Shoma Hayat

Fellowship Site: Iccrd,B, Bangladesh

US Institution: UC Berkeley

Project Title: Contribution of gut microbiome and nutritional status in clinical outcome of intravenous immunoglobulin (IVIg)-treated patients with Guillain-Barré syndrome in Bangladesh

Guillain-Barré syndrome (GBS) is a post-infectious, immune-mediated neurological disease. Currently, intravenous immunoglobulin (IVIg) is one of the standard treatments for GBS patients; but, one-third of GBS patients did not response with IVIg treatment. Therefore, it is utmost importance to find a biomarker of treatment response that, preferably, can be determined within the first 2 weeks after the disease onset to enable a personalized medicine approach. The gut microbial diversity and gut microbiome specially the V4 region of the 16S rRNA gene may give us a new insight in searching “hidden” dysbiosis in IVIg-responder or non-responder GBS patients with respect to healthy controls. In addition, poverty and poor nutritional status may also have influence on gut microbiome community and subsequent treatment with IVIg in patients with GBS. We will investigate the relationship between IVIg responsiveness in association with variation in gut microbiome and host nutrition in GBS that would possibly provide new information regarding effectiveness of IVIg and could lead to develop new preventative methods employing bacteria as therapeutic probiotics. Blood and fecal samples along with the clinical, demographic, anthropometric data will be collected from 25 patients with IVIg-treated GBS patients and 25 age/sex matched healthy controls from Bangladesh for microbiome study and nutritional status analysis. DNA will be extracted from all fecal samples and V4 region will be amplified by polymerase chain reactions using universal primers. The V4 region of 16S rRNA gene will be sequenced using Illumina MiSeq and sequences will be analyzed using QIIME2-DADA2 pipeline. Data comparisons, alignment, assembling, phylogenetic trees, diversity check will be done using web resources through bioinformatics tools. Data will be analyzed through unpaired t-test, one way ANOVA test and logistic regression analysis. Written informed consent from all participants and approval of the study will be obtained from Institutional Review Board (IRB) of icddr,b. Bangladesh. Data obtained from this prospective case-control study will be helpful to determine the possible roles of gut microbiome and nutritional factors in IVIg-responsiveness and to select future personalized strategies of healthcare for poor patient who will unable to bear the high expense treatment of IVIg