抽动障碍和强迫症中的炎症：儿科自身免疫性神经精神障碍相关链球菌感染（PANS）和儿科急性发作性神经精神综合征（PANDAS）是前进的方向吗？
Inflammation in Tic Disorders and Obsessive-Compulsive Disorder: Are PANS and PANDAS a Path Forward?
作者信息
Gilbert Donald L
机构信息
1 Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA.
出版信息
J Child Neurol. 2019 Sep;34(10):598-611. doi: 10.1177/0883073819848635. Epub 2019 May 21.
Abstract
This review and commentary is the product of an invited lecture called "Autoimmunity: PANS/PANDAS" presented at the 2018 Neurobiology of Diseases in Children Symposium in Chicago, IL. The talk addressed clinical and scientific questions and recently published data. At this time, among highly experienced and respected clinicians and researchers spanning relevant disciplines, there is substantial controversy regarding a role for inflammation in producing tics and obsessive-compulsive disorder. This commentary summarizes these controversies, discusses reasons for opposing views on best clinical practices, and concludes with suggestions for pathways forward.
摘要
本综述与评论是在伊利诺伊州芝加哥市举行的2018年儿童疾病神经生物学研讨会上发表的题为“自身免疫：儿科自身免疫性神经精神障碍/链球菌感染相关儿童自身免疫性神经精神障碍”的特邀讲座的成果。该讲座探讨了临床和科学问题以及最近发表的数据。目前，在相关学科的经验丰富且备受尊敬的临床医生和研究人员中，对于炎症在引发抽动症和强迫症中所起的作用存在重大争议。本评论总结了这些争议，讨论了对最佳临床实践存在反对观点的原因，并最后提出了未来的发展途径建议。
相似文献
1
Inflammation in Tic Disorders and Obsessive-Compulsive Disorder: Are PANS and PANDAS a Path Forward?抽动障碍和强迫症中的炎症：儿科自身免疫性神经精神障碍相关链球菌感染（PANS）和儿科急性发作性神经精神综合征（PANDAS）是前进的方向吗？
J Child Neurol. 2019 Sep;34(10):598-611. doi: 10.1177/0883073819848635. Epub 2019 May 21.
2
Clinical presentation of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections in research and community settings.研究及社区环境中与链球菌感染相关的儿童自身免疫性神经精神障碍的临床表现
J Child Adolesc Psychopharmacol. 2015 Feb;25(1):26-30. doi: 10.1089/cap.2014.0073.
3
Clinical factors associated with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.与链球菌感染相关的小儿自身免疫性神经精神障碍相关的临床因素。
J Pediatr. 2012 Feb;160(2):314-9. doi: 10.1016/j.jpeds.2011.07.012. Epub 2011 Aug 25.
4
Passive transfer of streptococcus-induced antibodies reproduces behavioral disturbances in a mouse model of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection.被动转移链球菌诱导的抗体可重现与链球菌感染相关的小儿自身免疫性神经精神障碍疾病小鼠模型中的行为障碍。
Mol Psychiatry. 2010 Jul;15(7):712-26. doi: 10.1038/mp.2009.77. Epub 2009 Aug 11.
5
Pediatric autoimmune neuropsychiatric disorders associated with streptococci (PANDAS): update.与链球菌相关的儿童自身免疫性神经精神障碍（PANDAS）：最新进展
Curr Opin Pediatr. 2009 Feb;21(1):127-30. doi: 10.1097/MOP.0b013e32831db2c4.
6
Prevalence of Acute-Onset Subtypes in Pediatric Obsessive-Compulsive Disorder.儿童强迫症急性起病亚型的患病率
J Child Adolesc Psychopharmacol. 2017 May;27(4):332-341. doi: 10.1089/cap.2016.0031. Epub 2017 Jan 25.
7
[Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). A report of two cases].[与链球菌感染相关的儿童自身免疫性神经精神障碍（PANDAS）。两例报告]
Psychiatr Pol. 2004 Jan-Feb;38(1):105-23.
8
[Therapeutic response to plasmapheresis in four cases with obsessive-compulsive disorder and tic disorder triggered by streptococcal infections].[4例由链球菌感染引发的强迫症和抽动障碍患者接受血浆置换治疗的疗效]
Turk Psikiyatri Derg. 2007 Fall;18(3):270-6.
9
PANDAS and immunomodulatory therapy.儿童自身免疫性神经精神障碍相关的链球菌感染与免疫调节治疗
Lancet. 1999 Oct 2;354(9185):1137-8. doi: 10.1016/S0140-6736(99)00204-4.
10
Clinical-Serological Characterization and Treatment Outcome of a Large Cohort of Italian Children with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection and Pediatric Acute Neuropsychiatric Syndrome.一大群患有与链球菌感染相关的儿童自身免疫性神经精神障碍和儿童急性神经精神综合征的意大利儿童的临床血清学特征及治疗结果
J Child Adolesc Psychopharmacol. 2019 Oct;29(8):608-614. doi: 10.1089/cap.2018.0151. Epub 2019 May 29.
引用本文的文献
1
Frequency and impact of paediatric acute-onset neuropsychiatric syndrome/paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections diagnosis in Canada.加拿大儿童急性起病神经精神综合征/与链球菌感染相关的儿童自身免疫性神经精神障碍的诊断频率及影响
Paediatr Child Health. 2024 Dec 23;30(3):157-163. doi: 10.1093/pch/pxae092. eCollection 2025 Jun.
