Anti- #ganglioside #antibodies in patients with #Zika virus #infection-associated #GBS in #Brazil (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Anti-ganglioside antibodies in patients with Zika virus infection-associated Guillain-Barré Syndrome in Brazil

Juan Rivera-Correa, Isadora Cristina de Siqueira, Sabrina Mota, Mateus Santana do Rosário, Pedro Antônio Pereira de Jesus, Luiz Carlos Junior Alcantara, Joel D. Ernst, Ana Rodriguez

Published: September 17, 2019 / DOI: https://doi.org/10.1371/journal.pntd.0007695 / This is an uncorrected proof.

 

Abstract

Zika virus infection is associated with the development of Guillain-Barré syndrome (GBS), a neurological autoimmune disorder caused by immune recognition of gangliosides and other components at nerve membranes. Using a high-throughput ELISA, we have analyzed the anti-glycolipid antibody profile, including gangliosides, of plasma samples from patients with Zika infections associated or not with GBS in Salvador, Brazil. We have observed that Zika patients that develop GBS present higher levels of anti-ganglioside antibodies when compared to Zika patients without GBS. We also observed that a broad repertoire of gangliosides was targeted by both IgM and IgG anti-self antibodies in these patients. Since Zika virus infects neurons, which contain membrane gangliosides, antigen presentation of these infected cells may trigger the observed autoimmune anti-ganglioside antibodies suggesting direct infection-induced autoantibodies as a cause leading to GBS development. Collectively, our results establish a link between anti-ganglioside antibodies and Zika-associated GBS in patients.

 

Author summary

Zika virus infection can trigger the development of Guillain Barré syndrome (GBS), a neurological autoimmune disorder mediated by antibodies recognizing gangliosides in nerve membranes. Mechanisms such as molecular mimicry have been identified as a cause for GBS development in certain infections, such as Campylobacter jejuni, but the broad self reactivity observed during GBS suggests a role for alternative mechanisms. Our finding that Zika patients with GBS present higher levels of anti-ganglioside antibodies compared to uncomplicated Zika patients in Brazil points to these auto-antibodies as a trigger for GBS in these patients. These findings further support infection-induced autoantibodies as a factor contributing to GBS development, adding novel mechanisms for GBS development beyond molecular mimicry.

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Citation: Rivera-Correa J, de Siqueira IC, Mota S, do Rosário MS, Pereira de Jesus PA, Alcantara LCJ, et al. (2019) Anti-ganglioside antibodies in patients with Zika virus infection-associated Guillain-Barré Syndrome in Brazil. PLoS Negl Trop Dis 13(9): e0007695. https://doi.org/10.1371/journal.pntd.0007695

Editor: Rebecca C. Christofferson, Louisiana State University, UNITED STATES

Received: March 18, 2019; Accepted: August 7, 2019; Published: September 17, 2019

Copyright: © 2019 Rivera-Correa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files

Funding: AR and JRC received funding for this project from New York University School of Medicine Internal Funds. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Zika Virus; Immunopathology; GBS; Neurology; Brazil.

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Incidence of Guillain-Barré Syndrome (#GBS) in #Latin #America and the #Caribbean before and during the 2015–2016 #Zika virus #epidemic: A systematic review and meta-analysis (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean before and during the 2015–2016 Zika virus epidemic: A systematic review and meta-analysis

Ariadna Capasso, Danielle C. Ompad, Dorice L. Vieira, Annelies Wilder-Smith, Yesim Tozan

Published: August 26, 2019 / DOI: https://doi.org/10.1371/journal.pntd.0007622 / This is an uncorrected proof.

 

Abstract

Background

A severe neurological disorder, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. Enhanced surveillance of GBS in Latin America and the Caribbean (LAC) following the 2015–2016 Zika virus (ZIKV) epidemic presents an opportunity to estimate, for the first time, the regional incidence of GBS.

