Autoantibody Biomarkers for Basal Ganglia Encephalitis in Sydenham Chorea and Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infections

Chain, Jennifer L.; Alvarez, Kathy; Mascaro-Blanco, Adita; Reim, Sean; Bentley, Rebecca; Hommer, Rebecca; Grant, Paul; Leckman, James F.; Kawikova, Ivana; Williams, Kyle; Stoner, Julie A.; Swedo, Susan E.; Cunningham, Madeleine W.

doi:10.3389/fpsyt.2020.00564

Cited by 53 publications

(58 citation statements)

References 80 publications

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“…The results of a recent study revealed an increase in anti-neuronal autoantibody titers and the activity of CaMKII pathway in human neuronal cells in the acute phase of PANDAS ( 17 ). The autoantibody titers decreased during improvement.…”

Section: Resultsmentioning

confidence: 99%

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (Review)

et al. 2020

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Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are clinically characterized by the sudden onset of obsessive-compulsive manifestations, motor and verbal tics, as well as other behavioral symptoms in a group of children with B-hemolytic streptococcal infection. PANDAS are considered autoimmune diseases because the streptococcal infection and response can be demonstrated. The most frequent physiopathological mechanism is molecular mimicry: A foreign antigen shares sequence or structural similarities with self-antigens. A thorough review of the literature was carried out using the PubMed database and SCOPUS, searching for immunological, clinical and microbiological aspects, as well as the treatment of the PANDAS syndrome. The diagnosis is clinical and it requires a careful medical history and a thorough physical examination, while the treatment is complex. Untreated or unrecognized manifestations of PANDAS can increase the risk of obsessive-compulsive manifestations and tics during adulthood. Taking this into consideration, further studies are required to establish the best method of therapy. Contents 1. Introduction 2. Methods 3. Results 4. Conclusions

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Section: Resultsmentioning

confidence: 99%

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (Review)

et al. 2020

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“…Because this patient had concurrent infections, we have referred to this case as a patient with PANDAS and Lyme co-infection. We suggest that the utilization of the term “Basal Ganglia Encephalitis (BGE)” may have more clinical utility when referring to the possible pathophysiology, where the type of infectious trigger may not be essential in the nomenclature of the clinical syndrome ( 26 , 36 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: PANDAS and Persistent Lyme Disease With Neuropsychiatric Symptoms: Treatment, Resolution, and Recovery

Cross

Bouboulis²,

Shimasaki

et al. 2021

Front. Psychiatry

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This case report describes the diagnosis and treatment of a pre-pubertal (onset at age 7) Caucasian female with serological evidence of Lyme disease accompanied by multiple neuropsychiatric symptoms 6 months following a vacation in a tick endemic area of the United States. Prior to the diagnosis of Lyme disease, the patient also met the clinical diagnostic criteria for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep), with serological evidence of three distinct episodes of streptococcal pharyngitis. All three episodes of strep occurred during the 6-months interval between suspected Lyme disease exposure and the onset of multiple neuropsychiatric symptoms. Her sometimes incapacitating symptoms followed a relapsing and remitting course that impacted her personal, family, social, and academic domains. Over a span of 31 consecutive months of treatment with various antimicrobials and three courses of intravenous immunoglobulins (IVIg) she experienced complete remission and remains symptom free at the time of this publication. Written permission was obtained from the minor patient's mother allowing the submission and publication of this case study.

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“…SC and PANDAS may share an underlying pathogenesis. Accumulating evidence shows that autoantibodies target antigens in the basal ganglia of these patients [ 84 , 85 , 86 , 87 , 88 ]. Through the molecular mimicry process, autoantibodies against N-acetyl-beta-D-glucosamine (GlcNAc), the dominant epitope of the GAS carbohydrate, cross-react with neuronal antigens, leading to neurological symptoms [ 85 , 89 ].…”

Section: Immune Dysregulation In Tsmentioning

confidence: 99%

“…Through the molecular mimicry process, autoantibodies against N-acetyl-beta-D-glucosamine (GlcNAc), the dominant epitope of the GAS carbohydrate, cross-react with neuronal antigens, leading to neurological symptoms [ 85 , 89 ]. Cross-reacting neuronal antigens include lysoganglioside-GM1 and beta-tubulin, both of which immunologically mimic GLcNAc [ 84 , 85 , 86 ]. They further induced CaMKII kinase activation [ 84 , 85 ].…”

Section: Immune Dysregulation In Tsmentioning

confidence: 99%

“…No dopamine-1 receptor (D1R) IgG was detected in the disease or control groups. However, subsequent studies have shown that anti-D1R and anti-D2R were significantly elevated in patients with active SC and PANDAS [ 86 , 88 ]. The anti-D2R/anti-D1R ratio is correlated with the severity of neuropsychiatric symptoms in SC [ 88 ].…”

Section: Immune Dysregulation In Tsmentioning

confidence: 99%

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Immunological Dysfunction in Tourette Syndrome and Related Disorders

Hsu

Wong

Lee

2021

IJMS

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Chronic tic disorder and Tourette syndrome are common childhood-onset neurological diseases. However, the pathophysiology underlying these disorders is unclear, and most studies have focused on the disinhibition of the corticostriatal–thalamocortical circuit. An autoimmune dysfunction has been proposed in the pathogenetic mechanism of Tourette syndrome and related neuropsychiatric disorders such as obsessive–compulsive disorder, autism, and attention-deficit/hyperactivity disorder. This is based on evidence from animal model studies and clinical findings. Herein, we review and give an update on the clinical characteristics, clinical evidence, and genetic studies in vitro as well as animal studies regarding immune dysfunction in Tourette syndrome.

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Autoantibody Biomarkers for Basal Ganglia Encephalitis in Sydenham Chorea and Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infections

Cited by 53 publications

References 80 publications

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (Review)

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (Review)

Case Report: PANDAS and Persistent Lyme Disease With Neuropsychiatric Symptoms: Treatment, Resolution, and Recovery

Immunological Dysfunction in Tourette Syndrome and Related Disorders

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