Radhakrishnan, VVSumi, MGReuben, SMathai, ANair, MD2012-12-042012-12-042003INDIAN JOURNAL OF MEDICAL RESEARCH. 117; ; 216-220http://www.ncbi.nlm.nih.gov/pubmed/14609050https://dspace.sctimst.ac.in/handle/123456789/258Background & objectives: Tumour necrosis factor-alpha (TNF-alpha) is regarded as one of the immune factors that can induce demyelination of peripheral nerves in patients with Guillian-Barre syndrome (GBS). This present study was undertaken to find out the role of TNF-alpha and soluble TNF receptors in the pathogenesis of GBS; and to study the effect of intravenous immunoglobulin (ivlg) therapy on the serum TNF-a and soluble TNF receptors in patients with GBS.Methods: Thirty six patients with GBS in progressive stages of motor weakness were included in this study. The serum TNF-alpha and soluble TNF receptors (TNF-RI, TNF-RII) were measured in the serum samples of these patients before and after ivIg therapy by a sandwich ELISA.Results: Of the 36 patients with GBS, 26 (72.2%) showed elevated serum TNF-alpha levels prior to ivIg therapy. Following a complete course of ivIg therapy there was a progressive decrease in the serum TNF-alpha concentrations in these 26 patients. On the other hand, the soluble TNF receptors, particularly TNF-RII showed an increase in the serum of GBS patients following ivIg therapy.Interpretation & conclusion: The results indicate that ivIg reduces the serum TNF-alpha. concentrations in the GBS patients having elevated levels prior to ivlg therapy. Elevated serum levels of soluble TNF receptors following ivIg therapy may play a protective role by inhibiting the demyelinating effect of TNF-alpha in the peripheral nerves of patients with GBS.Pathology