Bacterial infections in Guillain-Barré and Fisher syndromes.
OBJECTIVE
Progress has been made in our understanding of Guillain-Barré syndrome, especially in identifying the Campylobacter jejuni genes responsible for the development of clinical features.


RESULTS
C. jejuni is grouped into several classes based on the organization of lipo-oligosaccharide biosynthesis genes. A specific class carrying a sialyltransferase gene (cst-II) is associated with the development of Guillain-Barré syndrome, which is essential for the biosynthesis of ganglioside-like lipo-oligosaccharides. The class of C. jejuni expressed both GM1-like and GD1a-like lipo-oligosaccharides, which could induce the production of autoantibodies to GM1, to GD1a or to the GM1/GD1a complex, possibly increasing the risk of development. C. jejuni sialyltransferase (Cst-II) consists of 291 amino acids, and the 51st amino acid determines its enzymatic activity. Strains with cst-II (Thr51) expressed GM1-like or GD1a-like lipo-oligosaccharide whereas strains with cst-II (Asn51) expressed GT1a-like or GD1c-like lipo-oligosaccharide. Patients infected with the cst-II (Thr51) strains had anti-GM1 or anti-GD1a IgG antibodies, and showed limb weakness. Patients infected with the cst-II (Asn51) strains had anti-GQ1b IgG antibodies, and showed ophthalmoplegia and ataxia.


CONCLUSIONS
The cst-II gene is responsible for the development of Guillain-Barré and Fisher syndromes, and the polymorphism (Thr/Asn51) determines which syndrome develops after C. jejuni enteritis.
Yuki
Nobuhiro
N
Department of Neurology and Research Institute for Neuroimmunological Diseases, Dokkyo Medical University School of Medicine, Tochigi, Japan. yuki@dokkyomed.ac.jp
Koga
Michiaki
M
D000818:Animals; D000907:Antibodies, Bacterial / Q000378:metabolism; D001323:Autoantibodies / Q000378:metabolism; D002169:Campylobacter Infections / Q000150:complications*; D016123:Campylobacter jejuni; D005677:G(M1) Ganglioside / Q000276:immunology / Q000378:metabolism; D020275:Guillain-Barre Syndrome / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D019846:Miller Fisher Syndrome / Q000209:etiology* / Q000382:microbiology; D012799:Sialyltransferases / Q000235:genetics
D000907:Antibodies, Bacterial; D001323:Autoantibodies; D005677:G(M1) Ganglioside; D012799:Sialyltransferases; C043662:alpha-N-acetylneuraminate alpha-2,8-sialyltransferase