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Pedijatrijsko autoimuno neuropsihijatrijsko oboljenje udruženo sa streptokokom

Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection

Jasmina Škorić1, Bojan Pavković1. 1 Dom zdravlja Dr Simo Milošević’, Beograd, Srbija

http://prevped.preventivnapedijatrija.rs/index.php/casopis/article/download/41/24

Conclusion: The patient showed signs of improvement after the intravenous administration of immunoglobulin which confirmed the underlying immunological aspect of the disease. Additionally, serologic test results that showed elevated antistreptolysin O titer and antideoxyribonuclease–B titer indicated streptococcal etiology. Precisely, these misdirected antibodies set off an inflammatory response that led to the basal ganglia damage resulting in behavioral changes, motor, cognitive and emotional disorders.

PANDAS in an Adult?: A Case Report. Deshmukh RP, Mane AB, Singh S.Ind J Priv Psychiatry 2022; 16 (1):44-45. DOI: 10.5005/jp-journals-10067-0104

“We report a case in order to suggest that we should be alert while assessing OCD in young patients, as it might be secondary to streptococcal infection. This has therapeutic implications. Trials of immunomodulator therapy can be given as suggested in a few kinds of literature. Although still experimental, it may have potential for the future, especially in those not responding to conventional treatment… This report might suggest that PANDAS-like syndrome may occur in adults also. We should be cautious of this syndrome during treatment.”

Neuroinflammation in a Rat Model of Tourette Syndrome, Zhongling Ke, Yanhui Chen, Guofeng Chen, Yanyan Liu, Neuroinflammation in a Rat Model of Tourette Syndrome, Frontiers in Behavioral Neuroscience, Vol 16, Front. Behav. Neurosci., 10 March 2022, DOI: 10.3389/fnbeh.2022.710116   

Conclusion: The IDPN-induced TS rats had significant neuroinflammation in the brain, and the interaction between dopamine (DA) dysregulation and immune dysfunction may play a vital role in the pathogenic mechanisms of TS.

Bambauer R, Schiel R. Therapeutic Apheresis and Immunosuppression in Immunologic Diseases: A Review and OwnObservations. Clin Immunol Res. 2021; 5(2): 1-36. ISSN 2639-8486

“TA should be reserved for treatment of children and adolescents

who are severely affected by PANDAS. In such patients, it

appears to be safe, well-tolerated, and beneficial treatment

option [130]. Bien et al reported in 2020, besides the first-line

interventions of steroids, IVIG, and TA as second-line treatments

cyclophosphamide or rituximab [131].”

Trifonova, E.A.; Mustafin, Z.S.; Lashin, S.A.; Kochetov, A.V. Abnormal mTOR Activity in Pediatric Autoimmune Neuropsychiatric and MIA-Associated Autism Spectrum Disorders. Int. J. Mol. Sci. 2022, 23, 967. https://doi.org/10.3390/ijms23020967

Abstract: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by

the early onset of communication and behavioral problems. ASD is highly heritable; however,

environmental factors also play a considerable role in this disorder. A significant part of both

syndromic and idiopathic autism cases could be attributed to disorders caused by mammalian

target of rapamycin (mTOR)-dependent translation deregulation. This narrative review analyzes both bioinformatic and experimental evidence that connects mTOR signaling to the maternal autoantibody-related (MAR) autism spectrum and autoimmune neuropsychiatric disorders simultaneously. In addition, we reconstruct a network presenting the interactions between the mTOR signaling and eight MAR ASD genes coding for ASD-specific maternal autoantibody target proteins. The research discussed in this review demonstrates novel perspectives and validates the need for a subtyping of ASD on the grounds of pathogenic mechanisms. The utter necessity of designing ELISA-based test panels to identify all antibodies related to autism-like behavior is also considered.