Methods and findings

For this systematic review and meta-analysis, we searched nine scientific databases and grey literature from January 1, 1980 to October 1, 2018. Sources with primary data on incident GBS cases in LAC within a well-defined population and timeframe, published in English, Spanish, Portuguese, or French, were included. We calculated the annual GBS incidence rates (IRs) and 95% confidence intervals (CIs) for each source based on published data. Following an assessment of heterogeneity, we used random-effects meta-analysis to calculate the pooled annual IR of GBS. The study is registered with PROSPERO, number CRD42018086659. Of the 6586 initial citation hits, 31 were eligible for inclusion. Background annual GBS IRs in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29–2.12, I2<0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.6 (95% CI 2.3–2.9) times during ZIKV and 1.9 (95% CI 1.1–3.4) times during chikungunya outbreaks over background rates. A limitation of this review is that the studies included employed different methodologies to find and ascertain cases of GBS, which could contribute to IR heterogeneity. In addition, it is important to consider that data on GBS are lacking for many countries in the region.

Conclusions

Background IRs of GBS appear to peak during arboviral disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness, particularly during arboviral epidemics.

Trial registration

Registered with PROSPERO: CRD42018086659.

 

Author summary

A severe neurological disorder, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. This is the first systematic review on GBS incidence in Latin America and the Caribbean before and during arboviral disease outbreaks. There is a large sub-regional and annual fluctuation in the incidence of GBS. Background annual GBS incidence rates (IRs) in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29–2.12, I2<0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.9 times during ZIKV and 1.9 times during chikungunya outbreaks over background rates. GBS is a costly disease, which can result in long-term disability and high mortality rates in resource constrained healthcare settings. Because GBS can be triggered by arboviral infections, baseline incidence of GBS is critical for detecting neglected tropical disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness.

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Citation: Capasso A, Ompad DC, Vieira DL, Wilder-Smith A, Tozan Y (2019) Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean before and during the 2015–2016 Zika virus epidemic: A systematic review and meta-analysis. PLoS Negl Trop Dis 13(8): e0007622. https://doi.org/10.1371/journal.pntd.0007622

Editor: David Harley, University of Queensland, AUSTRALIA

Received: March 4, 2019; Accepted: July 10, 2019; Published: August 26, 2019

Copyright: © 2019 Capasso et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: AWS’s participation in this study was partially funded by the European Union’s Horizon 2020 research and innovation program ZikaPLAN, under Grant Agreement No. 734584. URL:https://ec.europa.eu/programmes/horizon2020/en. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Zika Virus; GBS; Latin America; Caribbean.

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#GBS After Trivalent #Influenza #Vaccination in Adults (Front Neurol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Front Neurol. 2019 Jul 24;10:768. doi: 10.3389/fneur.2019.00768. eCollection 2019.

Gulllain-Barre Syndrome After Trivalent Influenza Vaccination in Adults.

Chang KH1,2, Lyu RK1,2, Lin WT3, Huang YT3, Lin HS4, Chang SH2,3,5,6.

Author information: 1 Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 2 College of Medicine, Chang Gung University, Taoyuan, Taiwan. 3 Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 4 Division of Infectious Diseases, Chang Gung Memorial Hospital, Chiayi, Taiwan. 5 Division of Cardiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 6 Graduate Institute of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.

 

