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Pesticide use associated with Guillian-Barr? syndrome (GBS) clusters

Emily

Editor, Senior Moderator
http://www.ncbi.nlm.nih.gov/pubmed/19580646
Hart, D. E., Rojas, L. A., Ros?rio, J. A., Recalde, H. and Rom?, G. C. (1994), Childhood Guillain-Barr? syndrome in Paraguay, 1990 to 1991. Ann Neurol., 36: 859?863. doi: 10.1002/ana.410360609 [h=3]Abstract[/h] During 1990 to 1991, through a national surveillance program for poliomyelitis, the Paraguayan Ministry of Health received reports of 50 children with incident acute flaccid paralysis (< 15 years old). On the basis of established criteria, 37 were diagnosed with Guillian-Barr? syndrome. The average annual incidence rate for 1990 to 1991 was 1.1/100,000 children. The clinical course was more benign than reported in other pediatric series. There were low rates of hospitalization (57%), respiratory compromise (8%), and intubation (5%). The overall severity, however, was similar to that described in previous reports, with a 3% case-fatality rate and an 81% total recovery rate at 12 months. Seventy-six percent of patients had symptom onset during January to April, the warmest months of the year. Thirty percent of patients had definite or possible exposure to organophosphate pesticides, and the peak use coincides with the peak incidence of Guillian-Barr? syndrome There was no correlation between occurrence of Guillian-Barr? syndrome and prior immunization.


http://www.ncbi.nlm.nih.gov/pubmed/16599005
Arch Environ Health. 2004 Nov;59(11):575-80.
Guillain-Barre syndrome in a rural farming district in South Africa: a possible relationship to environmental organophosphate exposure.
London L[SUP]1[/SUP], Bourne D, Sayed R, Eastman R.
[h=3]Author information[/h] Abstract

Although organophosphate (OP) insecticides have been recognized as having neuropathic potential, a relationship with Guillain-Barre syndrome (GBS) has not been previously confirmed. A cluster of 7 cases of GBS was noted over an 11-yr period in an isolated farming region in the Northern Cape Province of South Africa, an area subject to intensive aerial application of OP insecticides. Observed cases were more than 4 times higher than expected based on a Poisson probability distribution. Four cases were clustered in an area where the topography showed a marked hollow, and where spray drift of aerial OP insecticides was anticipated. The rate of GBS in this subcluster was more than 14 times higher than expected. The authors explored the hypothesis that aerial OP insecticide application was related to the raised incidence of GBS in this area and made suggestions for future research.


PMID: 16599005 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/19580646
BMC Public Health. 2009 Jul 6;9:219. doi: 10.1186/1471-2458-9-219.

Pesticide-related illness reported to and diagnosed in primary care: implications for surveillance of environmental causes of ill-health.
Rushton L[SUP]1[/SUP], Mann V.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] In Great Britain (GB), data collected on pesticide associated illness focuses on acute episodes such as poisonings caused by misuse or abuse. This study aimed to investigate the extent and nature of pesticide-related illness presented and diagnosed in Primary Care and the feasibility of establishing a routine monitoring system.
[h=4]METHODS:[/h] A checklist, completed by General Practitioners (GP) for all patients aged 18+ who attended surgery sessions, identified patients to be interviewed in detail on exposures and events that occurred in the week before their symptoms appeared.
[h=4]RESULTS:[/h] The study covered 59320 patients in 43 practices across GB and 1335 detailed interviews. The annual incidence of illness reported to GPs because of concern about pesticide exposure was estimated to be 0.04%, potentially 88400 consultations annually, approximately 1700 per week. The annual incidence of consultations where symptoms were diagnosed by GPs as likely to be related to pesticide exposure was 0.003%, an annual estimate of 6630 consultations i.e. about 128 per week. 41% of interviewees reported using at least one pesticide at home in the week before symptoms occurred. The risk of having symptoms possibly related to pesticide exposure compared to unlikely was associated with home use of pesticides after adjusting for age, gender and occupational pesticide exposure (OR = 1.88, 95% CI 1.51 - 2.35).
[h=4]CONCLUSION:[/h] GP practices were diverse and well distributed throughout GB with similar symptom consulting patterns as in the Primary Care within the UK. Methods used in this study would not be feasible for a routine surveillance system for pesticide related illness. Incorporation of environmental health into Primary Care education and practice is needed.


