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Síndrome de Guillain-Barré
Nortina Shahrizaila1, Helmar C Lehmann2, Satoshi Kuwabara3
1Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Lancet (London, England)
|March 1, 2021
Resumen
El síndrome de Guillain-Barré, una causa de parálisis, está relacionado con infecciones como el COVID-19. Si bien la inmunoterapia ayuda a muchos, se necesita un mejor acceso global y nuevos tratamientos para reducir la discapacidad y la muerte.
Área de la Ciencia:
- Neurología
- Inmunología
- Enfermedades infecciosas
Sus antecedentes:
- El síndrome de Guillain-Barré es una de las principales causas de parálisis flácida aguda a nivel mundial.
- A menudo sigue a las infecciones, incluidas las infecciones del tracto respiratorio superior, y se ha relacionado con Campylobacter jejuni, el virus Zika y el SARS-CoV-2.
- La patogénesis implica una respuesta inmune mediada por autoanticuerpos, potencialmente desencadenada por la imitación molecular.
Objetivo del estudio:
- Revisar el conocimiento actual del síndrome de Guillain-Barré.
- Destacar los desafíos de diagnóstico y las limitaciones de los criterios existentes para las variantes del síndrome.
- Discutir los resultados del tratamiento, las disparidades geográficas en la atención y las direcciones terapéuticas futuras.
Principales métodos:
- Revisión de la literatura existente sobre el síndrome de Guillain-Barré.
- Análisis de los datos del Estudio Internacional de Resultados del Síndrome de Guillain-Barré.
- Discusión de los ensayos clínicos en curso para nuevas terapias.
Principales resultados:
- El diagnóstico del síndrome de Guillain-Barré clásico es generalmente sencillo, pero las variantes pueden pasarse por alto.
- Si bien la inmunoterapia es efectiva para la mayoría, persisten una discapacidad y una mortalidad significativas.
- Se identificaron variaciones geográficas en el acceso al tratamiento, especialmente en los países de bajos ingresos.
Conclusiones:
- La mejora del acceso mundial a la inmunoterapia para el síndrome de Guillain-Barré es crucial.
- Es necesario desarrollar terapias modificadoras de la enfermedad para limitar la lesión nerviosa.
- La investigación en curso y los ensayos clínicos, incluidos los inhibidores del complemento, prometen avanzar en la comprensión y el tratamiento.
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