Gause Colin, Morris Christina, Vernekar Shilpa, Pardo-Villamizar Carlos, Grados Marco A, Singer Harvey S
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
J Neuroimmunol. 2009 Sep 29;214(1-2):118-24. doi: 10.1016/j.jneuroim.2009.06.015. Epub 2009 Jul 22.
Autoimmunity associated with a streptococcal infection has been proposed as a pathogenic mechanism for obsessive-compulsive disorder (OCD) in children. Antibrain antibody profiles were compared in children with OCD-only (n = 13; 14.1 +/- 3.1 years), OCD+PANDAS (n = 20; 11.3 +/- 1.5 years), OCD+Chronic Tic Disorder (n = 23; 13.4 +/- 3.5 years), and controls (n = 29; 12.4 +/- 2.4 years) using ELISA (orbitofrontal (OFC) and dorsolateral prefrontal cortex (DLPFC), caudate (CD), cingulate gyrus (CG)), immunoblotting (four regions plus putative antigens), and immunohistochemistry. ELISA and immunohistochemistry showed no differences among groups. Immunoblot showed that a greater percentage of individuals in the OCD+PANDAS cohort had reactive bands at 27 kDa (CD, CG, DLPFC), 36 kDa (CD), and 100 kDa (CD, OFC) and increased peak height at 67 kDa (all regions). Immunoblotting studies using the putative antigens (pyruvate kinase M1, aldolase C, alpha- and gamma-enolase) did not differ among groups. ASO titers were similar in all groups and did not correlate with immunoassays. It remains controversial whether childhood OCD is associated with autoimmune mechanisms.
链球菌感染相关的自身免疫被认为是儿童强迫症（OCD）的一种致病机制。采用酶联免疫吸附测定（ELISA）（眶额皮质（OFC）和背外侧前额叶皮质（DLPFC）、尾状核（CD）、扣带回（CG））、免疫印迹法（四个区域加假定抗原）和免疫组化法，比较了单纯强迫症儿童（n = 13；14.1±3.1岁）、强迫症+小儿自身免疫性神经精神障碍伴链球菌感染（PANDAS）儿童（n = 20；11.3±1.5岁）、强迫症+慢性抽动障碍儿童（n = 23；13.4±3.5岁）和对照组（n = 29；12.4±2.4岁）的抗脑抗体谱。ELISA和免疫组化显示各组之间无差异。免疫印迹显示，强迫症+PANDAS队列中，更大比例的个体在27 kDa（CD、CG、DLPFC）、36 kDa（CD）和100 kDa（CD、OFC）处有反应条带，在67 kDa处峰高增加（所有区域）。使用假定抗原（丙酮酸激酶M1、醛缩酶C、α和γ烯醇化酶）的免疫印迹研究在各组之间没有差异。所有组的抗链球菌溶血素O（ASO）滴度相似，且与免疫测定不相关。儿童强迫症是否与自身免疫机制有关仍存在争议。
