{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:52:06Z","timestamp":1787503926557,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T00:00:00Z","timestamp":1639699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The immunoglobulin G synthesis rate (IgG SR) and immunoglobulin G (IgG) index are indicators of abnormal intrathecal humoural immune responses, and the albumin quotient (QALB) is an indicator used to evaluate the completeness of the blood-cerebrospinal fluid barrier (BCB). No systematic reports regarding differences in Guillain-Barr\u00e9 syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are available. We assessed differences in the IgG SR, IgG index and QALB between GBS and CIDP patients in a Chinese cohort.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    A total of 234 patients were retrospectively enrolled in this study, and 167 clinically confirmed GBS and CIDP patients were selected. Meanwhile, 67 non-GBS and non-CIDP patients requiring cerebrospinal fluid (CSF) examination were enrolled as the control group. The IgG SR, IgG index and QALB were calculated using formulas. The relevant clinical data were subjected to statistical analysis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Among the GBS and CIDP study groups and the control group, the QALB had the highest positive rate (80.00%) in the CIDP group (\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.01). The QALB stratification analysis showed that the ranges of 10 &amp;lt; QALB \u2264 30 were dominant in the GBS and CIDP groups, and the positive rate of CIDP was higher than that of GBS. Furthermore, a QALB \u2264 7 was dominant in the control group, and a QALB &amp;gt; 30 was dominant in the CIDP group. In receiver operating characteristic (ROC) curve analysis with the CIDP group as the trial group and the GBS group as the control group, the differences in the QALB were statistically significant (\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.01). To achieve a high specificity of 98~99%, the diagnostic cut-off value for the QALB was above 57.37 (sensitivity: 9.33%) or below 0.60 (sensitivity: 4.35%). Multivariate logistic regression analysis showed that the CIDP patients had a QALB higher than 57.37, and compared with that in the GBS patients, the difference in the QALB was statistically significant (\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.01).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    QALB elevation was associated with CIDP, while QALB values above 57.37 or below 0.60 had high specificity in differentiating between GBS and CIDP. In CIDP, the BCB is generally moderately to severely damaged; in GBS, the BCB is generally moderately damaged.\n                  <\/jats:p>","DOI":"10.3389\/fneur.2021.746186","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T02:40:51Z","timestamp":1639708851000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Correlation Among the Immunoglobulin G Synthesis Rate, IgG Index and Albumin Quotient in Guillain-Barr\u00e9 Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Retrospective Case\u2013Control Study"],"prefix":"10.3389","volume":"12","author":[{"given":"Yu","family":"Tu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiewei","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyan","family":"Zhuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S7","DOI":"10.1212\/WNL.59.12_suppl_6.S7","article-title":"Immune mechanisms in chronic inflammatory demyelinating neuropathy","volume":"59","author":"Kieseier BC Dalakas","year":"2002","journal-title":"Neurology."},{"key":"B2","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1177\/1352458515601903","article-title":"Increased albumin quotient (QAlb) in patients after first clinical event suggestive of multiple sclerosis is associated with development of brain atrophy and greater disability 48 months later","volume":"22","author":"Uher","year":"2016","journal-title":"Mult Scler."},{"key":"B3","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1111\/ene.12924","article-title":"Quantitation of intrathecal immunoglobulin synthesis - a new empirical formula","volume":"23","author":"Auer","year":"2016","journal-title":"Eur J Neurol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"296184","DOI":"10.1155\/2015\/296184","article-title":"Intrathecal IgG synthesis: a resistant and valuable target for future multiple sclerosis treatments","volume":"2015","author":"Bonnan","year":"2015","journal-title":"Mult Scler Int."},{"key":"B5","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1038\/nrneurol.2014.138","article-title":"GBS Classification Group, GROUP GC. Guillain-Barr\u00e9 and Miller Fisher syndromes\u2013new diagnostic classification","volume":"10","author":"Wakerley","year":"2014","journal-title":"Nat Rev Neurol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1111\/j.1468-1331.2009.02930.x","article-title":"European Federation of Neurological Societies\/Peripheral Nerve Society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society - first revision","volume":"17","author":"Van den Bergh","year":"2010","journal-title":"Eur J Neurol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"385","DOI":"10.3109\/00365517709091496","article-title":"Principles of albumin and IgG analyses in neurological disorders. I establishment of reference values Scandinavian","volume":"37","author":"Tibbling","year":"1977","journal-title":"J Clin Lab Investig."