Mishu B, Blaser M J
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
Clin Infect Dis. 1993 Jul;17(1):104-8. doi: 10.1093/clinids/17.1.104.
Recent reports suggest that infection with Campylobacter jejuni, a common enteric pathogen, may cause Guillain-Barré syndrome (GBS) by triggering demyelination of peripheral nerves. GBS is preceded by an acute infectious illness (due to a variety of agents) in 50%-75% of cases; the onset of neurological symptoms is preceded by diarrhea in 10%-30% of cases. In the last decade, more than 20 published anecdotal reports and case series have described patients with C. jejuni infection documented 1-3 weeks before onset of GBS. Cultures of fecal samples obtained at the onset of neurological symptoms from patients with GBS have yielded C. jejuni in more than 25% of cases. A relatively rare serotype, Penner type O19, is overrepresented among isolates of C. jejuni from Japanese patients with GBS. Serological studies suggest that 20%-40% of patients with GBS have evidence of recent C. jejuni infection. In summary, infection with C. jejuni is a common antecedent to GBS and probably plays a role in initiating demyelination; although several pathogenic mechanisms are possible, none has been proven.
近期报告表明，空肠弯曲菌（一种常见的肠道病原体）感染可能通过引发周围神经脱髓鞘而导致吉兰-巴雷综合征（GBS）。在50%-75%的病例中，GBS之前有急性感染性疾病（由多种病原体引起）；在10%-30%的病例中，神经症状发作之前有腹泻。在过去十年中，超过20篇已发表的轶事报道和病例系列描述了在GBS发作前1-3周记录有空肠弯曲菌感染的患者。在GBS患者神经症状发作时采集的粪便样本培养物中，超过25%的病例培养出空肠弯曲菌。在日本GBS患者的空肠弯曲菌分离株中，一种相对罕见的血清型，即彭纳O19型，占比过高。血清学研究表明，20%-40%的GBS患者有近期空肠弯曲菌感染的证据。总之，空肠弯曲菌感染是GBS常见的前驱因素，可能在引发脱髓鞘过程中起作用；尽管有几种致病机制是可能的，但均未得到证实。
