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    Recent views on Guillain-Barré syndrome (GBS) question the accuracy of classification into axonal and demyelinating subtypes that represent convergent neurophysiological phenotypes rather than immunological targets. Instead it has been proposed to clarify the primarily affected fibre subunit in nerve biopsies. As nerve biopsies rarely are part of routine work-up in human patients we evaluated tissues taken from companion animals affected by GBS-like polyradiculoneuropathy to screen for distribution of immune cells, targeted fibre components and segregating non-inflammatory lesions. We identified that immune responses were directed either at Schmidt-Lanterman clefts, the paranode-node complex or both. Based on infiltrative and non-inflammatory changes, four subtypes and/or stages were distinguished, some of which indicate localisation of primary target antigens while others represent convergent late stage pictures, as a consequence to epitope spreading. The impact of histological subtyping onto clinical management and prognosis remains to be evaluated in future clinical trials. Natural development and clinical manifestation of large animal dysimmune neuropathy may reflect human Guillain-Barré syndrome more accurately than experimental models and therefore provide complementary clues for translational research. Copyright © 2016 Elsevier B.V. All rights reserved.

    Citation

    Simone Gross, Andrea Fischer, Marco Rosati, Lara Matiasek, Daniele Corlazzoli, Rodolfo Cappello, Laura Porcarelli, Tom Harcourt-Brown, Konrad Jurina, Laurent Garosi, Thomas Flegel, Pia Quitt, Jessica Molin, Velia-Isabel Huelsmeyer, Henning Schenk, Gualtiero Gandini, Kirsten Gnirs, Stéphane Blot, Aurélien Jeandel, Massimo Baroni, Shenja Loderstedt, Gianluca Abbiati, Carola Leithaeuser, Sabine Schulze, Marion Kornberg, Mark Lowrie, Kaspar Matiasek. Nodo-paranodopathy, internodopathy and cleftopathy: Target-based reclassification of Guillain-Barré-like immune-mediated polyradiculoneuropathies in dogs and cats. Neuromuscular disorders : NMD. 2016 Dec;26(12):825-836


    PMID: 27743643

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