Expression of TNF alpha and TGF beta 1 in Guillain-Barre syndrome: correlation of a low TNF alpha-/TGF beta 1-mRNA ratio with good recovery and signsfor immunoregulation within the cerebrospinal fluid compartment

In the pathogenesis of Guillain-Barre syndrome (GBS) a dysregulation of cyt okines is supposed. The protein concentration and mRNA expression of TNF al pha and TGF beta 1 were investigated in cerebrospinal fluid (CSF) and blood in 10 patients with GBS. TNF alpha-mRNA was increased at the beginning of the disease and demonstrated a decline during the time course (P = 0.001). The level of TNF alpha protein was elevated in only a few patients. TGF bet a 1-mRNA (P = 0.001) and the active TGF beta 1 protein (P < 0.05) increased during the course of GBS, and the level of total TGF beta 1 protein was te mporarily elevated (P = 0.005). A low ratio of TNF alpha-/TGF beta-mRNA exp ression correlated to a good clinical course (P < 0.05). The results indica te an association of TNF alpha with disease activity. TGF beta 1 seems to t erminate and limit the inflammatory reactions and to promote the healing co urse of GBS. In addition the investigations show that In GBS immunoregulato ry mechanisms also take place in the CSF compartment itself and that CSF ce lls are involved in the production of proinflammatory as well as immunosupp ressive cytokines.