Abstract

Lines of evidence suggest trivalent influenza vaccination may be associated with Guillain-Barre syndrome (GBS), an immune-mediated acute inflammatory neuropathy. On the other hand, this vaccination protects against influenza infection, which has been demonstrated as a trigger of GBS. To clarify the net effect of trivalent influenza vaccines on GBS, we conducted a retrospective nationwide nested case-control study using the database of the Taiwan National Health Insurance program. We identified 182 hospitalized patients with GBS aged ≥50 years from 2007 to 2015 as the cases, and 910 hospitalized patients, matched by gender, age, date of hospitalization, comorbidities, and medications, as the control subjects. Nearby and remote exposures of vaccination were defined as subjects who had received trivalent influenza vaccine 42 (nearby exposure) and 90 days (remote exposure) before the date of hospitalization, respectively. We found 7 (3.85%) GBS patients and 26 (2.86%) matched control subjects who demonstrated nearby exposures of influenza vaccine (odds ratio: 1.46, 95% confidence interval: 0.56-3.78). Seventeen (9.34%) GBS patients were exposed to influenza vaccines remotely, while the number of remote exposure of influenza vaccines in matched control subjects was 72 (7.91%, odds ratio: 1.26, 95% confidence interval: 0.67-2.38). These results do not support an association between trivalent influenza vaccine and GBS among the patients aged ≥50 years.

KEYWORDS: Guillain–Barre syndrome; endemic flu; influenza; polyneuropathy; vaccination

PMID: 31396144 PMCID: PMC6667925 DOI: 10.3389/fneur.2019.00768

Keywords: GBS; Seasonal Influenza; Vaccines; Neurology.

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#GBS and related #diseases after #influenza virus #infection (Neurol Neuroimmunol Neurinflamm., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Neurol Neuroimmunol Neuroinflamm. 2019 May 21;6(4):e575. doi: 10.1212/NXI.0000000000000575. eCollection 2019 Jul.

Guillain-Barré syndrome and related diseases after influenza virus infection.

Yamana M1, Kuwahara M1, Fukumoto Y1, Yoshikawa K1, Takada K1, Kusunoki S1.

Author information: 1 Department of Neurology (M.Y., M.K., Y.F., K.Y., K.T., S.K.), Kindai University Faculty of Medicine; and Department of Neurology (K.T.), Shinjinkai Hospital, Osaka, Japan.

 

Abstract

OBJECTIVE:

We examined the clinical and serologic features of Guillain-Barré syndrome (GBS)-related diseases (GBSRDs), including GBS, Fisher syndrome (FS), and Bickerstaff brainstem encephalitis (BBE), after influenza virus infection (GBSRD-I) to reveal potential underlying autoimmune mechanisms.

METHODS:

We retrospectively investigated the presence of antiglycolipid antibodies against 11 glycolipids and the clinical features of 63 patients with GBSRD-I. Autoantibody profiles and clinical features were compared with those of 82 patients with GBSRDs after Campylobacter jejuni infection (GBSRD-C).

RESULTS:

The anti-GQ1b seropositivity rate was significantly higher, whereas the GM1 and GD1a seropositivity rates were significantly lower in GBSRD-I compared with GBSRD-C. Anti-GQ1b and anti-GT1a were the most frequently detected antiglycolipid antibodies in GBSRD-I (both 15/63, 24%). Consequently, FS was more frequent in GBSRD-I than GBSRD-C (22% vs 9%, p < 0.05). In addition, as for GBS, cranial nerve deficits, sensory disturbances, and ataxia were more frequent in the cases after influenza infection (GBS-I) than in those after C. jejuni infection (GBS-C) (46% vs 15%, 75% vs 46%, and 29% vs 4%, respectively; all p < 0.01). Nerve conduction studies revealed acute inflammatory demyelinating polyneuropathy (AIDP) in 60% of patients with GBS-I but only 25% of patients with GBS-C (p < 0.01).

CONCLUSIONS:

Anti-GQ1b antibodies are the most frequently detected antibodies in GBSRD-I. Compared with GBS-C, GBS-I is characterized by AIDP predominance and frequent presence of cranial nerve involvement and ataxia.

PMID: 31355311 PMCID: PMC6624088 DOI: 10.1212/NXI.0000000000000575

Keywords: Seasonal Influenza; GBS; Neurology.

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#Chikungunya, a #risk #factor for #GBS (Clin Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Clin Infect Dis. 2019 Jul 9. pii: ciz625. doi: 10.1093/cid/ciz625. [Epub ahead of print]

Chikungunya, a risk factor for Guillain-Barré syndrome.

