Pediatric acute-onset neuropsychiatric syndromes and the gut-oral-brain axis: a narrative review of emerging microbiome-immune interactions and therapeutic perspectives

Matera M, Biagioli V, Illiceto MT, Palazzi CM, Cavecchia I, Manzi A, Lugli S, Pennazzi L, Meocci M, Pedaci FA, Bertuccioli A. Pediatric acute-onset neuropsychiatric syndromes and the gut-oral-brain axis: a narrative review of emerging microbiome-immune interactions and therapeutic perspectives. Frontiers in Immunology. 2025;16. doi:10.3389/fimmu.2025.1726630

  • Narrative review examining evidence linking gut and oral microbiota to immune dysregulation in PANS/PANDAS.Summarizes literature describing microbiome-related mechanisms including immune activation, increased intestinal permeability, and blood–brain barrier disruption.

  • Discusses how microbial metabolites and inflammatory signaling may influence neuroinflammation and neuropsychiatric symptoms.

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