title: Nodo-paranodopathy, internodopathy and cleftopathy: Target-based reclassification of Guillain-Barré-like immune-mediated polyradiculoneuropathies in dogs and cats.
abstract: Recent views on Guillain-Barré syndrome (GBS) question the accuracy of classification into axonal and demyelinating subtypes that represent convergent neurophysiological phenotypes rather than immunological targets. Instead it has been proposed to clarify the primarily affected fibre subunit in nerve biopsies. As nerve biopsies rarely are part of routine work-up in human patients we evaluated tissues taken from companion animals affected by GBS-like polyradiculoneuropathy to screen for distribution of immune cells, targeted fibre components and segregating non-inflammatory lesions. We identified that immune responses were directed either at Schmidt-Lanterman clefts, the paranode-node complex or both. Based on infiltrative and non-inflammatory changes, four subtypes and/or stages were distinguished, some of which indicate localisation of primary target antigens while others represent convergent late stage pictures, as a consequence to epitope spreading. The impact of histological subtyping onto clinical management and prognosis remains to be evaluated in future clinical trials. Natural development and clinical manifestation of large animal dysimmune neuropathy may reflect human Guillain-Barré syndrome more accurately than experimental models and therefore provide complementary clues for translational research.
authors.affiliation: Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Gross
authors.affiliation: Section of Neurology, Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität, München, Munich, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fischer
authors.affiliation: Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Rosati
authors.affiliation: Neurology Referral Service, Tierklinik Haar, Haar, Germany.
authors.forename: Lara
authors.initials: L
authors.lastname: Matiasek
authors.affiliation: Clinica Veterinaria Roma Sud, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Corlazzoli
authors.affiliation: North Downs Specialist Referrals, Bletchingley, Surrey, UK.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Cappello
authors.affiliation: Clinica Veterinaria Roma Sud, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Porcarelli
authors.affiliation: Section of Neurology, Langford Veterinary Services, University of Bristol, Bristol, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Harcourt-Brown
authors.affiliation: Section of Neurology, Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität, München, Munich, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Jurina
authors.affiliation: Neurology Referral Service, Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, UK.
authors.forename: Laurent
authors.initials: L
authors.lastname: Garosi
authors.affiliation: Neurology Unit, Department of Small Animal Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Flegel
authors.affiliation: Section of Neurology, Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität, München, Munich, Germany.
authors.forename: Pia
authors.initials: P
authors.lastname: Quitt
authors.affiliation: Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Molin
authors.affiliation: Section of Neurology, Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität, München, Munich, Germany.
authors.forename: Velia-Isabel
authors.initials: VI
authors.lastname: Huelsmeyer
authors.affiliation: Neurology Service, Tierklinik Lueneburg, Lueneburg, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Schenk
authors.affiliation: Department of Veterinary Medical Science, University of Bologna, Italy.
authors.forename: Gualtiero
authors.initials: G
authors.lastname: Gandini
authors.affiliation: Section of Neurology & Neurosurgery, Advetia Clinic for Small Animal Medicine, Paris, France.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Gnirs
authors.affiliation: Section of Neurologie, Ecole Nationale Vétérinaire d'Alfort, University of Paris Est, Maisons Alfort, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Blot
authors.affiliation: Section of Neurologie, Ecole Nationale Vétérinaire d'Alfort, University of Paris Est, Maisons Alfort, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Jeandel
authors.affiliation: Section of Neurology, Clinica Veterinaria Valdinievole, Monsummano, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Baroni
authors.affiliation: Section of Neurology, Clinic of Small Animal Medicine, University of Berlin, Berlin, Germany.
authors.forename: Shenja
authors.initials: S
authors.lastname: Loderstedt
authors.affiliation: Clinica Veterinaria Malpensa, Samarate, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Abbiati
authors.affiliation: Small Animal Clinic Magunna-Magunna-Nickel, Norderstedt, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Leithaeuser
authors.affiliation: Small Animal Clinic Fuerstenwalde, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Schulze
authors.affiliation: Small Animal Clinic Trier, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Kornberg
authors.affiliation: Dovecote Veterinary Hospital, Castle Donington, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Lowrie
authors.affiliation: Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany. Electronic address: kaspar.matiasek@neuropathologie.de.
authors.forename: Kaspar
authors.initials: K
authors.lastname: Matiasek
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000145:classification* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D002415:Cats; D004283:Dog Diseases / Q000145:classification* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D004285:Dogs; D004576:Electromyography; D005260:Female; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D010525:Peripheral Nerves / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D011129:Polyradiculoneuropathy / Q000145:classification / Q000473:pathology / Q000503:physiopathology / Q000662:veterinary*; D012189:Retrospective Studies
chemical_list: D007155:Immunologic Factors
keywords: Canine; Coonhound paralysis; Feline; Immune-mediated; Peripheral nerve; Polyneuritis; Polyradiculoneuritis; Subtype; Teasing