Wednesday, February 22, 2023
Guillain-Barré syndrome (GBS) is an autoimmune polyneuropathy that causes symmetrical weakness or paralysis of the legs and arms. The condition usually occurs after a virus infection, gastrointestinal infection and on rare occasions after patient vaccination.
It affects approximately 2 out of every 100,000 people each year. Symptoms include sensory dysfunction such as tingling, numbness, and motor nerves dysfunction leading to muscle weakness and difficulty walking.
There is no known and reliable cure for Guillain-Barré syndrome, however, symptoms can often be treated with integrative approaches. Stem cell therapeutics are especially brought into Guillain-Barré syndrome treatment protocols to address the demyelinating polyneuropathy, progressive weakness and the plethora of systemic diseases that follow.
What causes Guillain-Barré syndrome?
The exact cause of Guillain-Barré syndrome is not known. Why it strikes some people and not others is not clearly understood. It is not contagious, it does not appear inherited, it arises usually after a viral infection, after patient vaccination or after severe physical stress, like surgery.
What we know is that an autoimmune attack takes place, onset of symptoms being not immediate, usually days or weeks after a triggering event. This self-directed immune attack is originally launched to help fight an infection. Some components of infecting bacteria and viruses mimic those on nerve cells, which, in turn, become targets of attack (molecular mimicry).
What are the symptoms of Guillain-Barré syndrome?
In Guillain-Barré syndrome, the immune system mistakenly targets healthy peripheral nerves, sensory nerves, motor nerves, and other nerve fibers.
In the acute phase, sensory symptoms occur, such as tingling in the feet or hands, or even pain starting in the legs or back. This is neuropathy, often a demyelinating polyneuropathy.
In the progressive phase, a progressive weakness appears, in the arms and then legs. Patients have difficulty using their arms and climbing stairs or simply walking. This is due to motor axonal changes.
In both phases, there may be clear cranial nerve involvement and cranial nerve deficits, leading to autonomic disturbances. changes in blood pressure, heart rate, pulse rate, ventilation and breathing difficulty comprise some of the autonomic symptoms.
Additional symptoms may include:
- facial weakness or bulbar weakness
- oropharyngeal weakness
- Sensory dysfunction, sensory symptoms
- Coordination problems, unsteadiness with sensory involvement
- bowel dysfunction and/or bladder dysfunction, urinary retention
- poor respiratory function
- poor muscle strength
- Symptom severity can range between mild weakness to severe weakness.
Severe symptoms may include:
- bulbar failure
- autonomic dysfunction
- muscle pain
- respiratory failure
How is Guillain-Barré syndrome diagnosed?
The exact clinical presentation of Guillain-Barré syndrome varies from person to person. Antecedent infections and preceding physical stressors point to a diagnosis of GBS, in addition to the following diagnostic indices.
The majority of patients exhibit an onset of weakness, with a loss of reflexes. The electrical activity on nerve conduction tests shows absent reflexes, especially the deep tendon reflexes and myotatic reflexes. The nerve fibers are affected and a symmetrical weakness seen on nerve conduction velocity test is the most common form.
On neurological examination, medical professionals see apparent cranial nerve deficits. The antiganglioside antibodies (anti-GQ1b antibodies), are type of autoimmunine crossreactive antibodies, and can target cranial nerve involvement. This leads to symptoms of autonomic dysfunction, like blood pressure instability.
On blood tests, blood cells and immune cells like the white blood cells can be out of balance. On lumbar puncture, protein levels of the cerebrospinal fluid in the spinal cord are elevated in thirds of patients in the first week of symptoms. Elevated fluid protein level in the spinal fluid is a hallmark of GBS.
How long will it take to recover from Guillain-Barré syndrome?
The recovery phase from Guillain-Barré syndrome can take weeks or months, depending on the type of immune response, on the disease severity, on the types of supportive therapy and treatment options that are available to the individual patients. It's truly case by case. Some recover within weeks, and some worsen over time and may become diagnosed with further progressive muscle weakness, demyelinating polyneuropathy (where the myelin sheath is destroyed), transverse myelitis (common subtype), Miller Fisher syndrome (MFS), motor axonal and axonal neuropathy and other severe disease axonal subtypes. Chronic residual deficits may appear months or even weeks after symptoms appear. Many chronic patients require mechanical ventilation and long term supportive care.
How can stem cell therapy help people with Guillain-Barré syndrome?
Conventional treatment of GBS includes medications, immune globulin therapy ( IVIg treatment ) or plasma exchange, physical therapy. Anti-inflammatory treatments are used to tackle the inflammatory neuropathies.
One of the most comprehensive effective alternative treatments for GBS is stem cell therapy. Pluripotent stem cells can repair the nerve tissue in the brain and in the periphery, balance the immune system and help recover the lost physical and organ function. With each injection, self-healing mechanisms are triggered and disease activity gradually attenuated. This stem cell type simultaneously addresses the autonomic dysfunction, the autoimmune responses, the demyelinating forms, and the axonal degeneration. Pluripotent stem cells target all 220+ tissue types of the body and signal repair and epigenetic reprogramming in areas that are affected.
One of the key beneficial effects of pluripotent stem cell treatment options is shift in immune responses, especially the autoimmune response. The immunomodulatory effects of hPSC treatment are critical in easing the autoimmune diseases inflammatory phase of GBS. Pluripotent stem cells and exosomes release transcription factors that help immune cells to shift away from TH1 autoimmune reactivity and quench the inflammatory fire destroying axonal integrity. This helps to gradually turn around the acute-onset chronic inflammatory demyelinating polyneuropathy.
The second level of therapeutic effects is improvement in the sensory symptoms, once the inflammatory fire is quenched and the myelin sheath and other injured tissue have a chance to start restoring. Growth factor peptides, nerve growth factor peptides, mRNAs & miRNAs signal renewal, repair, and regeneration in the brain and in the periphery.
The third level of therapeutic outcome in patients is restoration of autonomic symptoms balance and the return of reparative vital capacity of the patient. Long term effective treatment with pluripotent stem cells and their exosomes allows for the daily activities of patients with GBS to improve with functional outcomes being positive.
1. Guillain-Barré syndrome: the evolution of therapy - Johns Hopkins University
2. Pharmacological treatment other than corticosteroids, intravenous immunoglobulin and plasma exchange for Guillain-Barré syndrome. The Cochrane Database of Systematic Reviews. 2013
3. Campylobacter gene polymorphism as a determinant of clinical features of Guillain-Barré syndrome - PubMed
4. Treatment guidelines for Guillain-Barré Syndrome - PubMed
5. Diagnosis and management of Guillain-Barré syndrome in ten steps
6. Efficacy of therapies in the treatment of Guillain-Barre syndrome: A network meta-analysis