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Correspondence |

The Th1/Th2 Paradigm in Guillain-Barré Syndrome

Hong-Liang Zhang, MD; Hai-Feng Li, MD, PhD
Arch Neurol. 2011;68(9):1209-1210. doi:10.1001/archneurol.2011.214.
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Nyati and colleagues1 described a cohort of 65 patients with Guillain-Barré syndrome (GBS) with characteristic lymphocyte cytokine expression profiles in response to Campylobacter jejuni outer membrane protein stimulation. While their findings followed the T helper (Th) 1/Th2 paradigm, they should be interpreted with caution before robust conclusions are drawn.

Guillain-Barré syndrome is a heterogeneous disease entity with several clinical subtypes including acute inflammatory demyelinating polyneuropathy (AIDP) and the axonal variants.2 The latter is closely associated with C jejuni infection.3 Given the different etiologies and clinical features, we would like to know if the authors performed stratified analyses, eg, AIDP vs axonal variants. Although an association between C jejuni infection and AIDP has been proposed, we wonder whether the characteristic responses of lymphocytes are antigen specific. Unless they can provide more evidence, eg, C jejuni–specific antibodies or GM1 antibodies supporting an overwhelming ratio of C jejuni infection in the studied cohort, further stratified analysis seems a necessity.

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September 1, 2011
Kishan K. Nyati, MSc; Avantika Verma, MSc; Kashi N. Prasad, MD
Arch Neurol. 2011;68(9):1209-1210. doi:10.1001/archneurol.2011.215.
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