Neurology ·
CSF T-cell profiles in Guillain–Barré syndrome change after IVIg
A prospective observational cohort study used single-cell RNA and paired T-cell receptor sequencing to examine blood and cerebrospinal fluid (CSF) in treatment-naïve patients with Guillain–Barré syndrome (GBS). CSF showed enrichment of inflammatory T-cell populations, with exploratory post-treatment changes observed after intravenous immunoglobulin (IVIg).
- GBS CSF was enriched for inflammatory T-cell populations.
- Overall T-cell clonal expansion was similar to controls.
- Post-IVIg CSF changes were assessed in three patients.
- Findings are exploratory and do not establish clinical benefit.
Researchers analyzed paired single-cell RNA and T-cell receptor sequencing data from blood and CSF collected before and after IVIg in treatment-naïve patients with GBS. Pre-treatment samples were available from nine patients for blood and eight for CSF; post-treatment samples were available from six and three patients, respectively. Previously published healthy-control datasets were used for comparison.
Compared with blood, GBS CSF was enriched for Th1-polarized CD4+ T cells, activated and resident-memory CD8+ T cells, and macrophages. The CSF-to-blood enrichment of Th1 cells, activated effector-memory CD8+ cells, and inflammatory macrophages exceeded that in healthy controls, although overall T-cell clonal expansion was similar. After IVIg, CSF samples showed reductions in Th1-associated and activated effector-memory states, alongside increases in Th2 and regulatory T-cell populations; changes in peripheral blood were minimal.
The findings suggest compartment-specific immune activity in GBS and possible treatment-associated changes in CSF. The small post-treatment sample, particularly the three CSF samples, limits interpretation; the observational study does not establish that IVIg caused the changes or that they improve clinical outcomes. The authors identify these cellular patterns as candidates for further biomarker and therapeutic research.
In practice
This study does not support changing GBS treatment practice. In a small observational cohort, CSF immune-cell profiles differed from peripheral blood, and post-IVIg CSF samples showed shifts in T-cell states; only three patients had post-treatment CSF available. The findings may inform future biomarker or mechanistic research, but they do not establish that IVIg caused these changes, link them to clinical outcomes, or identify a biomarker ready for clinical use.
AI-generated clinical interpretation · Not editor-reviewed
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Brain: Dysregulated CSF T-cell responses and their evolution after intravenous immunoglobulin in Guillain–Barré syndrome ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.