Campylobacter Infection as a Trigger for Guillain-Barré Syndrome in Egypt 英文参考文献.docVIP

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Campylobacter Infection as a Trigger for Guillain-Barré Syndrome in Egypt 英文参考文献.doc

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Campylobacter Infection as a Trigger for Guillain-Barré Syndrome in Egypt 英文参考文献

CampylobacterInfectionasaTriggerforGuillain-Barre′ SyndromeinEgypt ThomasF.Wierzba1¤a*,IbrahimAdibAbdel-Messih1,BayoumiGharib2,ShahidaBaqar3 ,Amina Hendaui4,IbrahimKhalil2,TarekA.Omar3,HamedE.Khayat5,ShannonD.Putnam1,JohnW.Sanders6¤b, Lai-KingNg7,LawrenceJ.Price7,DanielA.Scott8¤c,RobertR.Frenck1¤d 1USNavalMedicalResearchUnitNo.3,Cairo,Egypt,2NeurologyDepartment,AlexandriaUniversityHospitals,Alexandria,Egypt,3NavalMedicalResearchCenter,Silver Spring,Maryland,UnitedStatesofAmerica,4NeurologyDepartment,CairoUniversityHospitals,Cairo,Egypt,5NeurologyDepartment,AinShamsUniversityChildren’s Hospital, Ain Shams, Egypt, 6US Naval Medical Research Unit No.3, Cairo, Egypt, 7Bacteriology and Enteric Diseases Program, National Microbiology Laboratory, Winnipeg,Manitoba,Canada,8NavalMedicalResearchCenter,Bethesda,Maryland,UnitedStatesofAmerica Abstract Background:MoststudiesofCampylobacterinfectiontriggeringGuillain-Barre′ Syndrome(GBS)areconductedinwestern nationswereCampylobacterinfectionandimmunityisrelativelyrare.Inthisstudy,weexploredCampylobacterinfections, Campylobacter serotypes, autoantibodies togangliosides, and GBS in Egypt, acountry where Campylobacter exposure is common. Methods:GBScases(n=133)werecomparedtoage-andhospital-matchedpatientcontrols(n=374).Anerveconduction studywasperformedoncasesandaclinicalhistory,serumsample,andstoolspecimenobtainedforallsubjects. Results:Most(63.3%)casesweredemyelinatingtype;medianagefouryears.Casesweremorelikelythancontrolstohave diarrhea (29.5% vs. 22.5%, Adjusted Odds Ratio (ORa)=1.69, P=0.03), to have higher geometric mean IgM anti- Campylobacterantibodytiters(8.18vs.7.25P,0.001),andtoproduceantigangliosideantibodies(e.g.,anti-Gd1a,35.3vs. 11.5, ORa=4.39, P,0.0001). Of 26 Penner:Lior Campylobacter serotypes isolated, only one (41:27, C. jejuni, P=0.02) was associatedwithGBS. Conclusions:Unlikeresultsfromwesternnations,datasuggestedthatGBScaseswereprimarilyintheyoungandcasesand many controls had a history of infection to a