Morer Astrid, Lázaro Luisa, Sabater Lidia, Massana Joan, Castro Josefina, Graus Francesc
Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Carrer Villarroel 170, Barcelona 08036, Spain.
J Psychiatr Res. 2008 Jan;42(1):64-8. doi: 10.1016/j.jpsychires.2006.09.010. Epub 2006 Nov 17.
An autoimmune hypothesis has been suggested for early onset obsessive-compulsive disorder and Tourette syndrome. The term: Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) has been proposed as an aetiological subtype of OCD and TS, related to a Group A beta haemolytic streptococcal (GABHS) infection that triggers an autoimmune response. Antineural antibodies have been studied and found in the sera of some patients with these disorders, and they are thought to cross-react with streptococcal and basal ganglia antigens. The present study included 32 prepubertal-onset OCD patients, 21 with TS diagnosis (some of them meeting criteria for PANDAS) and 19 normal children, all aged between 9 and 17 years. Antibodies were assayed by immunohistochemistry and immunoblot. Special attention was paid to the methodology and a high serum dilution was used to minimize non-specific binding. No anti-basal ganglia antibodies were detected by immunohistochemistry in any of the samples. Two proteins, with approximate molecular weights of 86 kDa and 55 kDa, were found in sera from 7 patients. Though the study supports the hypothesis of an autoimmune process underlying OCD or TS in some patients, further research is needed.
一种自身免疫假说已被提出用于解释早发性强迫症和抽动秽语综合征。“儿童自身免疫性神经精神障碍伴链球菌感染(PANDAS)”这一术语已被提议作为强迫症和抽动秽语综合征的一种病因亚型,它与引发自身免疫反应的A组β溶血性链球菌(GABHS)感染有关。已对一些患有这些疾病的患者血清中的抗神经抗体进行了研究并发现了它们,并且认为这些抗体与链球菌和基底神经节抗原发生交叉反应。本研究纳入了32例青春期前发病的强迫症患者、21例诊断为抽动秽语综合征的患者(其中一些符合PANDAS标准)以及19名正常儿童,所有患者年龄均在9至17岁之间。通过免疫组织化学和免疫印迹法检测抗体。特别关注了方法学,并使用高血清稀释度以尽量减少非特异性结合。在任何样本中通过免疫组织化学均未检测到抗基底神经节抗体。在7例患者的血清中发现了两种蛋白质,其分子量约为86 kDa和55 kDa。尽管该研究支持了一些患者中强迫症或抽动秽语综合征存在自身免疫过程的假说,但仍需要进一步研究。