title: Comprehensive analysis of bacterial risk factors for the development of Guillain-Barre syndrome after Campylobacter jejuni enteritis.
abstract: BACKGROUND
  Guillain-Barre syndrome (GBS), a postinfectious autoimmune-mediated neuropathy, is a serious complication after Campylobacter jejuni enteritis.
  
  
  METHODS
  To investigate the bacterial risk factors for developing GBS, genotypes, serotypes, and ganglioside mimics on lipo-oligosaccharide (LOS) were analyzed in C. jejuni strains from Japanese patients.
  
  
  RESULTS
  Strains from patients with GBS had LOS biosynthesis locus class A more frequently (72/106; 68%) than did strains from patients with enteritis (17/103; 17%). Class A strains predominantly were serotype HS:19 and had the cstII (Thr51) genotype; the latter is responsible for biosynthesis of GM1-like and GD1a-like LOSs. Both anti-GM1 and anti-GD1a monoclonal antibodies regularly bound to class A LOSs, whereas no or either antibody bound to other LOS locus classes. Mass-spectrometric analysis showed that a class A strain carried GD1a-like LOS as well as GM1-like LOS. Logistic regression analysis showed that serotype HS:19 and the class A locus were predictive of the development of GBS.
  
  
  CONCLUSIONS
  The high frequency of the class A locus in GBS-associated strains, which was recently reported in Europe, provides the first GBS-related C. jejuni characteristic that is common to strains from Asia and Europe. The class A locus and serotype HS:19 seem to be linked to cstII polymorphism, resulting in promotion of both GM1-like and GD1a-like structure synthesis on LOS and, consequently, an increase in the risk of producing antiganglioside autoantibodies and developing GBS.
authors.affiliation: Department of Neurology, Dokkyo University School of Medicine, Tochigi, Japan. kogamrk@dokkyomed.ac.jp
authors.forename: Michiaki
authors.initials: M
authors.lastname: Koga
authors.forename: Michel
authors.initials: M
authors.lastname: Gilbert
authors.forename: Masaki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
authors.forename: Saiko
authors.initials: S
authors.lastname: Koike
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yuki
mesh_terms: D000907:Antibodies, Bacterial / Q000276:immunology; D002169:Campylobacter Infections / Q000150:complications* / Q000382:microbiology; D016123:Campylobacter jejuni; D004751:Enteritis / Q000150:complications / Q000382:microbiology*; D005677:G(M1) Ganglioside / Q000737:chemistry / Q000276:immunology*; D020275:Guillain-Barre Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D008070:Lipopolysaccharides / Q000737:chemistry / Q000276:immunology / Q000378:metabolism*; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial; D008070:Lipopolysaccharides; D005677:G(M1) Ganglioside