From the Guidelines
Guillain-Barré syndrome (GBS) is primarily caused by an aberrant immune response to infections, resulting in damage to peripheral nerves. The exact pathogenesis is not fully understood, but it is thought to involve an immune response to infections that triggers damage to the peripheral nerves 1. According to the study published in Nature Reviews Neurology in 2019 1, GBS is usually triggered by infections, and the incidence of GBS can increase during outbreaks of infectious diseases.
Common Triggers
Some common infectious triggers include:
- Campylobacter jejuni
- Cytomegalovirus
- Epstein-Barr virus
- Influenza virus
- Zika virus These infections can trigger an abnormal immune response, leading to the development of GBS 1.
Mechanism
The mechanism involves molecular mimicry, where antibodies produced to fight the infection cross-react with components of peripheral nerve sheaths because of structural similarities between microbial antigens and nerve components 1. This immune attack damages the myelin sheath or sometimes the nerve axons themselves, disrupting proper nerve signal transmission and causing the weakness, numbness, and paralysis characteristic of GBS.
Key Points
- GBS is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots 1
- The annual global incidence of GBS is approximately 1–2 per 100,000 person-years 1
- GBS occurs more frequently in males than in females, and the incidence increases with age 1
From the Research
Causes of Guillain-Barré Syndrome
The causes of Guillain-Barré Syndrome (GBS) are complex and multifactorial. Some of the key factors that contribute to the development of GBS include:
- Autoimmune factors, such as antibodies, which play a crucial role in the pathogenesis of the disease 2
- Previous infections, such as gastrointestinal or respiratory infections, which can trigger the onset of GBS 3, 4
- Molecular mimicry between surface structures of pathogens and components of myelin or the axon, which can lead to the production of autoantibodies 3, 4
Infectious Triggers
Several infectious agents have been identified as triggers for GBS, including:
- Campylobacter jejuni, which is responsible for approximately one-third of GBS cases 3, 4, 5
- Mycoplasma pneumoniae and cytomegalovirus, which are also common triggers for GBS 3, 4
- Zika virus and severe acute respiratory syndrome coronavirus 2, which have also been linked to GBS 4
Pathophysiology
The pathophysiology of GBS involves an immune-mediated response to the infectious trigger, which leads to the production of autoantibodies against components of the myelin sheath or axolemma 3, 4. This can result in demyelination or axonal damage, leading to the clinical symptoms of GBS.