TH1 and TH2 Response to Campylobacter jejuni Antigen in Guillain-Barre Syndrome

Objectives: To determine the expression of proinflammatory and anti-inflammatory cytokines in lymphocytes from the progressive and recovery phases of Guillain-Barre syndrome (GBS) after stimulation with Campylobacter jejuni outer membrane proteins. Design: Case-control study. Setting: Sanjay Gandhi Postgraduate Institute of Medical Sciences. Participants: Sixty-five patients with GBS, 60 age-and sex-matched disease control individuals, and 68 healthy control individuals were included in the study. Main Outcome Measures: Lymphocytes from patients with GBS were stimulated with C jejuni outer membrane proteins, and the levels of different proinflammatory (T(H)1 [helper T cell, subtype 1]) and anti-inflammatory (T(H)2) cytokines were determined by reverse-transcription polymerase chain reaction and enzyme-linked immunosorbent assay. Results: In the progressive phase of the disease, the expressions of interferon gamma (IFN-gamma), interleukin 1 beta (IL-1 beta), tumor necrosis factor (TNF), IL-6, IL-10, and the IFN-gamma : IL-4 ratio were significantly upregulated, but expressions of transforming growth factor (TGF)-beta 1 and IL-4 were lower in patients compared with disease and healthy controls. In contrast, the levels of IFN-gamma, IL-1 beta, TNF, IL-6, IL-10, and the IFN-gamma : IL-4 ratio were significantly lower, but TGF-beta 1 and IL-4 were upregulated in the recovery phase of GBS patients compared with controls. Conclusions: Upregulation of T(H)1 cytokines in the early disease course may be associated with immune-mediated disease progression due to neuronal inflammation, but upregulation of T(H)2 immune response during the later phase aids recovery from the disease.