The Quest for Biomarkers in Guillain-Barre Syndrome- Translational Research
Deepinder Maini1, Satyan Nanda2, Rajiv Anand1, VARUN REHANI1, Anubhuti Dixit3
1Neurology, BLK Max Super Speciality Hospital, 2Neurology, Yatharth Hopsital, 3Amity institute of of Neuropsychology and neurosciences, Amity University
Objective:
- The current study is designed to 1. understand the link between the clinical and molecular (neurofilaments subunits in cerebrospinal fluid (CSF), and serum samples of GBS patients) characteristics of GBS. 2. assess the correlation of neurofilament subunits levels with the electrophysiological variant, disease severity and prognosis of GBS.
Background:
Worldwide incidence of GBS is 0.81-1.89 per 100,000/yr, affecting males more often than females. Despite immunotherapy, up to 20% remain severely disabled and about 5% die. The current study endeavours to develop early, prognostic models for profiling clinical features with neurofilaments subunits light, heavy and phosphorylated heavy chains (NfL, NfH, pNfH) in the CSF and serum samples of GBS patients.
Design/Methods:
This is a prospective, observational, multi-centric cohort study from January 2022-August 2025. Patients were evaluated at baseline and followed at 4 weeks and 12 weeks to assess clinical course. Scales used to assess disease severity were Hughes Disability Scale (HDS, 0-6), and Erasmus scores (EGRIS and EGOS). Patients' consents were taken before collecting CSF and blood samples for analysing the levels of NfL, NfH, pNfH . Statistical tests used were independent t-test, ANOVA and Pearson correlation coefficient.
Results:
Neurofilaments heavy and phosphorylated heavy chain levels were not detected in more than 50% of the GBS patients. Elevated NfL levels inCSF were strongly associated with severe disability, poor prognosis (correlation coefficients in the range of r = 0.36-0.49). There was no staistically significant difference in NfL levels of axonal (p = 0.0023) and demyelinating (p = 0.001) variants of GBS.
Conclusions:
Amongst the three subunits of NF analysed, NfL level in CSF may serve as a sensitive biomarker for disease severity irrespective of age and disease variant. This can help in clinical assessment and risk stratification in GBS patients. This can be the base for early therepeutic intervention, prognosis and long-term planning for better outcome.
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