Peripheral immune gene expression partially converges toward control profiles after clinical recovery from Guillain-Barré syndrome

Abstract Guillain-Barré Syndrome (GBS) is an acute, usually post-infectious, immune-mediated peripheral neuropathy. It is the most common cause of acute flaccid paralysis worldwide, with a mortality rate ranging from 5 to 7%, and recovered GBS may present chronic sequelae. In this study, we analyzed peripheral blood mononuclear cell (PBMC) RNA-seq profiles from 12 patients during the acute phase of GBS (T0), follow-up samples from eight clinically recovered patients collected up to 3 years after disease onset (T1), and samples from five healthy controls. Gene set enrichment analysis (GSEA) was performed, and predicted protein–protein interactions (PPI) were generated for each co-expression module. We found 1683 genes differentially expressed in T0 and 63 genes in T1. Module-level GSEA showed marked alterations at T0 and partial convergence of the enrichment profiles toward those observed in controls at T1. Furthermore, we identified three co-expression modules whose hub genes were associated with immune and inflammatory responses, neuroinflammation, and neuroprotection. We also identified previously undescribed GBS-associated hub genes that represent exploratory candidates for future biomarker and functional validation.