Bay Biosciences provides high-quality cryopreserved cerebrospinal fluid samples, with matched fresh frozen sera (serum), plasma, and peripheral blood mononuclear cells (PBMC) bio-fluids, from patients diagnosed with Guillain-Barré syndrome (GBS).
The sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluid specimens are processed from Guillain-Barré syndrome (GBS) patients peripheral whole-blood using customized collection and processing protocols.
Fresh frozen tissue and matched biofluid samples were, collected from unique patients diagnosed with Guillain-Barré syndrome (GBS).
Bio-samples are provided to a valued pharmaceutical customer for research, diagnostics, discovery, and drug development.
Guillain-Barré Syndrome Overview
Guillain-Barré syndrome is a rare, serious neurological disorder. It is an autoimmune disease that affects the peripheral nervous system and can lead to weakness and paralysis that may last for months or years.
Guillain-Barré syndrome (GBS) often appears after a respiratory infection or gastroenteritis, also known as food poisoning. Symptoms start within a few days or weeks after the infection. In certain rare cases GBS may follow a vaccination.
In the United States, around 1 in 100,000 people develop GBS each year. Experts do not know why this disease occurs in some people and not others. It is not inherited or contagious.
This article explores the symptoms, causes, diagnosis, and treatment of GBS. It also looks at possible links with vaccinations.
GBS is rare serious autoimmune disease that can affect any part of the nervous system outside the brain and spinal cord. This is called the peripheral nervous system.
An autoimmune disease causes the immune system to attack and destroy certain groups of healthy cells. In the case of GBS, it attacks the myelin sheaths of peripheral nerves.
Myelin sheaths coat the axons of nerves. The myelin helps these long, thin extensions of nerve cells pass on messages. In some cases, GBS also attacks the axons themselves.
The damage prevents the nerves from sending certain information, such as touch sensations, to the spinal cord and brain. This causes a feeling of numbness. In addition, the brain and spinal cord can no longer transmit signals back to the body, leading to muscle weakness.
Anyone who develops unexplained tingling sensations and weakness should receive medical attention as soon as possible.
Types of Guillain-Barré Syndrome
There are three different forms of GBS:
- Acute inflammatory demyelinating polyradiculoneuropathy, which predominantly affects the myelin. The commonest form in America and Europe.
- Acute motor axonal neuropathy which affects the axons of the nerves going to the muscles. The commonest form in some Asian countries.
- Acute motor and sensory axonal neuropathy which affects the axons of the motor and sensory nerves.
GBS can take a number of forms. Acute inflammatory demyelinating polyradiculoneuropathy is the most common type of GBS in the United States Typically, the weakness begins in the lower part of the body and gradually moves upward to affect other areas.
Miller Fisher Syndrome is an acquired nerve disease and a variant of GBS. It represents around five to ten percent of GBS cases in the U.S. This disease can lead to problems with walking and balance. It affects the eye muscles and tendon reflexes.
Another rare form of GBS is acute motor axonal neuropathy, which causes sudden weakness in the limbs and sometimes trouble breathing. It may involve nerves in the head. A similar form of GBS is acute motor-sensory axonal neuropathy, which starts with sensory changes, such as tingling or numbness.
Some types begin more slowly and involve ongoing symptoms. In chronic inflammatory demyelinating polyneuropathy (CIDP), periods of weakness recur over a number of years. In multifocal motor neuropathy, weakness affects several muscles in a specific area of one or both arms or legs.
Signs and Symptoms of Guillain-Barré Syndrome
Weakness usually begins in the legs and spreads to the arms and body. Sometimes it spreads to the breathing muscles, face and throat. In up to a quarter of people with GBS, the breathing muscles become so weak as to need temporary support of respiration on a breathing machine.
Feelings of tingling, pins and needles, and numbness (loss of feeling) are common. These are due to damage to the sensory nerves that signal feeling from the skin and joints. The abnormal feelings are usually worst in the feet and hands. The tingling may be painful and the muscles may also hurt.
