Hafsteinsdóttir Brynhildur, Gonzalez-Ortiz Fernando, Gleisner Nina, Alpsten Ellen, Lycke Jan, Rosenstein Igal, Novakova Lenka, Blennow Kaj, Bergström Tomas, Zetterberg Henrik, Axelsson Markus
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden.
Eur J Neurol. 2025 Apr;32(4):e70155. doi: 10.1111/ene.70155.
Biomarkers for predicting disease severity and outcome in Guillain-Barré syndrome (GBS) are scarce. We aimed to determine if brain-derived tau in serum (sBD-tau) and cerebrospinal fluid (CSF BD-tau) are associated with long-term outcome and disease severity in GBS.
In this retrospective study of 100 GBS patients, we measured sBD-tau and CSF BD-tau at diagnosis. Outcome was defined as GBS disability scale (GBSDS) > 2 and overall neuropathy limitation scale (ONLS) at 12 months, disease severity as respiratory support and ONLS at nadir. BD-tau levels were compared between groups and correlated with ONLS scores. Regression analyses and receiver operator characteristic curve analyses were performed for GBSDS > 2 at 12 months.
BD-tau levels were higher for GBSDS > 2 at 12 months in serum and CSF. Odds ratio for sBD-tau was 1.9 (95% CI 1.08-3.2, p = 0.03) and for CSF BD-tau was 5.9 (95% CI 1.4-25, p = 0.02). Area under curve for sBD-tau was 0.75 (95% CI 0.57-0.9, p < 0.001) and for CSF BD-tau was 0.78 (95% CI 0.65-0.9, p = 0.001). ONLS at 12 months correlated with sBD-tau (ρ = 0.34 [95% CI 0.12-0.53], p = 0.002) and CSF BD-tau (ρ = 0.33 [95% CI 0.08-0.54], p = 0.01). Statistically significant difference in BD-tau levels was not seen for respiratory support or ONLS at nadir.
BD-tau at GBS onset is associated with long-term outcome but not disease severity. Because BD-tau is essentially a CNS biomarker, our results suggest that CNS involvement influences recovery.
用于预测吉兰 - 巴雷综合征（GBS）疾病严重程度和预后的生物标志物稀缺。我们旨在确定血清中脑源性tau蛋白（sBD - tau）和脑脊液中脑源性tau蛋白（CSF BD - tau）是否与GBS的长期预后及疾病严重程度相关。
在这项对100例GBS患者的回顾性研究中，我们在诊断时测量了sBD - tau和CSF BD - tau。预后定义为12个月时吉兰 - 巴雷综合征残疾量表（GBSDS）>2和总体神经病变限制量表（ONLS），疾病严重程度定义为呼吸支持情况及最低点时的ONLS。比较了各组间的BD - tau水平，并将其与ONLS评分进行相关性分析。对12个月时GBSDS>2进行了回归分析和受试者工作特征曲线分析。
血清和脑脊液中，12个月时GBSDS>2的患者BD - tau水平较高。sBD - tau的优势比为1.9（95%可信区间1.08 - 3.2，p = 0.03），CSF BD - tau的优势比为5.9（95%可信区间1.4 - 25，p = 0.02）。sBD - tau的曲线下面积为0.75（95%可信区间0.57 - 0.9，p < 0.001），CSF BD - tau的曲线下面积为0.78（95%可信区间0.65 - 0.9，p = 0.001）。12个月时的ONLS与sBD - tau（ρ = 0.34 [95%可信区间0.12 - 0.53]，p = 0.002）和CSF BD - tau（ρ = 0.33 [95%可信区间0.08 - 0.54]，p = 0.01）相关。最低点时呼吸支持情况或ONLS的BD - tau水平未见统计学显著差异。
GBS发病时的BD - tau与长期预后相关，但与疾病严重程度无关。由于BD - tau本质上是一种中枢神经系统生物标志物，我们的结果表明中枢神经系统受累影响恢复。
