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Background <p>There is an unmet need for predictive biomarkers in Guillain–Barré syndrome (GBS). We aimed to determine whether cerebrospinal fluid (CSF) alpha-internexin (AINX) concentrations are associated with disease severity and outcome in GBS.</p> Methods <p>This retrospective cohort included 100 GBS patients. AINX concentrations were measured at diagnosis using a sensitive Simoa assay. Disease severity at nadir was assessed with the GBS Disability Scale (GBSDS) and the need for mechanical ventilation. Poor outcome was defined as GBSDS &gt; 2 at 12&#xa0;months. Logistic regression with log-transformed AINX assessed associations with severe disease at nadir (GBSDS &gt; 2), need for mechanical ventilation, and poor outcome at 12&#xa0;months (GBSDS &gt; 2). ROC curve analysis assessed the ability of AINX to predict poor outcome and compared its performance with previously reported biomarkers re-analyzed in this cohort.</p> Results <p>AINX concentrations at diagnosis were higher in patients with poor outcome and remained associated with poor outcome after adjustment for age (OR 12.48, 95% CI 1.20–129.1, <i>p</i> = 0.034). This association remained significant after additional adjustment for axonal subtypes (OR 26.38, 95% CI 1.12–619.77, <i>p</i> = 0.042).&#xa0;ROC analysis demonstrated good discriminative performance (AUC of 0.79, 95% CI 0.61–0.97, <i>p</i> = 0.002). The optimal cutoff of 2.9&#xa0;ng/L yielded 50% sensitivity and 95.7% specificity. AINX concentrations were not associated with disease severity at nadir or with need for mechanical ventilation.</p> Conclusions <p>Elevated CSF AINX at diagnosis was associated with poor long-term outcome in GBS, consistent with a possible contribution of CNS-related injury to recovery.</p>

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Cerebrospinal fluid alpha-internexin concentrations measured in patients with Guillain–Barré syndrome: a possible prognostic biomarker for disability at 12 months

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  • 发表日期：

    2026年4月7日

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  • Nina Gleisner,
  • Francisco Meda,
  • Magnus Johnsson,
  • Igal Rosenstein,
  • Ellen Alpsten,
  • Lenka Novakova,
  • Jan Lycke,
  • Henrik Zetterberg,
  • Hlin Kvartsberg,
  • Brynhildur Hafsteinsdottir,
  • Markus Axelsson

摘要

Background

There is an unmet need for predictive biomarkers in Guillain–Barré syndrome (GBS). We aimed to determine whether cerebrospinal fluid (CSF) alpha-internexin (AINX) concentrations are associated with disease severity and outcome in GBS.

Methods

This retrospective cohort included 100 GBS patients. AINX concentrations were measured at diagnosis using a sensitive Simoa assay. Disease severity at nadir was assessed with the GBS Disability Scale (GBSDS) and the need for mechanical ventilation. Poor outcome was defined as GBSDS > 2 at 12 months. Logistic regression with log-transformed AINX assessed associations with severe disease at nadir (GBSDS > 2), need for mechanical ventilation, and poor outcome at 12 months (GBSDS > 2). ROC curve analysis assessed the ability of AINX to predict poor outcome and compared its performance with previously reported biomarkers re-analyzed in this cohort.

Results

AINX concentrations at diagnosis were higher in patients with poor outcome and remained associated with poor outcome after adjustment for age (OR 12.48, 95% CI 1.20–129.1, p = 0.034). This association remained significant after additional adjustment for axonal subtypes (OR 26.38, 95% CI 1.12–619.77, p = 0.042). ROC analysis demonstrated good discriminative performance (AUC of 0.79, 95% CI 0.61–0.97, p = 0.002). The optimal cutoff of 2.9 ng/L yielded 50% sensitivity and 95.7% specificity. AINX concentrations were not associated with disease severity at nadir or with need for mechanical ventilation.

Conclusions

Elevated CSF AINX at diagnosis was associated with poor long-term outcome in GBS, consistent with a possible contribution of CNS-related injury to recovery.