},{"key":"B8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1002\/ana.410170107","article-title":"The basis of intra-blood-brain-barrier IgG synthesis","volume":"17","author":"Tourtellotte","year":"1985","journal-title":"Ann Neurol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.neulet.2010.05.012","article-title":"Cerebrospinal fluid secretory Ca2+-dependent phospholipase A2 activity: a biomarker of blood\u2013cerebrospinal fluid barrier permeability","volume":"478","author":"Chalbot","year":"2010","journal-title":"Neurosci Lett."},{"key":"B10","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s12974-016-0785-2","article-title":"BAFF index and CXCL13 levels in the cerebrospinal fluid associate respectively with intrathecal IgG synthesis and cortical atrophy in multiple sclerosis at clinical onset","volume":"14","author":"Puthenparampil","year":"2017","journal-title":"J Neuroinflamm"},{"key":"B11","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1136\/jnnp-2020-325868","article-title":"Oligoclonal IgG bands in chronic inflammatory polyradiculoneuropathies","volume":"92","author":"Ruiz","year":"2021","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B12","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1111\/ene.14600","article-title":"Cerebrospinal fluid protein in Guillain-Barre syndrome: need for age-dependent interpretation","volume":"28","author":"Hegen","year":"2021","journal-title":"Eur J Neurol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1590\/0004-282x-anp-2020-0094","article-title":"Blood-cerebrospinal fluid (CSF) barrier dysfunction means reduced CSF flow not barrier leakage - conclusions from CSF protein data","volume":"79","author":"Reiber","year":"2021","journal-title":"Arq Neuro-Psiquiat."},{"key":"B14","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.jneuroim.2014.06.012","article-title":"Laquinimod exerts strong clinical and immunomodulatory effects in Lewis rat experimental autoimmune neuritis","volume":"274","author":"Pitarokoili","year":"2014","journal-title":"J Neuroimmunol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s12883-016-0564-9","article-title":"Albumin and multiple sclerosis","volume":"16","author":"Levine","year":"2016","journal-title":"BMC Neurol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"116908","DOI":"10.1016\/j.jns.2020.116908","article-title":"Association of matrix metalloproteinase-9 polymorphism with severity of Guillain-Barr\u00e9 syndrome","volume":"415","author":"Hayat","year":"2020","journal-title":"J Neurol Sci."},{"key":"B17","doi-asserted-by":"publisher","first-page":"4297","DOI":"10.1007\/s10072-021-05314-y","article-title":"Expression pattern of matrix metalloproteinases-2 and\u22129 and their tissue inhibitors in patients with chronic inflammatory demyelinating polyneuropathy","volume":"42","author":"Cosentino","year":"2021","journal-title":"Neurol Sci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1038\/s41426-018-0157-3","article-title":"miR-1303 regulates BBB permeability and promotes CNS lesions following CA16 infections by directly targeting MMP9","volume":"7","author":"Song","year":"2018","journal-title":"Emerg Microbes Infec."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1040272230","DOI":"10.1177\/2058739220942340","article-title":"Inflammatory polyradiculoneuropathies: clinical and immunological aspects, current therapies, and future perspectives","volume":"18","author":"Di Stefano","year":"2020","journal-title":"Eur J Inflamm."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e00924","DOI":"10.1002\/brb3.924","article-title":"Fingolimod promotes blood-nerve barrier properties in vitro","volume":"8","author":"Nishihara","year":"2018","journal-title":"Brain Behav."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e104205","DOI":"10.1371\/journal.pone.0104205","article-title":"Severity and patterns of blood-nerve barrier breakdown in patients with chronic inflammatory demyelinating polyradiculoneuropathy: correlations with clinical subtypes","volume":"9","author":"Shimizu","year":"2014","journal-title":"PLoS ONE."},{"key":"B22","doi-asserted-by":"publisher","first-page":"446","DOI":"10.3390\/jcm8040446","article-title":"K index is a reliable marker of intrathecal synthesis, and an alternative to IgG index in multiple sclerosis diagnostic work-up","volume":"8","author":"Crespi","year":"2019","journal-title":"J Clin Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1111\/j.1468-1331.2006.01161.x","article-title":"Anti-ganglioside antibodies and elevated CSF IgG levels in Guillain-Barr\u00e9 syndrome","volume":"13","author":"Mat\u00e0","year":"2006","journal-title":"Eur J Neurol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1111\/jns.12121","article-title":"Severe childhood Guillain-Barre syndrome associated with Mycoplasma pneumoniae infection: a case series","volume":"20","author":"Meyer Sauteur","year":"2015","journal-title":"J Peripher Nerv Syst."},{"key":"B25","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1046\/j.1468-1331.2001.00327.x","article-title":"Chemokines CXCL10 and CCL2: differential involvement in intrathecal inflammation in multiple sclerosis","volume":"8","author":"Sorensen","year":"2001","journal-title":"Eur J Neurol."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.746186\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T02:40:52Z","timestamp":1639708852000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.746186\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,17]]},"references-count":25,"alternative-id":["10.3389\/fneur.2021.746186"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.746186","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,17]]},"article-number":"746186"}}