抽动秽语综合征患儿体内抗人壳核抗体

Antibodies against human putamen in children with Tourette syndrome.

作者信息

Singer H S, Giuliano J D, Hansen B H, Hallett J J, Laurino J P, Benson M, Kiessling L S

机构信息

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Neurology. 1998 Jun;50(6):1618-24. doi: 10.1212/wnl.50.6.1618.

DOI:10.1212/wnl.50.6.1618

PMID:9633702

Abstract

BACKGROUND

Similar to the model for Sydenham's chorea, antineuronal antibodies, which develop in response to a preceding streptococcal infection, have been speculated to have a role in the development of Tourette syndrome (TS).

METHODS

Serum antibodies against human caudate, putamen, and globus pallidus (interna and externa) were assayed by enzyme-linked immunosorbent assay (ELISA) and Western blot techniques and results were correlated with clinical characteristics and markers of streptococcal infection.

SUBJECTS

A total of 41 children with TS (mean age, 11.3 years) and 39 controls (mean age, 12.1 years) were included.

RESULTS

Compared with controls, TS subjects had a significant increase in the mean (p=0.006) and median (p=0.002) ELISA optical density (OD) levels of serum antibodies against putamen, but not caudate or globus pallidus. Western blots on 20 control and 20 TS serum samples showed that specific antibodies to caudate/putamen occurred more frequently in TS subjects at 83, 67, and 60 kDa; antigens were present in a synaptosomal fraction. TS subjects with a positive family history of tics had higher OD values (p < or = 0.04), but no association was shown with age of tic onset, tic severity, sudden onset of tics, or presence of attention-deficit hyperactivity disorder or obsessive-compulsive disorder. Risk ratio calculations in TS and control groups and in study subjects dichotomized for high and low putamen OD values were similar for titers of antistreptolysin O > or = 166 or antideoxyribonuclease B > or = 170. A subgroup analysis limited to subjects with elevated streptococcal titers, however, showed a significantly (p < or = 0.004) larger number of TS subjects with elevated OD levels.

CONCLUSION

Children and adolescents with TS had significantly higher serum levels of antineuronal antibodies against putamen than did controls, but their relation to clinical characteristics and markers for streptococcal infection remains equivocal.

摘要

背景

与Sydenham舞蹈病的模型类似，推测因先前的链球菌感染而产生的抗神经元抗体在抽动秽语综合征（TS）的发病中起作用。

方法

采用酶联免疫吸附测定（ELISA）和蛋白质印迹技术检测血清中针对人类尾状核、壳核和苍白球（内侧和外侧）的抗体，并将结果与链球菌感染的临床特征和标志物进行关联分析。

研究对象

共纳入41例TS儿童（平均年龄11.3岁）和39例对照（平均年龄12.1岁）。

结果

与对照组相比，TS患者血清中抗壳核抗体的ELISA光密度（OD）水平均值（p = 0.006）和中位数（p = 0.002）显著升高，但抗尾状核或苍白球抗体水平未升高。对20例对照和20例TS患者的血清样本进行蛋白质印迹分析显示，TS患者中针对尾状核/壳核的特异性抗体在83、67和60 kDa处出现的频率更高；抗原存在于突触体组分中。有抽动家族史阳性的TS患者OD值更高（p≤0.04），但与抽动发作年龄、抽动严重程度、抽动突然发作或注意缺陷多动障碍或强迫症的存在无关。TS组和对照组以及根据壳核OD值高低二分的研究对象中，抗链球菌溶血素O≥166或抗脱氧核糖核酸酶B≥170的滴度的风险比计算结果相似。然而，仅限于链球菌滴度升高的受试者的亚组分析显示，OD水平升高的TS受试者数量显著更多（p≤0.004）。