Campylobacter jejuni lipopolysaccharides in Guillain-Barre syndrome: Molecular mimicry and host susceptibility

Objective: This study was designed to determine if the presence of specific ganglioside-like moieties in Campylobacter lipopolysaccharides (LPSs) is related to the development of Guillain-Barre syndrome (GBS), and to discover how frequently such moieties, including GM1, are present in these LPSs. Methods: We studied Campylobacter isolates and sera from seven patients with GBS (five acute motor axonal neuropathy, one acute inflammatory demyelinating polyneuropathy, and one Fisher's syndrome), and compared them with similar specimens from patients with Campylobacter enteritis alone. Results: All GBS patients had antiganglioside antibodies. Anti-GM1 and anti- GD1a titers were significantly elevated in post-Campylobacter GBS, both axonal and demyelinating, compared with normal control subjects or those with uncomplicated Campylobacter diarrhea. Campylobacter isolated from patients with GBS and with enteritis alone had similar ganglioside-like moieties. Conclusions: These results indicate that patients who develop GBS respond differently to the ganglioside-like epitopes on Campylobacter than do non- GBS diarrhea patients. Our findings support a role for host susceptibility as a determinant for the outcome following Campylobacter infection. These findings have important implications for the development of vaccines against Campylobacter jejuni.