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Sep 2011

The Th1/Th2 Paradigm in Guillain-Barré Syndrome—Reply

Author Affiliations

Author Affiliations: Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Arch Neurol. 2011;68(9):1209-1210. doi:10.1001/archneurol.2011.215

In reply

We appreciate the comments raised by Zhang and Li regarding our article,1 presenting an overview of Th1/Th2 response to C jejuni antigen in patients in the progressive and recovery phases of GBS. Campylobacter jejuni infection is identified as a major triggering agent of GBS. Several studies also confirmed the association between C jejuni and axonal subtypes of GBS.2 Although there are conflicting reports, both subtypes, demyelinating (AIDP) and axonal, can follow C jejuni infection. We had earlier reported the stratified analyses that showed C jejuni (26%) was the most common preceding infection in our GBS cohort and had more frequent association with the axonal subtype than demyelinating subtype (41% vs 6%; P < .001). Further, antiganglioside antibodies were detected more frequently in patients with GBS than controls (81% vs 10%; P < .001), and a higher proportion of axonal cases had anti-GM1 antibodies than patients with AIDP (IgG: 65% vs 32%; P = .004 and IgM: 46% vs 29%; P = .05).2

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