Stegmann-Planchard S1,2, Gallian P3,4, Tressières B2, Leparc-Goffart I5, Lannuzel A6, Signaté A7, Laouénan C8, Cabié A9, Hoen B10.

Author information: 1 Unité de Maladies Infectieuses, Centre Hospitalier Louis-Constant Fleming, Saint Martin, France. 2 Centre d’Investigation Clinique Antilles Guyane, Inserm CIC 1424, Pointe-à-Pitre, Guadeloupe, France. 3 Etablissement Français du Sang, Saint Denis-La Plaine Stade de France, France. 4 Unité des Virus Emergents (UVE: Aix-Marseille Univ – IRD 190 – Inserm 1207 – IHU Méditerranée Infection), Marseille, France. 5 Centre national de référence des arbovirus, Errit-IRBA HIA Laveran, Marseille, France. 6 Service de Neurologie, Centre Hospitalier Universitaire de Pointe-à-Pitre, Guadeloupe, France. 7 Service de Neurologie, Centre Hospitalier Universitaire de Martinique, Fort de France, Martinique, France. 8 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité ; Centre d’Investigation Clinique Inserm CIC-EC 1425 and Département d’Epidémiologie, Biostatistiques et recherche Clinique, Hôpital Bichat-Claude Bernard, AP-HP, all in Paris, France. 9 Centre d’Investigation Clinique Antilles Guyane, Inserm CIC 1424 and Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de la Martinique and Université des Antilles, EA 4537, all in Fort-de-France, France. 10 Centre d’Investigation Clinique Antilles Guyane, Inserm CIC 1424 and Service de Maladies Infectieuses et Tropicales, Dermatologie, Médecine Interne, Centre Hospitalier Universitaire de la Guadeloupe and Université des Antilles, EA 4537, all in Pointe-à-Pitre, France.

 

Abstract

In a matched case-control study where 24 cases developed Guillain-Barré syndrome (GBS) during the 2014 chikungunya outbreak in the French West Indies and 72 controls were blood donors who donated their blood at the same period, Chikungunya infection was a risk factor for GBS (OR 8.3, 95% CI 2.3-29.7, p=0.001).

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

KEYWORDS: Chikungunya virus; Guillain-Barré syndrome; case-control study; chikungunya infection

PMID: 31290540 DOI: 10.1093/cid/ciz625

Keywords: Chikungunya fever; GBS.

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#Zika virus #infection and #risk of #GBS: A meta-analysis (J Neurol Sci., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Neurol Sci. 2019 Jun 21;403:99-105. doi: 10.1016/j.jns.2019.06.019. [Epub ahead of print]

Zika virus infection and risk of Guillain-Barré syndrome: A meta-analysis.

Bautista LE1.

Author information: 1 Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 Walnut Street, WARF 703, Madison, WI 53726-2397, United States. Electronic address: lebautista@wisc.edu.

 

Abstract

OBJECTIVE:

Findings from studies of the association between Zika virus (ZIKV) infection and Guillain-Barré syndrome (GBS) are inconsistent. I conducted a systematic review and meta-analysis to clarify the nature of this association.

METHODS:

I searched PubMed, Scopus, Cochrane, CINAHL, Web of Science, Scielo, and DOAJ for case report, ecological, and analytic studies with “Zika” and “Guillain-Barré syndrome” as keywords, published up to July 1stth 2018. I evaluated if ZIKV infection status influenced the diagnosis of GBS (detection bias) in case-report and analytic studies; assessed if changes in weekly number of cases of ZIKV infection during outbreaks were followed by changes in number of GBS cases 1-8 weeks later; gauged the likelihood of selection, confounding, information, sparse data, and time-dependent bias (i.e. when ZIKV infection was ascertained after GBS onset) in analytic studies; and calculated the average ZIKV-GBS odds ratio (OR) in studies without time-dependent bias.

