Murphy Tanya K, Sajid Muhammad W, Goodman Wayne K
Department of Psychiatry, University of Florida School of Medicine, Gainesville, FL 32610, USA.
Psychiatr Clin North Am. 2006 Jun;29(2):445-69. doi: 10.1016/j.psc.2006.02.003.
Childhood OCD often develops into a chronic illness that lasts decades. Proof that some type of immunotherapy (such as antibiotic prophylaxis) could significantly reduce recurrence or exacerbation of symptoms of OC or tics would suggest a supportive role for immune triggers in the onset or worsening of these conditions and provide additional tools for improving outcome. The validity of PANDAS will continue to be questioned, however,because demonstrating a clear causation will be difficult on a background ofa common childhood illness. Along with the previously mentioned immuno-therapy study, validation of the PANDAS phenotype (broadly interpreted)would be advanced from new and continued research in the following areas: (1) prospective studies to identify infectious triggers in the onset and exacerbations of OCD spectrum disorders, (2) biological measures for immune and genetic susceptibility, and (3) large scale epidemiological studies demonstrating the relationship between infection and OCD spectrum disorders. The assimilation of these study results should allow for elucidation of the immune system's role in the onset and maintenance of OCD.
儿童强迫症常常发展成一种持续数十年的慢性疾病。有证据表明某种免疫疗法（如抗生素预防）能显著降低强迫症或抽动症症状的复发或加重，这将提示免疫触发因素在这些病症的发病或病情恶化中起到支持作用，并为改善治疗效果提供更多手段。然而，熊猫症候群（PANDAS）的有效性仍将受到质疑，因为在常见儿童疾病的背景下，很难证明明确的因果关系。除了上述免疫疗法研究外，对熊猫症候群表型（广义解释）的验证将通过以下新的和持续的研究领域取得进展：（1）前瞻性研究，以确定强迫症谱系障碍发病和病情加重时的感染触发因素；（2）免疫和遗传易感性的生物学检测方法；（3）大规模流行病学研究，以证明感染与强迫症谱系障碍之间的关系。这些研究结果的整合应有助于阐明免疫系统在强迫症发病和维持过程中的作用。
