Infectious Triggers and Immune Dynamics in Guillain–Barré Syndrome: Revisiting Campylobacter jejuni and the Silent Role of Haemophilus influenzae

Aswathi Ramesh ¹, Rajasekaran Subbarayan ^1,2*, Dhasarathdev Srinivasan ¹, Ranjith Balakrishnan ¹, Rupendra Shrestha ^3*, Ankush Chauhan ²

1. Centre for Advanced Biotherapeutics and Regenerative Medicine, Faculty of Research, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India

2. Centre for Herbal Pharmacology and Environmental Sustainability, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India

3. Department of Natural and Applied Sciences, Nexus Institute of Research and Innovation (NIRI), Lalitpur, Nepal.

Publications: MicrobiologyOpen. 2025;14(6):e70177. doi: 10.1002/mbo3.70177

Abstract – Guillain–Barré Syndrome (GBS) is a rapidly progressing immune-mediated neuropathy that remains the leading cause of acute flaccid paralysis worldwide. A substantial proportion of GBS cases are precipitated by infectious agents, most notably Campylobacter jejuni and Haemophilus influenzae, which initiate pathogenic autoimmunity via molecular mimicry. This narrative review aimed to synthesize current evidence on the microbial triggers of GBS and elucidate the immune mechanisms linking infection to neuropathic damage. We discuss the evolving landscape of GBS pathogenesis, emphasizing the roles of ganglioside-like lipooligosaccharide (LOS), host genetic predisposition, and dysregulated immune responses. The clinical heterogeneity of GBS subtypes, including axonal and demyelinating variants, was analyzed in relation to serotype-specific antibody profiles that inform the diagnosis and prognosis. Current therapeutic interventions, including intravenous immunoglobulin and plasma exchange, are critically assessed alongside experimental strategies, such as monoclonal antibody therapies, microbiome modulation, and LOS-targeted vaccines. This review highlights microbial surveillance and precision immunotherapy in the management of GBS. Collectively, this study underscores the central role of microbiological insights in redefining the prevention, diagnosis, and treatment of this complex neuroimmune disorder.

Cite: Ramesh, A., Subbarayan, R.,  Srinivasan, D., Balakrishnan, R., Shrestha, R., Chauhan, A. Infectious Triggers and Immune Dynamics in Guillain–Barré Syndrome: Revisiting Campylobacter jejuni and the Silent Role of Haemophilus influenzae. MicrobiologyOpen. 2025;14(6):e70177.