RESULTS:

In case reports, ZIKV infection prevalence in GBS cases was 2.4 to 25 times higher than expected. Changes in the number of ZIKV-infection cases during outbreaks were not consequentially followed by changes in the number of GBS cases (OR: 1.01; 95% CI: 0.99-1.03). Major biases were likely in all but one analytic study, which showed a non-significant ZIKV-GBS association. The average ZIKV-GBS OR in studies without time-dependent bias was 1.57 (95% CI: 0.86-2.86).

INTERPRETATION:

These findings indicate the available evidence is insufficient to claim ZIKV infection causes GBS. Therefore, stakeholders may want to reconsider current ZIKV-GBS public health and patient care recommendations.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS: Disease outbreaks; Guillain-Barre syndrome; Systematic review; Zika virus

PMID: 31255970 DOI: 10.1016/j.jns.2019.06.019

Keywords: Zika Virus; GBS.

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#GBS and its correlation with #dengue, #Zika and #chikungunya viruses #infection based on a literature review of reported cases in #Brazil (Acta Trop., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Acta Trop. 2019 Jun 17:105064. doi: 10.1016/j.actatropica.2019.105064. [Epub ahead of print]

Guillain-Barre Syndrome and its correlation with dengue, Zika and chikungunya viruses infection based on a literature review of reported cases in Brazil.

de Sousa Lima ME1, Rodrigues Bachur TP2, Frota Aragão G3.

Author information: 1 Curso de Medicina, Universidade Estadual do Ceará, Campus Itaperi, Av. Dr. Silas Munguba, 1700 – Itaperi, Fortaleza, CE, CEP 60.714-903, Brazil. Electronic address: matheus.eugenio@aluno.uece.br. 2 Curso de Medicina, Universidade Estadual do Ceará, Campus Itaperi, Av. Dr. Silas Munguba, 1700 – Itaperi, Fortaleza, CE, CEP 60.714-903, Brazil. Electronic address: tatiana.bachur@uece.br. 3 Curso de Medicina, Universidade Estadual do Ceará, Campus Itaperi, Av. Dr. Silas Munguba, 1700 – Itaperi, Fortaleza, CE, CEP 60.714-903, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos, Faculdade de Medicina, Universidade Federal do Ceará, Campus do Porangabuçu, Rua Cel. Nunes de Melo, 1000 – Rodolfo Teófilo, Fortaleza, CE, CEP 60.430-275, Brazil. Electronic address: gislei.frota@uece.br.

 

Abstract

Guillain-Barre syndrome (GBS) is one of the main neurologic manifestations of arboviruses, especially Zika virus infection. As known, the prevalence of these diseases is high, so the risk of having an increase on GBS is relevant. The study purposes making a comparative survey between the involvement of dengue, Zika and chikungunya infections in the development of the GBS in Brazil, as well as search in literature resemblances and distinctions between beforehand reported cases. It was performed an electronic search in online databases, with articles published between the years of 2004 to 2018. A total of 729 articles about the proposed search were found, and 10 were selected according to inclusion and exclusion criteria. The medium age found in Brazilian studies was 42,9. The time lapse for the neurological symptoms manifest was 6,5 to 11 days. Facial palsy, paresthesia and member weakness were the main symptoms related. Pediatric cases are rare. There are many studies that implicated the association of GBS and arboviruses and point it to one of the main neurological manifestation of these infections. More research and consistent data are needed to clarify unanswered questions and guide public health measures.

Copyright © 2019. Published by Elsevier B.V.

KEYWORDS: Guillain-Barre syndrome; Zika virus; chikungunya; dengue fever

PMID: 31220435 DOI: 10.1016/j.actatropica.2019.105064

Keywords: Arbovirus; GBS; Chikungunya fever, Zika Virus, Dengue fever, Brazil.

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