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Miller Fisher syndrome and Haemophilus influenzae infection
1Department of Neurology, Dokkyo University School of Medicine, Tochigi, Japan. kogamrk@par.odn.ne.jp
Objective:
To examine the association between Miller Fisher syndrome (MFS) and antecedent Haemophilus influenzae infection.
Background:
Little is known about agents in prior respiratory tract infection of MFS, whereas antecedent upper respiratory symptoms are frequent. H. influenzae is a major pathogen that can cause human respiratory tract infection.
Methods:
The authors used ELISA to detect serum antibody against the bacterium in 70 consecutive patients with MFS and 110 with Guillain-Barré syndrome (GBS).
Results:
Serum anti-H. influenzae IgG and IgM antibody activities were significantly higher in the MFS group than in age- and sex-matched patients with other neurologic diseases (n = 62) and normal control subjects (n = 82). The GBS group showed no significant increase in any class of antibody activities compared with control groups. Serologic evidence of recent infection was found in five (7%) of the patients with MFS and two (2%) of 110 patients with GBS, all of whom had a history of antecedent respiratory tract infection. They frequently showed ophthalmoplegia, but other neurologic features were not remarkable. Serum anti-GQ1b IgG antibody that had cross-reactivity with GT1a ganglioside was detected in six of these seven patients. Thin-layer chromatography with immunostaining showed that serum IgG from H. influenzae-seropositive patients with high anti-GQ1b and anti-GT1a IgG antibody titers bound to the lipopolysaccharide fraction extracted from the type b H. influenzae serostrain. These bands were also stained by anti-GT1a monoclonal antibody (GMR11), indicating that the lipopolysaccharide bears the GT1a epitope.
Conclusions:
These findings point to H. influenzae being an agent associated with MFS. Epitopic overlap between H. influenzae and human nerve tissue may be involved in the development of MFS much as GBS is associated with Campylobacter jejuni enteritis.
Insights
Haemophilus influenzae infection is linked to Miller Fisher syndrome (MFS), with higher antibody levels found in MFS patients. This suggests a potential role for H. influenzae in MFS development, similar to Campylobacter jejuni in Guillain-Barré syndrome.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Miller Fisher syndrome (MFS) often follows upper respiratory symptoms, but causative agents are unclear.
- Haemophilus influenzae is a common respiratory pathogen with potential links to neurological disorders.
Purpose of the Study:
- To investigate the association between Miller Fisher syndrome (MFS) and antecedent Haemophilus influenzae infection.
- To determine if H. influenzae infection is a trigger for MFS.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to detect serum antibodies against H. influenzae.
- Antibody levels in 70 MFS patients were compared to 110 Guillain-Barré syndrome (GBS) patients and control groups.
Main Results:
- MFS patients showed significantly higher serum anti-H. influenzae IgG and IgM antibody levels compared to controls.
- No significant antibody increase was observed in GBS patients.
- Molecular analysis revealed cross-reactivity between H. influenzae lipopolysaccharide and neural epitopes (GT1a).
Conclusions:
- Haemophilus influenzae is identified as a potential infectious agent associated with Miller Fisher syndrome.
- Epitopic overlap between H. influenzae and neural tissues may underlie MFS pathogenesis, analogous to Campylobacter jejuni in GBS.