Individualized Immunological Data for Precise Classification of OCD Patients

Lamothe, Hugues; Baleyte, Jean–Marc; Smith, Pauline; Pélissolo, Antoine; Mallet, Luc

doi:10.3390/brainsci8080149

Cited by 18 publications

(17 citation statements)

References 184 publications

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“…Recent research has shown that dopamine levels may contribute to the immunological mechanisms involved in PANDAS pathogenesis [109][110][111]. Altered levels of dopamine may also be an explanation of the decrease of Treg levels and elevations in proinflammatory cytokines [112][113][114][115]. Moreover, it was observed that among PANDAS patients, vitamin D deficiency was significantly more frequent in comparison to the control groups [78].…”

Section: The Pathophysiology Of Gas Infection and Pandasmentioning

confidence: 99%

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Baj

Sitarz

Forma

et al. 2020

IJMS

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The objective of this paper is to review and summarize conclusions from the available literature regarding Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). The authors have independently reviewed articles from 1977 onwards, primarily focusing on the etiopathology, symptoms, differentiation between similar psychiatric conditions, immunological reactions, alterations in the nervous system and gut microbiota, genetics, and the available treatment for PANDAS. Recent research indicates that PANDAS patients show noticeable alterations within the structures of the central nervous system, including caudate, putamen, globus pallidus, and striatum, as well as bilateral and lentiform nuclei. Likewise, the presence of autoantibodies that interact with basal ganglia was observed in PANDAS patients. Several studies also suggest a relationship between the presence of obsessive-compulsive disorders like PANDAS and alterations to the gut microbiota. Further, genetic predispositions—including variations in the MBL gene and TNF-α—seem to be relevant regarding PANDAS syndrome. Even though the literature is still scarce, the authors have attempted to provide a thorough insight into the PANDAS syndrome, bearing in mind the diagnostic difficulties of this condition.

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Section: The Pathophysiology Of Gas Infection and Pandasmentioning

confidence: 99%

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Baj

Sitarz

Forma

et al. 2020

IJMS

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“…Nevertheless, up to half of all OCD patients do not benefit from this combination treatment in a clinically meaningful way [ 6 ], which has prompted efforts aimed at identifying diagnostic subgroups with specific pathogenic mechanisms that may mediate treatment resistance, as well as improving treatment options. In this line, a subgroup of patients may have a secondary form of OCD with an organic cause, which often appears to be autoimmune mediated [ 19 , 24 – 26 ]. In the novel ICD-11 criteria, reflecting DSM-5 nosology, this aspect is taken into account by introducing the category “secondary OCD or related syndrome” ( https://icd.who.int ).…”

Section: Introductionmentioning

confidence: 99%

Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype?

Endres

Pollak

Bechter³

et al. 2022

Transl Psychiatry

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Obsessive-compulsive disorder (OCD) is a highly disabling mental illness that can be divided into frequent primary and rarer organic secondary forms. Its association with secondary autoimmune triggers was introduced through the discovery of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS) and Pediatric Acute onset Neuropsychiatric Syndrome (PANS). Autoimmune encephalitis and systemic autoimmune diseases or other autoimmune brain diseases, such as multiple sclerosis, have also been reported to sometimes present with obsessive-compulsive symptoms (OCS). Subgroups of patients with OCD show elevated proinflammatory cytokines and autoantibodies against targets that include the basal ganglia. In this conceptual review paper, the clinical manifestations, pathophysiological considerations, diagnostic investigations, and treatment approaches of immune-related secondary OCD are summarized. The novel concept of “autoimmune OCD” is proposed for a small subgroup of OCD patients, and clinical signs based on the PANDAS/PANS criteria and from recent experience with autoimmune encephalitis and autoimmune psychosis are suggested. Red flag signs for “autoimmune OCD” could include (sub)acute onset, unusual age of onset, atypical presentation of OCS with neuropsychiatric features (e.g., disproportionate cognitive deficits) or accompanying neurological symptoms (e.g., movement disorders), autonomic dysfunction, treatment resistance, associations of symptom onset with infections such as group A streptococcus, comorbid autoimmune diseases or malignancies. Clinical investigations may also reveal alterations such as increased levels of anti-basal ganglia or dopamine receptor antibodies or inflammatory changes in the basal ganglia in neuroimaging. Based on these red flag signs, the criteria for a possible, probable, and definite autoimmune OCD subtype are proposed.

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“…In addition to these genetic and epidemiological findings, there is an emerging body of preliminary data that is focused on inflammatory markers (cytokine and immunoglobulin levels), immune cell populations, and gene expression profiling of peripheral lymphocytes. These data indicate some degree of hyperactivity of both the innate and the adaptive immune systems in TS, childhood-onset OCD and ADHD [131][132][133][134][135] .…”

Section: Stress Neuroinflammation Maternal Immune Activation and Tmentioning

confidence: 72%

What does immunology have to do with brain development and neuropsychiatric disorders?

Leckman¹,

Alvarenga²,

Ravagnani³

et al. 2019

Rev. Med. (São Paulo)

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Introduction: Neural development is an enormously complex and dynamic process. From very early in brain development ‘immune cells’ play a key role in a number of processes including the formation and refinement of neural circuits, as well as sexual differentiation. There is a growing body of evidence that the immune system also plays an important role in the pathobiology of several neurodevelopmental and neuropsychiatric disorders. Objective: The goal of this article is to review the currently available data concerning the role of the ‘immune system’ in normal brain development, as well as its role in the pathobiology of neurodevelopmental and neuropsychiatric disorders. Methodology: We conducted a traditional literature search using PubMed and recent special issues of journals to locate relevant review articles. Results: The cellular and molecular processes that make up our ‘immune system’ are crucial to normal brain development and the formation and maintenance of neural circuits. It is also increasingly evident that the immune system and neuroinflammation play important roles in the pathobiology of at least a subset of individuals with Autism Spectrum Disorder (ASD), schizophrenia, obsessive-compulsive disorder, Tourette syndrome and mood disorders, such as depression, as well as autoimmune and neurodegenerative disorders. Emerging evidence also points to the importance of the ‘gut-brain axis’ and an individual’s microbiome, which can impact an individual’s somatic and mental well-being. Conclusions: There are multidirectional interconnections across multiple biological systems in our brains and bodies that are mediated in part by the immune system. At present, however, the ‘promise’ of this field remains greater than the ‘deliverables.’ Time will tell whether novel interventions will be developed that will make a positive difference in the care of our patients. It is also possible that valid biomarkers will emerge that will guide a more personalized approach to treatment.

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Individualized Immunological Data for Precise Classification of OCD Patients

Cited by 18 publications

References 184 publications

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype?

What does immunology have to do with brain development and neuropsychiatric disorders?

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