Introduction
Guillain-Barré syndrome (GBS) is an acute condition that severely threatens the peripheral nervous system. GBS is primarily characterized by bilateral progressive limb weakness and acute areflexia or hyporeflexia. Other common clinical manifestations include, but are not limited to, tachycardia, hypertension, bradycardia, and urinary retention. Additionally, the patient may experience either profound sweating or no sweating at all (Leung et al., 2020). Leung et al. (2020) report that respiratory failure occurs in 20–30% of cases, and acute complications cause death in up to 15% of patients.
Incidence and Risk Groups
Infectious diseases and viral infections are the main antecedents of GBS development. According to Mamishi et al. (2021), between 60% and 70% of all GBS cases occur in patients who have recently sustained an infection. GBS has a steady incidence of approximately 1.3 cases per 100,000 individuals. Additionally, adults are more susceptible to GBS, as the disease incidence is lower in children (Mamishi et al., 2021). Various viruses may cause GBS; however, Campylobacter jejuni and cytomegalovirus (CMV) are typically the most prevalent as antecedents of GBS.
The Role of Cytomegalovirus (CMV) in GBS Pathogenesis
CMV’s distinctive pathogenesis mechanism directly affects the development of GBS cases following CMV infection. The most prevalent C. jejuni GBS is characterized by complement-mediated blockade of nerve conduction or axolemmal destruction (Lunn & Hughes, 2011). In contrast, the CMV GBS was associated with increased activation of T-cells (Lunn & Hughes, 2011).
In this regard, CMV GBS has a particularly destructive impact on the autoimmune regulatory mechanisms, which begin to aggressively target peripheral nerves, especially in younger populations. Compared to other GBS types, CMV GBS damages the cranial nerve more severely (Lunn & Hughes, 2011). As a result, this GBS type more frequently leads to sensory loss and persistent disability.
Conclusions
In summary, infectious diseases are the primary cause of GBS. Whereas adults are more susceptible to GBS, younger population groups are not immune to this dangerous condition. Cytomegalovirus (CMV) has a unique pathogenesis pattern, making it more dangerous than other GBS antecedents. Ultimately, an aggressive autoimmune response typical of CMV CBS is more likely to cause persistent disability, especially in younger patients.
References
Leung, J., Sejvar, J. J., Soares, J., & Lanzieri, T. M. (2020). Guillain-Barré syndrome and antecedent cytomegalovirus infection, USA 2009–2015. Neurological Sciences, 41, 885-891. Web.
Lunn, M., & Hughes, R. (2011). The relationship between cytomegalovirus infection and Guillain–Barré syndrome. Clinical Infectious Diseases, 52(7), 845-847. Web.
Mamishi, S., Ashrafi, M. R., Mohammadi, M., Zamani, G., Pourakbari, B., Mahmoudi, S., & Aziz-Ahari, S. (2021). Cytomegalovirus infection and Guillain-Barre syndrome: The first case-control study in Iran. Iranian Journal of Child Neurology, 15(4), 35-41. Web.