Attarian S, Bonnefoi-Kyriacou B, Gayraud D, Mignard P, Boucraut J, Pouget J, Viallet F
Service de Neurologie, CHG d'Aix-en-Provence.
Rev Neurol (Paris). 1997 Apr;153(3):205-8.
Infection by Campylobacter jejuni (C. jejuni) has been reported in 17 to 55 p. 100 of the GBS. The "axonal" GBS has been recently attributed to such an association. It is characterized by rapid progression to severe widespread paralysis, respiratory failure, poor and delayed recovery. The acute "axonal" form of Guillain-Barré syndrome has been and remains a matter of controversy. A typical case of GBS with serological evidence of recent C. jejuni infection and increased antibodies to GM1 is reported. An immune mechanism remains most likely. Recent studies have suggested the hypothesis of "shared epitope" between C. jejuni and peripheral nervous system cell (Gal beta 1-3 N Acetylgalactosamine epitope). Such a cross-reactivity could provoke a severe form of GBS with a poor recovery in some predisposed hosts (antiganglioside antibodies, HLA "immunogenic" groups such as B8, B35 or DR3).
空肠弯曲菌(C. jejuni)感染在17%至55%的吉兰-巴雷综合征(GBS)患者中被报道。“轴索性”GBS最近被归因于这种关联。其特征是迅速进展为严重的广泛麻痹、呼吸衰竭、恢复不佳且延迟。急性“轴索性”吉兰-巴雷综合征一直存在争议。报道了一例典型的GBS病例,有近期空肠弯曲菌感染的血清学证据且抗GM1抗体增加。免疫机制仍然最有可能。最近的研究提出了空肠弯曲菌与外周神经系统细胞之间“共同表位”的假说(Galβ1-3 N-乙酰半乳糖胺表位)。这种交叉反应可能在一些易感宿主(抗神经节苷脂抗体、HLA“免疫原性”组如B8、B35或DR3)中引发严重形式的GBS且恢复不佳。