Ganglioside mimicry and peripheral nerve disease

Area of Science:

• Neuroimmunology
• Microbiology
• Neurology

Background:

• Guillain-Barré syndrome (GBS) and Fisher syndrome (FS) are often associated with anti-ganglioside antibodies.
• Establishing a causative link between microorganisms and these syndromes requires rigorous criteria.

Purpose of the Study:

• To outline the essential criteria for attributing GBS/FS to specific microorganisms.
• To identify microorganisms definitively or possibly linked to GBS/FS and anti-ganglioside antibodies.

Main Methods:

• Review and synthesis of established criteria for microbial causation of GBS/FS.
• Evaluation of evidence linking specific microbes (e.g., Campylobacter jejuni) to GBS/FS and anti-ganglioside antibodies.
• Consideration of ganglioside mimicry as a pathogenic mechanism.

Main Results:

• Four key criteria were defined: epidemiological association, microbial isolation, ganglioside mimicry, and experimental models.
• Campylobacter jejuni is identified as a definitive cause of acute motor axonal neuropathy and a potential cause of FS.
• Haemophilus influenzae and Mycoplasma pneumoniae are considered possible causes of these neuropathies.

Conclusions:

• Meeting the four defined criteria is crucial for establishing microbial causality in GBS/FS.
• Campylobacter jejuni has a strong association with specific GBS/FS subtypes.
• Other mechanisms may underlie acute and chronic inflammatory demyelinating polyneuropathies beyond ganglioside mimicry.