Dale Russell C, Heyman Isobel, Giovannoni Gavin, Church Andre W J
Department of Child and Adolescent Psychiatry, PO Box 085, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Br J Psychiatry. 2005 Oct;187:314-9. doi: 10.1192/bjp.187.4.314.
Obsessions and compulsions may occur in the post-streptococcal disorders Sydenham's chorea and paediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS). The proposed mediators are anti-basal ganglia antibodies (ABGA).
We tested the hypothesis that post-streptococcal autoimmunity may have a role in'idiopathic'obsessive-compulsive disorder (OCD).
We examined 50 children with OCD for ABGA using enzyme-linked immunosorbent assay (ELISA) and western immunoblotting. The findings were compared with paediatric autoimmune (n=50), neurological (n=100) and streptococcal (n=40) controls.
The mean ABGA binding on ABGA binding on ELISA was elevated in the patient cohort compared with all control groups (P<0.005 in all comparisons). Western immunoblotting revealed positive antibody binding (as seen in Sydenham's chorea) in 42% of the patient cohort compared with 2-10% of control groups (P<0.001 in all comparisons).
Our findings support the hypothesis that central nervous system autoimmunity may have a role in a significant subgroup of cases of OCD. Further study is required to examine whether the antibodies concerned are pathogenic.
强迫观念与强迫行为可能出现于链球菌感染后疾病如 Sydenham 舞蹈病及小儿自身免疫性神经精神障碍伴链球菌感染（PANDAS）中。推测的介导物为抗基底节抗体（ABGA）。
我们检验了链球菌感染后自身免疫可能在“特发性”强迫症（OCD）中起作用这一假说。
我们采用酶联免疫吸附测定（ELISA）及免疫印迹法检测了 50 例 OCD 患儿的 ABGA。将结果与小儿自身免疫性疾病组（n = 50）、神经病学组（n = 100）及链球菌感染组（n = 40）对照进行比较。
与所有对照组相比，患者队列中 ELISA 检测的 ABGA 结合平均水平升高（所有比较中 P < 0.005）。免疫印迹法显示患者队列中有 42%出现阳性抗体结合（如同在 Sydenham 舞蹈病中所见），而对照组为 2% - 10%（所有比较中 P < 0.001）。
我们的研究结果支持中枢神经系统自身免疫可能在相当一部分 OCD 病例中起作用这一假说。需要进一步研究以检验相关抗体是否具有致病性。
