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Advancing Our Understanding of IVIg in Pediatric Acute-Onset Neuropsychiatric Syndrome. Journal of Mosaic of Autoimmunity

Danieli, M.G.; Buti, E.; Longhi, E.; et al. Advancing Our Understanding of IVIg in Pediatric Acute-Onset Neuropsychiatric Syndrome. Journal of Mosaic of Autoimmunity 2025, 1 (2), 5. doi.org/10.53941/jmai.2025.100012

  • Reviews intravenous immunoglobulin (IVIg) as a pooled IgG product with broad immunomodulatory and anti-inflammatory effects.

  • Describes mechanisms including modulation of Fcγ receptors, inhibition of complement activation, cytokine regulation, and control of pro-inflammatory immune cells.

  • Explains that IVIg can influence both innate and adaptive immune systems, including via epigenetic mechanisms.

  • Summarizes evidence indicating IVIg can attenuate neuropsychiatric symptoms and restore immune balance in children with PANS.

  • Notes variability in randomized trial outcomes but highlights converging clinical and mechanistic support for IVIg in selected patients.

  • Emphasizes the need for biomarker-guided studies to identify responders and optimize treatment strategies.

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.