Murphy T K, Goodman W K, Fudge M W, Williams R C, Ayoub E M, Dalal M, Lewis M H, Zabriskie J B
Department of Psychiatry, University of Florida College of Medicine, USA.
Am J Psychiatry. 1997 Mar;154(3):402-7. doi: 10.1176/ajp.154.3.402.
It has been hypothesized that Sydenham's chorea, a major manifestation of rheumatic fever, may provide a medical model for obsessive-compulsive disorder and associated conditions, such as Tourette's syndrome. Monoclonal antibody D8/17 identifies a B lymphocyte antigen with expanded expression in nearly all patients with rheumatic fever and is thought to be a trait marker for susceptibility to this complication of group A streptococcal infection. The authors investigated whether D8/17 expression is greater than normal in some forms of obsessive-compulsive disorder and Tourette's syndrome.
By immunofluorescence techniques, 31 patients with childhood-onset obsessive-compulsive disorder and/or Tourette's syndrome or chronic tic disorder and 21 healthy comparison subjects were evaluated for percentage of D8/17-positive B cells. None had rheumatic fever or Sydenham's chorea. Levels of antineuronal antibodies and streptococcal antibodies were also determined.
The average percentage of B cells expressing the D8/17 antigen was significantly higher in the patients (mean = 22%, SD = 5%) than in the comparison subjects (mean = 9%, SD = 2%). When classified categorically, all patients but only one comparison subject were D8/17 positive. No difference between groups in the presence of antineuronal antibodies or high streptococcal titers was found.
Patients with childhood-onset obsessive-compulsive disorder or Tourette's syndrome had significantly greater B cell D8/17 expression than comparison subjects despite the absence of documented Sydenham's chorea or rheumatic fever. These findings suggest that D8/17 may serve as a marker for susceptibility among some forms of childhood-onset obsessive-compulsive disorder and Tourette's syndrome, as well as rheumatic fever or Sydenham's chorea.
有假设认为，风湿热的主要表现之一—— Sydenham舞蹈症，可能为强迫症及相关病症（如妥瑞氏综合征）提供一种医学模型。单克隆抗体D8/17可识别一种B淋巴细胞抗原，在几乎所有风湿热患者中其表达均有增加，被认为是A组链球菌感染这一并发症易感性的特征性标志物。作者调查了在某些形式的强迫症和妥瑞氏综合征中，D8/17表达是否高于正常水平。
采用免疫荧光技术，对31例儿童期起病的强迫症和/或妥瑞氏综合征或慢性抽动障碍患者以及21名健康对照者进行评估，检测D8/17阳性B细胞的百分比。所有受试者均无风湿热或Sydenham舞蹈症。同时还测定了抗神经元抗体和链球菌抗体水平。
患者中表达D8/17抗原的B细胞平均百分比（均值 = 22%，标准差 = 5%）显著高于对照者（均值 = 9%，标准差 = 2%）。分类来看，所有患者均为D8/17阳性，而对照者中只有1例为阳性。两组在抗神经元抗体或高链球菌滴度的存在情况上无差异。
尽管没有记录到Sydenham舞蹈症或风湿热，但儿童期起病的强迫症或妥瑞氏综合征患者的B细胞D8/17表达显著高于对照者。这些发现表明，D8/17可能作为某些形式的儿童期起病的强迫症和妥瑞氏综合征以及风湿热或Sydenham舞蹈症易感性的标志物。
