Blog

Roles of Th17 cytokines in microglial and neurovascular responses to recurrent intranasal Streptococcus pyogenes infections

Theses Doctoral. Columbia Academic Commons. https://doi.org/10.7916/62va-6330

Academic Units: Cellular, Molecular and Biomedical Studies
Thesis Advisors: Agalliu, Dritan
Degree: Ph.D., Columbia University
Published:  September 7, 2022

A letter to my 14 year old self
A letter to my 14 year old self

Our friend gave ASPIRE permission to share this letter to her 14-year-old self. Many of us know how it feels to be too affected by PANS/PANDAS/BGE to go to school....

Read Story

Obsessive-Compulsive Disorder With Inflammatory Cerebrospinal Fluid Changes and Intrathecal Antinuclear Antibody Staining

D Endres, MA Schiele, BC Frye, A Schlump, B Feige, k Nickel, B Berger, M Reisert, H Urbach, K Domschke, N Venhoff, H Prüss, L Tebartz van Elst. Obsessive-Compulsive Disorder With Inflammatory Cerebrospinal Fluid Changes and Intrathecal Antinuclear Antibody Staining. Biological Psychiatry. Elsevier. 3 September 2022. DOI:https://doi.org/10.1016/j.biopsych.2022.06.037

Autoimmune-mediated obsessive-compulsive disorder (OCD) during childhood has long been established in the context of pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection. In adult psychiatry, the topic has increasingly gained interest in light of new developments regarding autoimmune encephalitis and autoimmune psychosis. Hence, diagnostic criteria for autoimmune OCD in adulthood have been proposed recently, and the first respective cases were reported. For the detection of neuroinflammatory processes, cerebrospinal fluid (CSF) analysis (besides the far more invasive brain biopsy) is considered the most sensitive diagnostic tool. Here, we present 2 paradigmatic OCD patients with inflammatory CSF signals including antinuclear antibody staining in CSF and magnetic resonance imaging (MRI)/electroencephalography (EEG) findings compatible with OCD.

 

 

Group A Beta-Hemolytic Streptococcus-Induced Tic-Like Movement Disorder in an Adult: A Case Report

Ilyas U, Umar Z, Lin D (August 26, 2022) Group A Beta-Hemolytic Streptococcus-Induced Tic-Like Movement Disorder in an Adult: A Case Report. Cureus 14(8): e28451. doi:10.7759/cureus.28451

“Our case report highlights the importance of a thorough history, including inquiring about past infections and investigations to look for autoimmune and infectious etiologies, including ASO and positive DNAse B titers, in adult patients with new onset movement disorders and no other identifiable etiology and risk factors. Further research is mandatory to investigate the incidence of movement disorders in the adult population after a streptococcal infection and the diagnostic approach and treatment modalities needed to manage such patients.”

An unusual case of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections(PANDAS) – diagnostic evaluation, treatment and the remarkable outcome
Divya Raj T, Santosh H, Chaturvedi S. 589 An unusual case of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections(PANDAS) – diagnostic evaluation, treatment and the remarkable outcome Archives of Disease in Childhood 2022;107:A224-A225.

“Conclusion Our observation in this case confirms the value of early diagnosis to reduce the risk of progression to disabling chronic neurologic sequelae in the PANDAS. Children with PANDAS derive a favourable response to IVIG. Our findings support its administration early in the course of the disease and continued until significant improvement or remission is achieved without side-effects.”

Sex and Aggression Characteristics in a Cohort of Patients with Pediatric Acute-Onset Neuropsychiatric Syndrome

Jaynelle Gao, Avis Chan, Theresa Willett, Bahare Farhadian, Melissa Silverman, Paula Tran, Sana Ahmed, Margo Thienemann, and Jennifer Frankovich.Sex and Aggression Characteristics in a Cohort of Patients with Pediatric Acute-Onset Neuropsychiatric Syndrome.Journal of Child and Adolescent Psychopharmacology.ahead of print http://doi.org/10.1089/cap.2021.0084

  • Males had a higher median Modified Overt Aggression Scale (MOAS) score in the first year of clinic when compared with females and a higher median subscore for physical aggression.
  • The median time from PANS symptom onset to first administration of immunotherapy, which did not include nonsteroidal anti-inflammatory drugs or short bursts of oral steroids, was 6.9 years for females and 3.7 years for males.
  • Although the physical aggression measured by the MOAS was significantly higher in males, caregivers of males and females reported similar levels of caregiver burden.
  • The two groups did not differ significantly in age of PANS onset, time from onset to clinic entry, other psychiatric symptom measures, or laboratory markers of inflammation.

Conclusion: Among patients with PANS, males exhibit more aggressive behavior when compared with females, which may advance the decision to treat with immunotherapy. Scores that capture a more global level of functioning show that despite there being a higher level of aggression in males, female patients with PANS have similar levels of overall impairment.

Cytokine dynamics and targeted immunotherapies in autoimmune encephalitis

Nicolás Lundahl Ciano-Petersen, Sergio Muñiz-Castrillo, Cristina Birzu, Alberto Vogrig, Antonio Farina, Macarena Villagrán-García, Bastien Joubert, Dimitri Psimaras, Jérôme Honnorat, Cytokine dynamics and targeted immunotherapies in autoimmune encephalitis, Brain Communications, Volume 4, Issue 4, 2022, fcac196, https://doi.org/10.1093/braincomms/fcac196

“Autoimmune encephalitides constitute a diverse group of immune-mediated central nervous system disorders mainly characterized by the presence of antibodies targeting neuronal or glial antigens. Despite the notable contribution of antibody discovery to the understanding of their physiopathology, the specific immune cells and inflammatory mediators involved in autoimmune encephalitis are still poorly defined. However, cytokines have recently emerged as crucial signalling molecules in the pathogenesis of autoimmune encephalitis…. Autoimmune encephalitides constitute a diverse group of immune-mediated central nervous system disorders mainly characterized by the presence of antibodies targeting neuronal or glial antigens. Despite the notable contribution of antibody discovery to the understanding of their physiopathology, the specific immune cells and inflammatory mediators involved in autoimmune encephalitis are still poorly defined. However, cytokines have recently emerged as crucial signalling molecules in the pathogenesis of autoimmune encephalitis.”