Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
Med Microbiol Immunol. 2010 May;199(2):109-16. doi: 10.1007/s00430-010-0144-3. Epub 2010 Feb 16.
Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy. Campylobacter jejuni-associated gastrointestinal infection is identified as a major precipitating agent of GBS; however, a standard test to diagnose this infection in patients with GBS is lacking. The aim of the present study was to evaluate an outer membrane protein (OMP)-based lymphocyte transformation test (LTT) for the diagnosis of C. jejuni infection in GBS. Forty patients with GBS, age and gender matched 52 healthy controls (HC) and 46 disease controls (DC) were analyzed for C. jejuni infection by culture, polymerase chain reaction (PCR) and LTT. Lymphocytes at concentration of 1 x 10(6)/well isolated from GBS patients and controls were stimulated with 20 microg/ml of C. jejuni OMP, and (3)H-thymidine was incorporated to measure cell proliferation. LTT detected significantly higher C. jejuni infection compared to culture (77.5 vs. 2.5%; P < 0.05) and PCR (77.5 vs. 22.5%; P < 0.05). The cutoff value of lymphocyte proliferation by receiver operating characteristic (ROC) curve of 2.5 had 77.5% sensitivity and 96.5% specificity. Area under ROC curve was 0.92. The mean SI of the cell proliferation for GBS cases was significantly higher than the controls (GBS vs. HC; P < 0.001, GBS vs. DC; P < 0.001). LTT appears to be a sensitive tool for detecting preceding C. jejuni infection in GBS patients with reasonable sensitivity and specificity. It is possible that the activated lymphocytes might play role in the pathogenesis of neuronal damage in GBS.
格林-巴利综合征（GBS）是一种免疫介导的多神经病。空肠弯曲菌相关的胃肠道感染被确定为 GBS 的主要诱发因素；然而，目前缺乏诊断 GBS 患者这种感染的标准检测方法。本研究旨在评估基于外膜蛋白（OMP）的淋巴细胞转化试验（LTT）用于诊断 GBS 中空肠弯曲菌感染。对 40 例 GBS 患者、年龄和性别匹配的 52 例健康对照者（HC）和 46 例疾病对照者（DC）进行了空肠弯曲菌感染的培养、聚合酶链反应（PCR）和 LTT 检测。将浓度为 1×106/孔的来自 GBS 患者和对照者的淋巴细胞与 20μg/ml 的空肠弯曲菌 OMP 一起刺激，并掺入（3）H-胸苷以测量细胞增殖。LTT 检测到的空肠弯曲菌感染明显高于培养（77.5%比 2.5%；P<0.05）和 PCR（77.5%比 22.5%；P<0.05）。ROC 曲线的淋巴细胞增殖截断值为 2.5，其具有 77.5%的敏感性和 96.5%的特异性。ROC 曲线下面积为 0.92。GBS 病例的细胞增殖平均 SI 明显高于对照组（GBS 与 HC；P<0.001，GBS 与 DC；P<0.001）。LTT 似乎是一种用于检测 GBS 患者先前空肠弯曲菌感染的敏感工具，具有合理的敏感性和特异性。激活的淋巴细胞可能在 GBS 中神经元损伤的发病机制中发挥作用。