2
Comorbidity of physical illnesses and mental disorders in outpatients with tic disorders: a retrospective study using the outpatient case system.抽动障碍门诊患者的躯体疾病与精神障碍共病情况：一项使用门诊病例系统的回顾性研究
Front Neurol. 2024 Dec 5;15:1397766. doi: 10.3389/fneur.2024.1397766. eCollection 2024.
3
Dietary inflammatory index and its impact on severity and recurrence of Tourette syndrome in children.饮食炎症指数及其对儿童抽动秽语综合征严重程度和复发的影响。
World J Psychiatry. 2024 Aug 19;14(8):1208-1215. doi: 10.5498/wjp.v14.i8.1208.
4
Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives.小儿急性起病神经精神综合征：当前观点
Neuropsychiatr Dis Treat. 2023 May 24;19:1221-1250. doi: 10.2147/NDT.S362202. eCollection 2023.
5
Identification of ultra-rare genetic variants in pediatric acute onset neuropsychiatric syndrome (PANS) by exome and whole genome sequencing.通过外显子组和全基因组测序鉴定儿科急性起病神经精神综合征（PANS）中的超罕见遗传变异。
Sci Rep. 2022 Jun 30;12(1):11106. doi: 10.1038/s41598-022-15279-3.
6
Anti-Inflammatory Activity and Mechanism of Cryptochlorogenic Acid from .白皮松中绿原酸的抗炎活性及其作用机制。
Nutrients. 2022 Jan 19;14(3):439. doi: 10.3390/nu14030439.
7
Allergic diseases influence symptom severity and T lymphocyte subgroups of children with tic disorders.过敏性疾病影响抽动障碍儿童的症状严重程度和 T 淋巴细胞亚群。
J Investig Med. 2021 Dec;69(8):1453-1457. doi: 10.1136/jim-2021-001788. Epub 2021 Jul 13.
8
A Comprehensive Review of Tic Disorders in Children.儿童抽动障碍综合综述
J Clin Med. 2021 Jun 3;10(11):2479. doi: 10.3390/jcm10112479.
9
Autoantibody-associated psychiatric syndromes in children: link to adult psychiatry.儿童自身抗体相关精神综合征：与成人精神病学的关联。
J Neural Transm (Vienna). 2021 Jun;128(6):735-747. doi: 10.1007/s00702-021-02354-8. Epub 2021 May 31.
10
Tourette's disorder in children and adolescents.儿童和青少年的抽动秽语综合征
Transl Pediatr. 2020 Feb;9(Suppl 1):S94-S103. doi: 10.21037/tp.2019.09.11.
本文引用的文献
1
Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part II-Use of Immunomodulatory Therapies.小儿急性起病神经精神综合征的临床管理：第二部分——免疫调节疗法的应用
J Child Adolesc Psychopharmacol. 2017 Sep;27(7):574-593. doi: 10.1089/cap.2016.0148. Epub 2017 Jul 19.
2
Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part III-Treatment and Prevention of Infections.小儿急性起病神经精神综合征的临床管理：第三部分——感染的治疗与预防
J Child Adolesc Psychopharmacol. 2017 Sep;27(7):594-606. doi: 10.1089/cap.2016.0151. Epub 2017 Jul 19.
3
Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis.长期抗生素治疗对莱姆病患者认知的影响。
Neurology. 2019 Mar 26;92(13):e1447-e1455. doi: 10.1212/WNL.0000000000007186. Epub 2019 Feb 22.
4
The Cunningham Panel is an unreliable biological measure.坎宁安小组是一种不可靠的生物学测量方法。
Transl Psychiatry. 2019 Jan 31;9(1):49. doi: 10.1038/s41398-019-0413-x.
5
The Rise of Pseudomedicine for Dementia and Brain Health.治疗痴呆症和促进大脑健康的伪医学的兴起。
JAMA. 2019 Feb 12;321(6):543-544. doi: 10.1001/jama.2018.21560.
6
Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis.单纯疱疹脑炎后自身免疫性脑炎的频率、症状、危险因素和结局：一项前瞻性观察研究和回顾性分析。
Lancet Neurol. 2018 Sep;17(9):760-772. doi: 10.1016/S1474-4422(18)30244-8. Epub 2018 Jul 23.
7
A Pediatric Neurology Perspective on Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection and Pediatric Acute-Onset Neuropsychiatric Syndrome.从儿科神经学角度看与链球菌感染相关的儿科自身免疫性神经精神障碍及儿科急性起病神经精神综合征
J Pediatr. 2018 Aug;199:243-251. doi: 10.1016/j.jpeds.2018.04.035. Epub 2018 May 21.
8
Comprehensive systematic review summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.全面系统综述摘要：多发性硬化症成人疾病修正治疗：美国神经病学学会指南制定、传播和实施小组委员会的报告。
Neurology. 2018 Apr 24;90(17):789-800. doi: 10.1212/WNL.0000000000005345.
9
Response Expectancy and the Placebo Effect.反应预期和安慰剂效应。
Int Rev Neurobiol. 2018;138:81-93. doi: 10.1016/bs.irn.2018.01.003. Epub 2018 Feb 28.
10
The Proposal to Lower P Value Thresholds to .005.将P值阈值降至0.005的提议。
JAMA. 2018 Apr 10;319(14):1429-1430. doi: 10.1001/jama.2018.1536.
Zotero 插件