AUTHOR=Sun Ting , Chen Xi , Shi Sha , Liu Qingshan , Cheng Yong 

TITLE=Peripheral Blood and Cerebrospinal Fluid Cytokine Levels in Guillain Barré Syndrome: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Neuroscience

VOLUME=13

YEAR=2019

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2019.00717

DOI=10.3389/fnins.2019.00717

ISSN=1662-453X

ABSTRACT=<p><bold>Background:</bold> Guillain Barré Syndrome (GBS) is an autoimmune disorder caused by the immune-mediated damage of the peripheral nervous system. Increasing evidence suggests that inflammatory cytokines are important mediators for the onset and progression of GBS. A number of clinical studies have demonstrated elevated levels of T helper-1 (Th1-), Th2-, and Th17-related cytokines in patients with GBS; however, the results were inconsistent across studies.</p><p><bold>Methods:</bold> We performed a systematic review and a meta-analysis of studies comparing the levels of inflammatory cytokines in the cerebrospinal fluid and peripheral blood between patients with GBS and healthy individuals, using Comprehensive Meta-Analysis Version 2 software. A database search identified 30 studies comprising 1,302 patients with GBS and 1,073 healthy controls.</p><p><bold>Results:</bold> The random-effects meta-analysis demonstrated that peripheral blood tumor necrosis factor-α (Hedges g, 1.544; 95% confidence interval (CI), 0.923–2.165; <italic>p</italic> &lt; 0.001), interleukin-1β (IL-1β; Hedges g, 0.678; 95% CI, 0.183–1.172; <italic>p</italic> = 0.007), IL-6 (Hedges g, 0.630; 95% CI, 0.100–1.160; <italic>p</italic> = 0.02), IL-4 (Hedges g, 0.822; 95% CI, 0.220–1.423; <italic>p</italic> = 0.007), IL-17 (Hedges g, 1.452; 95% CI, 0.331–2.573; <italic>p</italic> = 0.011), interferon-γ (Hedges g, 1.104; 95% CI, 0.490–1.719; <italic>p</italic> &lt; 0.001), and C-reactive protein (Hedges g, 0.909; 95% CI, 0.453–1.365; <italic>p</italic> &lt; 0.001) levels were significantly increased in patients with GBS when compared with healthy controls. Contrastingly, the blood IL-10 and transforming growth factor-β levels were not significantly associated with GBS. Furthermore, the meta-analysis found that cerebrospinal fluid IL-17 levels were significantly associated with GBS (Hedges g, 1.882; 95% CI, 0.104–3.661; <italic>p</italic> = 0.038).</p><p><bold>Conclusion:</bold> Altogether, our results clarified the circulating inflammatory cytokine profile in patients with GBS, and revealed that Th1-, Th2-, and Th17-related cytokines were highly elevated in the GBS patients, suggesting the potential use of these cytokines as biomarkers for GBS.</p>