with immune-system activation, especially by precedent infections, than by specific disease-related factors such as anti-myelin antibodies.
将20例吉兰 - 巴雷综合征（GBS）患者、10名健康对照者以及10例近期感染巨细胞病毒、爱泼斯坦 - 巴尔病毒或空肠弯曲菌/结肠弯曲菌的患者的血清注射到大鼠坐骨神经中。20例GBS患者分为两组，每组10例，具有不同的电生理和临床疾病模式。该研究的主要目的是调查这些亚组之间体液（自身）免疫的可能差异。我们发现，注射来自两个GBS组血清的神经之间，在电生理或组织学参数上没有统计学上的显著差异。与健康对照血清相比，GBS组血清在注射后3至5天导致复合肌肉动作电位降低明显更多。注射GBS血清的神经与注射已证实感染但无GBS患者血清的神经之间，在神经传导方面未发现显著差异。对进行电生理研究的相同神经进行组织学分析显示，注射后5天患者和对照之间在脱髓鞘或其他组织学参数上没有显著差异。基于本研究的结果，即疾病模式有重要差异的GBS组血清与已证实感染但无GBS患者的血清对大鼠神经显示出相似的体内效应，我们认为这些效应更可能是由与免疫系统激活相关的非特异性血清因子引起的，尤其是由先前的感染引起，而不是由抗髓鞘抗体等特定疾病相关因子引起。