The symptoms usually worsen for the first two weeks but the progression may last as little as one day or as long as four weeks. Symptoms usually affect both sides of the body equally.
Symptoms of GBS often start within 3 weeks of an infection. They usually begin with tingling and weakness in the feet and hands or pain in the legs or back. Children may have difficulty walking.
The weakness sometimes begins in the upper body, but it usually starts in the lower legs and spreads up. In some cases, it may not spread beyond the legs.
If the weakness extends beyond the legs, a person may develop:
- Difficulty breathing
- Muscle weakness in the arms
- Weakness on both sides of the body
- Paralysis of the whole body
The symptoms can worsen over several hours, days, or weeks. In 9 out of 10 cases, the symptoms are worse in the third week. After four weeks the weakness is unlikely to worsen.
As well as muscle weakness and tingling, nerve changes can lead to:
- Changes in heart rate or blood pressure
- Difficulty speaking, chewing, and swallowing
- Severe pain, especially at night
- Problems with coordination
- Vision problems, due to weakness in the eye muscles
- Problems with digestion and bladder control
Anyone with these symptoms needs urgent medical attention. In some cases, patients lose the use of their muscles, resulting in paralysis. And breathing problems and cardiovascular changes can be life threatening.
GBS can have emotional effects as well. Adjusting to rapid paralysis and the need for help can be distressing.
After four weeks, when the symptoms have peaked, they remain stable for a time and the nerves gradually heal.
Causes of Guillain-Barré Syndrome
The exact causes of GBS are unknown, but it often occurs after an infection. In certain rare cases, people have experienced it after a vaccination. It can affect anyone, but those aged over 50 years appear to have a higher risk.
People have developed GBS after infection with the following conditions:
- Campylobacter jejuni bacteria, which can cause a bowel infection and diarrhea
- The Epstein-Barr virus, which causes infectious mononucleosis or glandular fever
- Cytomegalovirus, which may cause no symptoms
- Mycoplasma pneumoniae bacteria, which can infect the respiratory tract
- Maybe the Zika virus, although researchers are still investigating this
One theory is that viral and bacterial infections change how the immune system reacts to the peripheral nerves. This results in the immune system misidentifying myelin and axons as a foreign substance and targeting them.
Diagnosis of Guillain-Barré Syndrome
GBS can be difficult to diagnose especially in its earlier phases. The symptoms vary between people, and they can resemble the symptoms of other neurological conditions.
A doctor will consider:
- How fast the symptoms have appeared
- The order in which they have appeared
- Whether the weakness affects both sides of the body
They may also recommend the following tests:
- A nerve conduction exam, which can show whether nerve signals are slow
- Electromyography, sometimes called EMG, which tests the nerve function within muscle fibers
- A lumbar puncture, which involves removing a sample of cerebrospinal fluid for testing
Treatment of Guillain-Barré Syndrome
There is currently no cure for GBS, but treatment can help manage it.
One approach is immunoglobulin therapy, which involves receiving antibodies from a donor intravenously, through an IV. This may help reduce the autoimmune response.
Another approach is plasma exchange, which involves removing blood and sending it through a machine that separates the plasma from the blood cells. This removes some of the antibodies that are attacking healthy cells and allows the body to regenerate its plasma.
These two methods are equally effective, as long as a person receives them within two weeks of GBS symptoms appearing. Using both treatments does not appear to improve the outcome.
When symptoms are severe, a patient may need help with breathing, a heart monitor, and help preventing saliva or food from entering their airways.
During recovery, a lack of movement can result in complications, such as blood clots. Receiving injected blood thinners can help prevent this. A physical therapist can also help.
Later, a rehabilitation plan may include physical and other types of therapy to rebuild strength and restore mobility and other functions. A person may also benefit from counseling, as GBS can affect mental and emotional well-being.
Some research has suggested that corticosteroid injections may help reduce the harmful immune response, but there is currently not enough evidence to support this.
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