Guillain-Barré Syndrome (GBS) is a neurological emergencies characterized by a diffuse inflammatory attack on the peripheral nervous system, often triggered by a preceding infection. Despite significant progress in both diagnosis and treatment, approximately 20–30% of patients are left with moderate to severe motor disability following the condition. Currently, only a few prognostic systems and useful biomarker have been proposed.

Serum levels of Galectin-3 (Gal-3) and Neurofilament Light Chain (NfL) were measured using the Simple Plex™ cartridge-based immunoassay on the Ella™ platform (ProteinSimple, San Jose, CA, USA) in serum samples from a cohort of patients with GBS (n = 19) and in a validation cohort of healthy control subjects (n = 13).

Galectin-3 (Gal-3) levels were significantly higher in patients with GBS (median: 7,041 pg/mL; IQR: 5,576–8,561) compared to healthy controls (median: 5,030 pg/mL; IQR: 3,877–5,998; p = 0.007).

Within the GBS cohort, Gal-3 levels were significantly elevated in patients with the AMAN variant (median: 8,561 pg/mL; IQR: 7,652–11,549) compared to those with the AIDP variant (median: 5,998 pg/mL; IQR: 3,884–7,102; p < 0.05). Patients requiring admission to the intensive care unit (ICU) exhibited higher Gal-3 levels (median: 11,239 pg/mL; IQR: 10,590–11,888) than those not admitted to the ICU (median: 6,738 pg/mL; IQR: 3,884–8,534; p < 0.05). Gal-3 levels distinguished AMAN from AIDP variants in a ROC curve analysis with an area under the curve (AUC) of 0.8462 (p < 0.05), outperforming NfL (AUC = 0.55).

A Gal-3 threshold of 6,457.5 pg/mL was identified, achieving 100% sensitivity and 61.5% specificity for distinguishing AMAN patients

Our findings suggest that Gal-3 may serve as a more sensitive biomarker than NfL in distinguishing patient axonal subgroups within the GBS spectrum.