Center for Infection and Immunity, Columbia University Mailman School of Public Health, New York, NY, USA.
Neurosci Biobehav Rev. 2013 Jul;37(6):1120-38. doi: 10.1016/j.neubiorev.2013.01.007. Epub 2013 Jan 10.
An autoimmune diathesis has been proposed in Tourette syndrome (TS) and related neuropsychiatric disorders such as obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism and anorexia nervosa. Environmental triggers including infection and xenobiotics are hypothesized to lead to the production of brain-directed autoantibodies in a subset of genetically susceptible individuals. Although much work has focused on Group A Streptococcus (GAS), the role of this common childhood infection remains controversial. Animal model studies based on immune and autoantibody findings in TS have demonstrated immunoglobulin (Ig) deposits and stereotypic movements and related behavioral disturbances reminiscent of TS following exposure to GAS, other activators of host anti-microbial responses, soluble immune mediators and anti-GAS or anti-neuronal antibodies. Demonstration of the ability to recreate these abnormalities through passive transfer of serum IgG from GAS-immunized mice into naïve mice and abrogation of this activity through depletion of IgG has provided compelling evidence in support of the autoimmune hypothesis. Immunologically-based animal models of TS are a potent tool for dissecting the pathogenesis of this serious neuropsychiatric syndrome.
自身免疫素质已被提出在妥瑞氏综合征(TS)和相关的神经精神疾病,如强迫症、注意缺陷多动障碍、自闭症和神经性厌食症。环境触发因素,包括感染和外源性化学物质,被假设会导致在一部分遗传易感个体中产生针对大脑的自身抗体。尽管许多工作都集中在 A 组链球菌(GAS)上,但这种常见的儿童感染的作用仍然存在争议。基于 TS 中的免疫和自身抗体发现的动物模型研究表明,在接触 GAS、宿主抗微生物反应的其他激活剂、可溶性免疫介质和抗 GAS 或抗神经元抗体后,会出现免疫球蛋白(Ig)沉积和刻板运动以及与 TS 相关的行为障碍。通过从 GAS 免疫小鼠向未致敏小鼠被动转移血清 IgG 来重现这些异常,并通过耗尽 IgG 来阻断这种活性,为自身免疫假说提供了有力证据。基于免疫的 TS 动物模型是剖析这种严重神经精神综合征发病机制的有力工具。