{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:02:33Z","timestamp":1790071353946,"version":"4.0.1"},"reference-count":61,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["TW010540"],"award-info":[{"award-number":["TW010540"]}],"id":[{"id":"10.13039\/100000002","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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The gut\u2010microbiota plays a significant role in neuro\u2010autoimmune diseases, like Guillain\u2010Barr\u00e9 syndrome (GBS), a post\u2010infectious disorder of the peripheral nervous system (PNS). By altering host immunity, gut dysbiosis may impact the standard therapeutic efficacy of intravenous immunoglobulin (IVIg) and plasma exchange (PE) and thereby, disease progression in GBS. In this study, we investigated the impact of gut\u2010microbiota diversity on therapeutic outcomes of IVIg and PE in patients with GBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 60 patients with GBS categorized into three treatment groups: IVIg\u2010treated, PE, and supportive\u2010care along with 60 age\u2010sex\u2010matched healthy controls from Bangladesh. Fecal microbial DNA was extracted at different timepoints and sequenced. Clinical and sequenced data were analyzed using the Qiime2\u2010Dada2 pipeline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Gut\u2010microbial diversity significantly differed in patients with GBS before and after treatment (Shannon:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037; Evenness:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), particularly in IVIg\u2010treated patients, showing significant changes after 6\u2010month treatment (Shannon:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034; Evenness:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). Beta diversity indicated microbiota restoration in IVIg\u2010treated patients toward a healthy state after treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.001). Phylum Actinobacteriota (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026), genera\n                      <jats:italic>Bifidobacterium<\/jats:italic>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), and\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.0001) were relatively abundant in severe patients. Mechanically ventilated patients showed significant gut\u2010microbial diversity (Unweighted\u2010UniFrac;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.001). Biomarker analysis identified a higher abundance of Eubacterium, Bacteroides,\n                      <jats:italic>Escherichia\u2010Shigella<\/jats:italic>\n                      , and\n                      <jats:italic>Actinomyces<\/jats:italic>\n                      in GBS patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Our exploratory study indicates that gut microbiota dysbiosis is associated with GBS severity and IVIg\u2010treatment outcomes. IVIg\u2010treatment promoted partial restoration of microbial diversity, suggesting a potential immunomodulatory effect mediated through the microbiota. Further studies using meta\u2010transcriptomics are warranted to define functional consequences of microbial shifts in treatment responses of GBS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jns.70141","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T08:48:17Z","timestamp":1783759697000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Gut Microbiota Dysbiosis in Treatment Outcomes of Guillain\u2010Barr\u00e9 Syndrome"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1064-9009","authenticated-orcid":false,"given":"Shoma","family":"Hayat","sequence":"first","affiliation":[{"name":"Gut\u2010Brain Axis Laboratory, Infectious Diseases Division (IDD) icddr,b  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2620-1762","authenticated-orcid":false,"given":"Md. 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Golam","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Gut\u2010Brain Axis Laboratory, Infectious Diseases Division (IDD) icddr,b  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8457-1293","authenticated-orcid":false,"given":"Ruma","family":"Begum","sequence":"additional","affiliation":[{"name":"Gut\u2010Brain Axis Laboratory, Infectious Diseases Division (IDD) icddr,b  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moriam Akter","family":"Munni","sequence":"additional","affiliation":[{"name":"Gut\u2010Brain Axis Laboratory, Infectious Diseases Division (IDD) icddr,b  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0914-4439","authenticated-orcid":false,"given":"Ayesha Akter","family":"Anjuman","sequence":"additional","affiliation":[{"name":"Gut\u2010Brain Axis Laboratory, Infectious Diseases Division 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