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Guillain‒barré syndrome: immunopathogenesis and therapeutic targets

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机构: [1]Department of Nuclear Medicine, Second Hospital of Jilin University, Changchun, China. [2]Department of Neurology, First Hospital of Jilin University, Jilin University, Changchun, China. [3]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China. [4]Department of Life Sciences, National Natural Science Foundation of China, Beijing, China.
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关键词: Guillain–Barré syndrome polyneuropathy immunopathogenesis therapeutic target coronavirus disease 2019

摘要:
Guillain‒Barré syndrome (GBS) is a group of acute immune-mediated disorders in the peripheral nervous system. Both infectious and noninfectious factors are associated with GBS, which may act as triggers of autoimmune responses leading to neural damage and dysfunction.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its vaccines as well as flaviviruses have been associated with GBS, although a robust conclusion has yet to be reached. Immunomodulatory treatments, including intravenous immunoglobulins (IVIg) and plasma exchange (PE), have long been the first-line therapies for GBS. Depending on GBS subtype and severity at initial presentation, the efficacy of IVIg and PE can be variable. Several new therapies showing benefits to experimental animals merit further investigation before translation into clinical practice. We review the state-of-the-art knowledge on the immunopathogenesis of GBS in the context of coronavirus disease 2019 (COVID-19). Immunomodulatory therapies in GBS, including IVIg, PE, corticosteroids, and potential therapies, are summarized.The association with SARS-CoV-2 remains uncertain, with geographical differences that are difficult to explain. Evidence and guidelines are lacking for the decision-making of initiating immunomodulatory therapies in mildly affected patients or patients with regional subtypes of GBS.

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出版当年[2023]版
大类 | 2 区 医学
小类 | 2 区 药学
最新[2023]版
大类 | 2 区 医学
小类 | 2 区 药学
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Q1 PHARMACOLOGY & PHARMACY
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Q1 PHARMACOLOGY & PHARMACY

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第一作者机构: [1]Department of Nuclear Medicine, Second Hospital of Jilin University, Changchun, China.
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通讯机构: [3]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China. [4]Department of Life Sciences, National Natural Science Foundation of China, Beijing, China. [*1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing 100053, China [*2]Department of Life Sciences, National Natural Science Foundation of China, Shuangqing Road 83#, Beijing 100085, China
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