Circulating T-cell subsets in Guillain-Barré syndrome

We compared the distribution of circulating T-cell subsets within 2 weeks of onset of symptoms in 14 patients with acute Guillain-Barré syndrome (GBS) and 37 normal controls. The levels of OKT4+ (putative helper-inducer) cells was definitely abnormal (decreased) in 3/13 tested. The levels of OKT8+ (putative suppressor-cytotoxic) cells were elevated in 3 and decreased in 2 of the 14 tested. Abnormal OKT4/OKT8 ratios were detected in 5 (2 elevated and 3 decreased) patients. Four of the 5 GBS patients with abnormal OKT4+/OKT8+ ratios were studied sequentially at least 4 times over 1-10 months; there was a return towards a normal ratio in all. Serial studies in 3 other GBS patients showed consistently normal values. In comparison, sequential studies over 5-24 months in 7 normals showed no abnormal OKT4+/OKT8+ ratios. Thus, abnormalities in OKT4+/OKT8+ ratios appear to be a marker of systemic events during symptomatic phases of GBS. It is not as yet known whether this is related to the cause or is secondary to the clinical manifestations of GBS.