Cerebrospinal fluid biomarkers in Guillain-Barré syndrome--where do we stand?

J Neurol. 2009 Jan;256(1):3-12. doi: 10.1007/s00415-009-0097-x. Epub 2009 Feb 16.


Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy affecting the myelin-protein sheathing and the axons themselves to various degrees. Damage to these structures causes biomarkers to be released into the adjacent body fluid compartment. In case of the proximal nerve roots these biomarkers diffuse into the cerebrospinal fluid (CSF). Here we review the literature on CSF biomarkers in GBS, including a discussion of CSF basic findings, myelin sheath-associated markers (myelin basic protein), axonal damage markers (neurofilaments, tau, anti-ganglioside antibodies), glial and neuronal markers (neuron specific enolase, 14-3-3 proteins, S100B, hypocretin-1), immunological markers (different chemokines and complement factors, cystatin C, tumor necrosis factor-alpha) as well as recent advances in the field of CSF proteome analysis in GBS. Second, the different pathophysiological mechanisms reflected by these biomarkers are discussed. Finally, candidate biomarkers are reviewed with regard to their clinical relevance to act as a surrogate for the disease process, their value for improving prognostic accuracy and their potential to be used as predictors of treatment response.

Publication types

  • Review

MeSH terms

  • 14-3-3 Proteins / cerebrospinal fluid
  • Axons / metabolism
  • Biomarkers / cerebrospinal fluid*
  • Cerebrospinal Fluid Proteins / cerebrospinal fluid*
  • Guillain-Barre Syndrome / cerebrospinal fluid*
  • Guillain-Barre Syndrome / diagnosis*
  • Guillain-Barre Syndrome / physiopathology
  • Humans
  • Myelin Basic Protein / cerebrospinal fluid
  • Neuroglia / metabolism
  • Neurons / metabolism
  • Phosphopyruvate Hydratase / cerebrospinal fluid
  • Predictive Value of Tests
  • Prognosis


  • 14-3-3 Proteins
  • Biomarkers
  • Cerebrospinal Fluid Proteins
  • Myelin Basic Protein
  • Phosphopyruvate Hydratase