PMID:19580646 [PubMed - indexed for MEDLINE] PMCID: PMC2718882 Free PMC Article
 
Now a mechanism - discovered by infectious disease researchers:

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0087051
Citation: van Alphen LB, Wenzel CQ, Richards MR, Fodor C, Ashmus RA, Stahl M, et al. (2014) Biological Roles of the O-Methyl Phosphoramidate Capsule Modification in Campylobacter jejuni. PLoS ONE 9(1): e87051. doi:10.1371/journal.pone.0087051
Editor: Mikael Skurnik, University of Helsinki, Finland
Received: September 7, 2013; Accepted: December 18, 2013; Published: January 30, 2014
This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Funding: LVA held an Alberta Innovates Health Solutions Postdoctoral Fellowship. RAA is an Alberta Innovates Technology Futures Scholarship awardee. CMS is an Alberta Innovates Scholar. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
[h=2]Introduction[/h] Campylobacter jejuni is a Gram-negative bacterium that is a leading cause of bacterial gastroenteritis worldwide [1]. The handling and consumption of contaminated poultry are the most common routes of infection in developed countries [2], although contaminated water and dairy products can also be significant sources [3]. In developing countries, campylobacteriosis is endemic and represents a major cause of diarrheal disease and infant mortality. Symptoms of infection typically range from mild to severe inflammatory diarrhea, but in rare cases infection leads to the life-threatening autoimmune disorder known as the Guillain-Barr? syndrome [4].
Capsular polysaccharide (CPS) forms the outermost structure on most bacteria and plays key roles in the interaction between the organism, host, and environment. In the case of C. jejuni, CPS is the major determinant of the Penner serotyping scheme [5] and has been demonstrated to be important for both serum resistance and invasion of epithelial cells [6]. The CPS produced by C. jejuni strains are structurally complex and highly variable, due in part to the addition of phase-variable modifications such as O-methyl, ethanolamine, aminoglycerol, and O-methyl phosphoramidate (MeOPN) groups [7], [8], [9]. Although phosphoramidates are rare in nature, our previous studies identified the presence of MeOPN modifications in ∼70% of C. jejuni isolates [10]. In C. jejuni strain 11168H, we identified four genes required for the biosynthesis of MeOPN, cj1415−cj1418, and two phase variable genes, cj1421 and cj1422, that encode transferases responsible for the addition of MeOPN to C-3 of β-D-GalfNAc or to C-4 of D-glycero-α-L-gluco-Hep, respectively [10].
While it is unknown whether MeOPN modifications are present in other Campylobacteraceae, their commonality among C. jejuni strains suggests an important biological role for these surface-expressed modifications within the species, and we have recently demonstrated that MeOPN is a receptor for several C. jejuni lytic bacteriophages [11], [12]. MeOPN has structural similarity to some synthetic pesticides [13], and infection studies with C. jejuni 11168H in the Galleria mellonella model showed a substantial decrease in insecticidal activity for a MeOPN biosynthesis mutant relative to the wild-type strain [14]. More recently, Maue et al. [15] demonstrated that disruption of a MeOPN biosynthetic gene in the virulent C. jejuni 81?176 strain correlated to reductions in both serum resistance and colonization in a mouse intestinal model, relative to the wild-type strain. In combination, these studies indicate that, when present, MeOPN biosynthesis is important for C. jejuni cellular interactions and infection.
In this study, we have determined that MeOPN modifications are prevalent among several Campylobacter species, and not limited to C. jejuni. We have mutated the MeOPN transferase gene homologues in C. jejuni strains 81?176 and 11168H. Both mutants exhibited similar levels of insecticidal activity compared to wild-type in the G. mellonella infection model, and no insecticidal activity was observed when G. mellonella was injected with either purified CPS or synthesized compounds containing MeOPN. However, the MeOPN mutant exhibits enhanced invasion of Caco-2 cells and reduced resistance to serum, primarily due to activation of the classical complement pathway. The mutant shows no difference in colonization of chickens compared to the wild-type, but the mutant shows a drop in colonization in piglets in co-infection studies with the wild-type. Our data suggests that, when present, MeOPN has a contributory role in pathogenesis.

https://jid.oxfordjournals.org/content/201/5/776.full
  • Olivia L. Champion,
  • Andrey V. Karlyshev,
  • Nicola J. Senior,
  • Martin Woodward,
  • Roberto La Ragione,
  • Sarah L. Howard,
  • Brendan W. Wren,
  • and Richard W. Titball
Insect Infection Model for Campylobacter jejuni Reveals That O-methyl Phosphoramidate Has Insecticidal Activity J Infect Dis. (2010) 201 (5): 776-782 doi:10.1086/650494 [h=2]Abstract[/h] Galleria mellonella (wax moth) larvae have elsewhere been shown to be susceptible to pathogens such as Francisella tularensis, Burkholderia mallei, and Pseudomonas aeruginosa. We report that the larvae are rapidly killed by Campylobacter jejuni at 37?C. Three strains of C. jejuni tested, 11168H (human diarrheal isolate), G1 (human Guillain-Barr? syndrome isolate), and 81?176 (human diarrheal isolate), were equally effective at killing G. mellonella larvae. A panel of defined mutants of C. jejuni 11168H, in known or putative virulence genes, showed different degrees of attenuation in G. mellonella larvae. A mutant lacking the O-methyl phosphoramidate (MeOPN) capsule side group was attenuated, clearly demonstrating that MeOPN has a role in virulence. This new model of C. jejuni infection should facilitate the identification of novel virulence genes...
 
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