The Chaim Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Tel-Aviv, Israel.
Clin Rev Allergy Immunol. 2012 Apr;42(2):121-30. doi: 10.1007/s12016-010-8213-3.
Guillain-Barré syndrome (GBS) is a rare autoimmune disorder, the incidence of which is estimated to be 0.6-4/100,000 person/year worldwide. Often, GBS occurs a few days or weeks after the patient has had symptoms of a respiratory or gastrointestinal microbial infection. The disorder is sub-acute developing over the course of hours or days up to 3 to 4 weeks. About a third of all cases of Guillain-Barré syndrome are preceded by Campylobacter jejuni infection. C. jejuni strains isolated from GBS patients have a lipooligosaccharide (LOS) with a GM1-like structure. Molecular mimicry between LOS and the peripheral nerves as a cause of GBS was demonstrated in animal models of human GBS. Following the "swine flu" virus vaccine program in the USA in 1976, an increase in incidence of GBS was observed and the calculated relative risk was 6.2. Later studies have found that influenza vaccines contained structures that can induce anti-GM1 (ganglioside) antibodies after inoculation into mice. More recent information has suggested that the occurrence of GBS after currently used influenza and other vaccines is rare. GBS involves genetic and environmental factors, may be triggered by infections or vaccinations, and predisposition can be predicted by analyzing some of these factors.
格林-巴利综合征(GBS)是一种罕见的自身免疫性疾病,其发病率估计为全球每 10 万人中有 0.6-4 人。通常,GBS 在患者出现呼吸道或胃肠道微生物感染症状后的几天或几周后发生。该疾病呈亚急性发展,在数小时或数天至 3-4 周内逐渐加重。约三分之一的格林-巴利综合征病例之前有空肠弯曲菌感染。从 GBS 患者中分离出的空肠弯曲菌菌株具有与 GM1 类似结构的脂寡糖 (LOS)。在人类 GBS 的动物模型中,证明了 LOS 与周围神经之间的分子模拟是 GBS 的原因。1976 年在美国进行“猪流感”病毒疫苗计划后,观察到 GBS 的发病率增加,计算出的相对风险为 6.2。后来的研究发现,流感疫苗接种到小鼠体内后会产生诱导抗 GM1(神经节苷脂)抗体的结构。最近的信息表明,目前使用的流感和其他疫苗接种后发生 GBS 的情况很少见。GBS 涉及遗传和环境因素,可能由感染或疫苗接种引发,通过分析其中一些因素可以预测易感性。