title: Intravenous immunoglobulin reduces serum tumor necrosis factor alpha in patients with Guillain-Barre syndrome.
abstract: BACKGROUND
  Tumor necrosis factor a TNF-alpha has a possible role in the pathogenesis of the Guillain-Barre syndrome (GBS).
  
  
  OBJECTIVE
  To study the effect of intravenous immunoglobulin (IVIg) on serum TNF-alpha concentrations in patients with GBS.
  
  
  METHODS
  The effect of IVIg on TNF-alpha was evaluated in 36 patients with GBS. Serum TNF-alpha concentration was measured by enzyme-linked immunosorbent assay (ELISA). The sera of 22 (61%) patients with GBS showed elevated concentrations of TNF-alpha (35-182 pg/ml) and these sera were individually incubated in vitro with IVIg (0.25 mg/ml) at 37 degrees C for 24 hours.
  
  
  RESULTS
  The serum TNF-alpha concentrations in the 22 GBS patients with elevated levels showed a steady decline (60.34-19.78 pg/ml) following incubation with IVIg. These 22 patients also received IVIg therapy, and serum TNF-alpha concentrations showed a significant decline (65.5-9.75 pg/ml) at the end of the therapy. At the time of discharge from the hospital, there was a positive correlation between neurological recovery and decline in TNF-alpha concentrations in these 22 GBS patients.
  
  
  CONCLUSIONS
  The results of this study indicate that elevated levels of TNF-alpha occur in a proportion of patients with GBS and in these patients elevated serum TNF-alpha levels decline with IVIg therapy.
authors.affiliation: Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram-695011, India.
authors.forename: S
authors.initials: S
authors.lastname: Reuben
authors.forename: M G
authors.initials: MG
authors.lastname: Sumi
authors.forename: A
authors.initials: A
authors.lastname: Mathai
authors.forename: M D
authors.initials: MD
authors.lastname: Nair
authors.forename: V V
authors.initials: VV
authors.lastname: Radhakrishnan
mesh_terms: D020275:Guillain-Barre Syndrome / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D016756:Immunoglobulins, Intravenous; D014409:Tumor Necrosis Factor-alpha