Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland.
Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland.
Int J Mol Sci. 2020 Feb 21;21(4):1476. doi: 10.3390/ijms21041476.
The objective of this paper is to review and summarize conclusions from the available literature regarding Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). The authors have independently reviewed articles from 1977 onwards, primarily focusing on the etiopathology, symptoms, differentiation between similar psychiatric conditions, immunological reactions, alterations in the nervous system and gut microbiota, genetics, and the available treatment for PANDAS. Recent research indicates that PANDAS patients show noticeable alterations within the structures of the central nervous system, including caudate, putamen, globus pallidus, and striatum, as well as bilateral and lentiform nuclei. Likewise, the presence of autoantibodies that interact with basal ganglia was observed in PANDAS patients. Several studies also suggest a relationship between the presence of obsessive-compulsive disorders like PANDAS and alterations to the gut microbiota. Further, genetic predispositions-including variations in the gene and T-seem to be relevant regarding PANDAS syndrome. Even though the literature is still scarce, the authors have attempted to provide a thorough insight into the PANDAS syndrome, bearing in mind the diagnostic difficulties of this condition.
本文旨在回顾和总结现有文献中关于与链球菌感染相关的儿童自身免疫性神经精神障碍（PANDAS）的结论。作者独立地回顾了 1977 年以来的文献，主要集中在病因学、症状、与类似精神疾病的鉴别、免疫学反应、神经系统和肠道微生物群的改变、遗传学以及 PANDAS 的现有治疗方法上。最近的研究表明，PANDAS 患者的中枢神经系统结构发生了明显改变，包括尾状核、壳核、苍白球和纹状体，以及双侧和豆状核。同样，在 PANDAS 患者中观察到与基底节相互作用的自身抗体的存在。几项研究还表明，像 PANDAS 这样的强迫症与肠道微生物群的改变之间存在关系。此外，遗传易感性——包括 基因和 T 基因的变异——似乎与 PANDAS 综合征有关。尽管文献仍然很少，但作者试图提供对 PANDAS 综合征的全面了解，同时考虑到这种疾病的诊断困难。
