title: Campylobacter jejuni capsular genotypes are related to Guillain-Barré syndrome.
abstract: In about one in a thousand cases, a Campylobacter jejuni infection results in the severe polyneuropathy Guillain-Barré syndrome (GBS). It is established that sialylated lipo-oligosaccharides (LOS) of C. jejuni are a crucial virulence factor in GBS development. Frequent detection of C. jejuni with sialylated LOS in stools derived from patients with uncomplicated enteritis implies that additional bacterial factors should be involved. To assess whether the polysaccharide capsule is a marker for GBS, the capsular genotypes of two geographically distinct GBS-associated C. jejuni strain collections and an uncomplicated enteritis control collection were determined. Capsular genotyping of C. jejuni strains from the Netherlands revealed that three capsular genotypes, HS1/44c, HS2 and HS4c, were dominant in GBS-associated strains and capsular types HS1/44c and HS4c were significantly associated with GBS (p 0.05 and p 0.01, respectively) when compared with uncomplicated enteritis. In a GBS-associated strain collection from Bangladesh, capsular types HS23/36c, HS19 and HS41 were most prevalent and the capsular types HS19 and HS41 were associated with GBS (p 0.008 and p 0.02, respectively). Next, specific combinations of the LOS class and capsular genotypes were identified that were related to the occurrence of GBS. Multilocus sequence typing revealed restricted genetic diversity for strain populations with the capsular types HS2, HS19 and HS41. We conclude that capsular types HS1/44c, HS2, HS4c, HS19, HS23/36c and HS41 are markers for GBS. Besides a crucial role for sialylated LOS of C. jejuni in GBS pathogenesis, the identified capsules may contribute to GBS susceptibility.
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Electronic address: a.heikema@erasmusmc.nl.
authors.forename: A P
authors.initials: AP
authors.lastname: Heikema
authors.affiliation: International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.
authors.forename: Z
authors.initials: Z
authors.lastname: Islam
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Horst-Kreft
authors.affiliation: Department of Immunology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Huizinga
authors.affiliation: Department of Immunology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands; Department of Neurology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.
authors.forename: B C
authors.initials: BC
authors.lastname: Jacobs
authors.affiliation: Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, The Netherlands; Central Veterinary Institute of Wageningen UR, Lelystad, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Wagenaar
authors.affiliation: Naval Medical Research Center, Silver Spring, MD, USA.
authors.forename: F
authors.initials: F
authors.lastname: Poly
authors.affiliation: Naval Medical Research Center, Silver Spring, MD, USA.
authors.forename: P
authors.initials: P
authors.lastname: Guerry
authors.affiliation: bioMérieux, R&D Microbiology, La Balme Les Grottes, France.
authors.forename: A
authors.initials: A
authors.lastname: van Belkum
authors.affiliation: Produce Safety and Microbiology Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, CA, USA.
authors.forename: C T
authors.initials: CT
authors.lastname: Parker
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, The Netherlands; International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh; Fondation Mérieux, Lyon, France.
authors.forename: H P
authors.initials: HP
authors.lastname: Endtz
mesh_terms: D016667:Bacterial Capsules / Q000235:genetics*; D001459:Bangladesh / Q000453:epidemiology; D002169:Campylobacter Infections / Q000150:complications* / Q000382:microbiology*; D016123:Campylobacter jejuni / Q000145:classification / Q000235:genetics*; D005838:Genotype; D020275:Guillain-Barre Syndrome / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D009426:Netherlands / Q000453:epidemiology
keywords: Campylobacter jejuni; Guillain–Barré syndrome; capsular genotype; lipo-oligosaccharide; multilocus sequence typing