Anti-streptococcal antibodies in Chinese patients with type −1 narcolepsy

Ding, Qidi; Li, Jing; Xiao, Fulong; Zhang, Chi; Xiao, Dong; Han, Fang

doi:10.1016/j.sleep.2020.03.019

Cited by 14 publications

(5 citation statements)

References 17 publications

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“…Therefore, the investigation of streptococcal antibodies (anti-streptolysin and anti-streptococcal DNAseB) are of great interest in OCD. Elevated streptolysin antibodies were detected in 40% of patients in the cohort, which is more than in a healthy control group of Han Chinese (14%) [46]. Regarding the antistreptococcal-DNAseB antibodies, the prevalence was comparable to the healthy adult Chinese population when applying the reference value of 480 IU/ml (6.4% in OCD patients of this cohort and 5.3% in healthy Chinese controls).…”

Section: Probable and Possible Organic Ocd Casesmentioning

confidence: 55%

Deep clinical phenotyping of patients with obsessive-compulsive disorder: an approach towards detection of organic causes and first results

et al. 2023

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In the revised diagnostic classification systems ICD-11 and DSM-5, secondary, organic forms of obsessive-compulsive disorder (OCD) are implemented as specific nosological entities. Therefore, the aim of this study was to clarify whether a comprehensive screening approach, such as the Freiburg-Diagnostic-Protocol for patients with OCD (FDP-OCD), is beneficial for detecting organic OCD forms. The FDP-OCD includes advanced laboratory tests, an expanded magnetic resonance imaging (MRI) protocol, and electroencephalography (EEG) investigations as well as automated MRI and EEG analyses. Cerebrospinal fluid (CSF), [18F]fluorodeoxyglucose positron emission tomography, and genetic analysis were added for patients with suspected organic OCD. The diagnostic findings of the first 61 consecutive OCD inpatients (32 female and 29 male; mean age: 32.7 ± 12.05 years) analyzed using our protocol were investigated. A probable organic cause was assumed in five patients (8%), which included three patients with autoimmune OCD (one patient with neurolupus and two with specific novel neuronal antibodies in CSF) and two patients with newly diagnosed genetic syndromes (both with matching MRI alterations). In another five patients (8%), possible organic OCD was detected (three autoimmune cases and two genetic cases). Immunological serum abnormalities were identified in the entire patient group, particularly with high rates of decreased “neurovitamin” levels (suboptimal vitamin D in 75% and folic acid in 21%) and increased streptococcal (in 46%) and antinuclear antibodies (ANAs; in 36%). In summary, the FDP-OCD screening led to the detection of probable or possible organic OCD forms in 16% of the patients with mostly autoimmune forms of OCD. The frequent presence of systemic autoantibodies such as ANAs further support the possible influence of autoimmune processes in subgroups of patients with OCD. Further research is needed to identify the prevalence of organic OCD forms and its treatment options.

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Section: Probable and Possible Organic Ocd Casesmentioning

confidence: 55%

Deep clinical phenotyping of patients with obsessive-compulsive disorder: an approach towards detection of organic causes and first results

et al. 2023

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“…It is plausible that other infections have been responsible for triggering NT1 before the reintroduction of the type A H1N1 influenza virus in 2009. Streptococcal infections have previously been proposed but supporting evidence remains inconclusive [11][12][13][14][15] . Other flu strains are likely candidates for triggering NT1 and we here provide first epidemiological evidence that infection with influenza type B Victoria could be an important new suspect 18,29 .…”

Section: Discussionmentioning

confidence: 99%

“…It seems plausible that various triggers must already have been present before the recirculation of type A H1N1 in 2009. Streptococcus pyogenes infections have been associated with onset of NT1 but supporting evidence remains limited [11][12][13][14][15] . The concept of the multiple-hit hypothesis emerged, suggesting that immune-mediated narcolepsy might not be specific to type A H1N1 influenza infection or Pandemrix vaccination but involves various triggers, potentially combined, to induce NT1 in genetically susceptible individuals 16,17 .…”

Section: Introductionmentioning

confidence: 99%

2010 and 2013 incidence peaks in narcolepsy and idiopathic hypersomnia linked to type A H1N1 and type B Victoria influenza strains

