{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:57:18Z","timestamp":1791593838671,"version":"4.3.4"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Peripheral Nervous Sys"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Intravenous immunoglobulin (IVIg) is the primary treatment for Guillain\u2010Barr\u00e9 syndrome (GBS), yet its immunological mechanisms underlying variable clinical outcomes remain unclear. This study investigated the immunomodulatory effect of IVIg on regulatory T cells (Tregs), cytokines, and their association with treatment response and clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective case\u2010controlled study, 57 GBS patients and 57 age\u2010 and sex\u2010matched healthy controls (HCs) were investigated. CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup>FoxP3<jats:sup>+<\/jats:sup> Treg percentages, cytokine production (IL\u201010, TNF\u2010\u03b1, IFN\u2010\u03b3, and IL\u201012), and serum C3 levels were measured using flow cytometry, Luminex assay, and turbidimetric methods, respectively. Treatment response was defined as \u2265\u20091\u2010point GBS\u2010disability score improvement during evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>GBS patients exhibited lower CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup>FoxP3<jats:sup>+<\/jats:sup> Tregs frequencies compared to HCs (<jats:italic>p<\/jats:italic>\u2009=\u20090.006), which were inversely associated with serum C3 levels (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) during the acute phase. At 4\u2009weeks post\u2010onset, patients with normal C3 levels (90\u2013180\u2009mg\/dL) exhibited higher Treg frequencies (<jats:italic>p<\/jats:italic>\u2009=\u20090.005) compared to acute GBS, whereas patients with persistently elevated C3 levels showed reduced Treg percentage (<jats:italic>p<\/jats:italic>\u2009=\u20090.009). Among I VIg\u2010treated patients, Tregs significantly increased at 2 and 4\u2009weeks post\u2010treatment, alongside significantly higher IL\u201010 and lower TNF\u2010\u03b1, IFN\u2010\u03b3, and IL\u201012 levels at 4\u2009weeks. However, patients with supportive care showed no such changes in Tregs and cytokine levels. Furthermore, Tregs elevated significantly in patients responsive to IVIg at 2 and 4\u2009weeks (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), but not in non\u2010responsive or supportive care patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>IVIg treatment modulates immune dysregulation in GBS by expanding CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup>FoxP3<jats:sup>+<\/jats:sup> Tregs and altering cytokines and serum C3 levels, which are associated with clinical improvement. These findings indicate Tregs as potential biomarkers for monitoring initial clinical response to IVIg in GBS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jns.70039","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T08:59:10Z","timestamp":1750841950000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Intravenous Immunoglobulin Elevates Regulatory T Cells in Guillain\u2010Barr\u00e9 Syndrome: A Potential Biomarker of Therapeutic Response"],"prefix":"10.1111","volume":"30","author":[{"given":"Israt","family":"Jahan","sequence":"first","affiliation":[{"name":"Laboratory of Gut\u2010Brain Axis, Infectious Diseases Division icddr,b  Dhaka Bangladesh"},{"name":"Department of Medical Microbiology and Infectious Diseases Erasmus MC, University Medical Center  Rotterdam the 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