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Early predictors of Guillain-Barre syndrome in the life course of women.

ABSTRACT: Background:We sought to determine if immune disorders early in life were associated with the later risk of Guillain-Barré syndrome, a neurological disorder thought to be infection-related. Methods:We conducted a longitudinal cohort study with 16?108?819 person-years of follow-up for a population of 1?108?541 parous women in Quebec, Canada (1989-2014). The outcome was Guillain-Barré syndrome. We identified women with potential risk factors for future Guillain-Barré syndrome, including immune-mediated and rheumatological diseases, cancer, transfusion, surgical procedures and pregnancy-specific disorders. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association of risk factors with later onset of Guillain-Barré syndrome, adjusted for personal characteristics of women. Results:The overall incidence of Guillain-Barré syndrome was 1.42 per 100?000 person-years. Incidence was higher for women with immune-mediated (8.79 per 100?000 person-years) and rheumatological disorders (9.84 per 100?000 person-years), transfusion (4.41 per 100?000 person-years), and preeclampsia (2.62 per 100?000 person-years). Immune-mediated disorders were associated with six times the risk of Guillain-Barré syndrome (HR 6.57, 95% CI 3.58 to 12.04), rheumatological disorders with seven times the risk (HR 7.23, 95% CI 3.21 to 16.28), transfusion three times the risk (HR 3.58, 95% CI 1.83 to 6.98) and preeclampsia two times the risk (HR 2.01, 95% CI 1.29 to 3.12). Women with other potential risk factors did not have an increased risk of Guillain-Barré syndrome. Conclusions:Immune-related conditions that occur early in life are associated with an increased risk of Guillain-Barré syndrome. The pathophysiology of Guillain-Barré syndrome may extend beyond infectious triggers.

SUBMITTER: Auger N

PROVIDER: S-EPMC5837790 | biostudies-other | 2018 Feb

REPOSITORIES: biostudies-other

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Early predictors of Guillain-Barré syndrome in the life course of women.

Auger Nathalie N Quach Caroline C Healy-Profitós Jessica J Dinh Trish T Chassé Michaël M

International journal of epidemiology 20180201 1

<h4>Background</h4>We sought to determine if immune disorders early in life were associated with the later risk of Guillain-Barré syndrome, a neurological disorder thought to be infection-related.<h4>Methods</h4>We conducted a longitudinal cohort study with 16 108 819 person-years of follow-up for a population of 1 108 541 parous women in Quebec, Canada (1989-2014). The outcome was Guillain-Barré syndrome. We identified women with potential risk factors for future Guillain-Barré syndrome, includ ...[more]

PMID: 29024971

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Project description:BackgroundGuillain-Barré syndrome (GBS) is an acute inflammatory neuropathy with a heterogeneous presentation. Although some evidences support the role of autoantibodies in its pathogenesis, the target antigens remain unknown in a substantial proportion of GBS patients. The objective of this study is to screen for autoantibodies targeting peripheral nerve components in Guillain-Barré syndrome.MethodsAutoantibody screening was performed in serum samples from all GBS patients included in the International GBS Outcome study by 11 different Spanish centres. The screening included testing for anti-ganglioside antibodies, anti-nodo/paranodal antibodies, immunocytochemistry on neuroblastoma-derived human motor neurons and murine dorsal root ganglia (DRG) neurons, and immunohistochemistry on monkey peripheral nerve sections. We analysed the staining patterns of patients and controls. The prognostic value of anti-ganglioside antibodies was also analysed.ResultsNone of the GBS patients (n = 100) reacted against the nodo/paranodal proteins tested, and 61 (61%) were positive for, at least, one anti-ganglioside antibody. GBS sera reacted strongly against DRG neurons more frequently than controls both with IgG (6% vs 0%; p = 0.03) and IgM (11% vs 2.2%; p = 0.02) immunodetection. No differences were observed in the proportion of patients reacting against neuroblastoma-derived human motor neurons. Reactivity against monkey nerve tissue was frequently detected both in patients and controls, but specific patterns were only detected in GBS patients: IgG from 13 (13%) patients reacted strongly against Schwann cells. Finally, we confirmed that IgG anti-GM1 antibodies are associated with poorer outcomes independently of other known prognostic factors.ConclusionOur study confirms that (1) GBS patients display a heterogeneous repertoire of autoantibodies targeting nerve cells and structures; (2) gangliosides are the most frequent antigens in GBS patients and have a prognostic value; (3) further antigen-discovery experiments may elucidate other potential antigens in GBS.

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Early predictors of Guillain-Barre syndrome in the life course of women.

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Early predictors of Guillain-Barré syndrome in the life course of women.

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