Zhang,

Gool,

Sirotkin

et al. 2024

Preprint

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Introduction - Increased narcolepsy type 1 (NT1) incidence rates have been reported globally in 2010, and were linked to the type A H1N1 2009-2010 influenza pandemic and Pandemrix vaccination. A European child-specific NT1 incidence peak was additionally observed in 2013 post the H1N1 pandemic. Thus, the relationship between NT1 and influenza infection remains unclear. Whether other influenza viruses may also trigger NT1 or other central disorders of hypersomnolence (CDH), is unknown. This study investigated annual European incidence patterns of all CDH in complete samples from multiple European centers, in relation to the severity of individual flu strains in preceding influenza seasons. Methods - Incidence rates of NT1 (N=981) and the combined group of narcolepsy type 2 (NT2) and idiopathic hypersomnia (IH) (N=545) from eight European countries were temporally analysed to identify possible incidence peaks from 1995 to 2019. Linear mixed models and spearman correlations were conducted between hypersomnolence disorder incidence rates and the number of influenza infections of preceding influenza season, split for types A H1N1 and H3N2, and in the Netherlands also types B Victoria and Yamagata influenza. Results - 2010 and 2013 incidence peaks were present in NT1, and a 2010 children peak was unexpectedly found in the combined group of NT2 and IH. Both hypersomnolence groups exhibited a significantly positive relationship with preceding H1N1 influenza season severity and a negative relationship with H3N2 influenza. NT1 was additionally significantly positively correlated with influenza type B Victoria in the Netherlands and showed highest correlation in children. Conclusions - Besides H1N1 influenza, the temporal association and severity correlation suggest that influenza type B Victoria may be a novel potential trigger for NT1 that requires further investigation. We additionally provide insights into possible immune-related pathophysiologies of NT2 and IH associated with the 2009-2010 H1N1 influenza pandemic. Further immunological investigations are warranted to unravel the complexities of these relationships and their implications for CDH.

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“…ASO titer was measured using nephelometry (Siemens Healthcare Diagnostics, Marburg, Germany). For upper limits of normal, previously published values for children from Chinese mainland of 200 for ASO were used [ 22 ]. Seropositivity was defined as (1) a 0.2 log10 rise in titer and a titer ≥200 IU/mL in the convalescent serum or (2) titers of both acute and convalescent sera ≥200 IU/mL.…”

Section: Methodsmentioning

confidence: 99%

Streptococcal infection in childhood Henoch-Schönlein purpura: a 5-year retrospective study from a single tertiary medical center in China, 2015–2019

Fan

Jiang

et al. 2021

Pediatr Rheumatol

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Background The present study focuses on the associations of streptococcal infection with the clinical phenotypes, relapse/recurrence and renal involvement in Henoch-Schönlein purpura (HSP) children. Methods Two thousand seventy-four Chinese children with HSP were recruited from January 2015 to December 2019. Patients’ histories associated with HSP onset were obtained by interviews and questionnaires. Laboratory data of urine tests, blood sample and infectious agents were collected. Renal biopsy was performed by the percutaneous technique. Results (1) Streptococcal infection was identified in 393 (18.9%) HSP patients, and served as the most frequent infectious trigger. (2) Among the 393 cases with streptococcal infection, 43.0% of them had arthritis/arthralgia, 32.1% had abdominal pain and 29.3% had renal involvement. (3) 26.1% of HSP patients relapsed or recurred more than 1 time within a 5-year observational period, and the relapse/recurrence rate in streptococcal infectious group was subjected to a 0.4-fold decrease as compared with the non-infectious group. (4) No significant differences in renal pathological damage were identified among the streptococcal infectious group, the other infectious group and the non-infectious group. Conclusions Streptococcal infection is the most frequent trigger for childhood HSP and does not aggravate renal pathological damage; the possible elimination of streptococcal infection helps relieve the relapse/recurrence of HSP.

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Anti-streptococcal antibodies in Chinese patients with type −1 narcolepsy

Cited by 14 publications

References 17 publications

Deep clinical phenotyping of patients with obsessive-compulsive disorder: an approach towards detection of organic causes and first results

Deep clinical phenotyping of patients with obsessive-compulsive disorder: an approach towards detection of organic causes and first results

2010 and 2013 incidence peaks in narcolepsy and idiopathic hypersomnia linked to type A H1N1 and type B Victoria influenza strains

Streptococcal infection in childhood Henoch-Schönlein purpura: a 5-year retrospective study from a single tertiary medical center in China, 2015–2019

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