Anti-inflammatory Augmentation Therapy in Obsessive-compulsive Disorder: A Review
Hanie Ghasemi, Homa Nomani, Amirhossein Sahebkar* and Amir Hooshang Mohammadpour*, “Anti-inflammatory Augmentation Therapy in Obsessive-compulsive Disorder: A Review”, Letters in Drug Design & Discovery (2020) 17: 1198. DOI: 10.2174/1570180817999200520122910
Anti-inflammatory Augmentation Therapy in Obsessive-compulsive Disorder: A Review
“Results: Recent studies display that inflammation processes and the dysfunction of the immune system are likely to play a role in the pathophysiology of OCD, indicating that the disturbances in neurotransmitters such as serotonin and dopamine cannot be alone involved in the development of OCD. Therefore, it seems that medications with anti-inflammatory effects have the potential to be evaluated as a new therapeutic strategy for OCD. However, this issue can be studied closely if OCD etiological factors are thoroughly understood. The present review study aims at gathering all obtained results concerning new treatments targeting inflammation in OCD patients. Reviewing the conducted studies shows that the use of agents with anti-inflammatory properties, including some NSAIDs, Minocycline and Atorvastatin, could lead to promising and intriguing results in the treatment of OCD. Curcumin also showed good efficacy in the reduction of OCD-like behavior when it has been used in an animal model. However, there is still no definitive and conclusive evidence for any of the medications proposed.
Conclusion: More future studies are needed to investigate anti-inflammatory treatment strategies for OCD and its other subtypes such as Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS), and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS)”
Borrelia miyamotoi Serology in a Clinical Population With Persistent Symptoms and Suspected Tick-Borne Illness

Borrelia miyamotoi Serology in a Clinical Population With Persistent Symptoms and Suspected Tick-Borne Illness

Delaney Shannon L., Murray Lilly A., Aasen Claire E., Bennett Clair E., Brown Ellen, Fallon Brian A. Borrelia miyamotoi Serology in a Clinical Population With Persistent Symptoms and Suspected Tick-Borne Illness. Front. Med., 27 October 2020 . DOI=10.3389/fmed.2020.567350

ABSTRACT=Eighty-two patients seeking consultation for long-term sequalae after suspected tick-borne illness were consecutively tested for Borrelia miyamotoi antibodies using a recombinant glycerophosphodiester phosphodiesterase (GlpQ) enzyme immunoassay. Twenty-one of the 82 patients (26%) tested positive on the GlpQ IgG ELISA. Nearly all of the patients (98%) had no prior B. miyamotoi testing, indicating that clinicians rarely test for this emerging tick-borne pathogen. Compared to patients who solely tested positive for Lyme disease antibodies, patients with B. miyamotoi antibodies presented with significantly more sleepiness and pain. A prospective study is needed to ascertain the relationship between the presence of B. miyamotoi antibodies and persistent symptoms.

The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis
Nykytyuk S, Boyarchuk O, Klymnyuk S, Levenets S. The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis. Reumatologia. 2020;58(5):335-338. doi: 10.5114/reum.2020.99143. Epub 2020 Oct 3. PMID: 33227092; PMCID: PMC7667941.
  • A 13-year-old boy developed Lyme arthritis and experienced a severe Jarisch-Herxheimer reaction on day 7 of doxycycline treatment.
  • Symptoms included low-grade fever, severe joint and muscle pain, and increased inflammatory markers.
  • Unlike the typical mild, short-lived reaction seen in adults, this case was prolonged and intense.
  • Raising awareness among healthcare professionals can help differentiate this reaction from allergies or other conditions, improving patient care.
Psychosocial Interventions and Immune System Function – A Systematic Review and Meta-analysis of Randomized Clinical Trials
Shields GS, Spahr CM, Slavich GM. Psychosocial Interventions and Immune System Function: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Psychiatry. 2020 Oct 1;77(10):1031-1043. doi: 10.1001/jamapsychiatry.2020.0431. PMID: 32492090; PMCID: PMC7272116.
  • Inflammation-linked diseases cause over 50% of global deaths. Psychosocial interventions may help, but it’s unclear which work best and for whom.
  • Study: Systematic review and meta-analysis of 56 RCTs (4,060 participants) across 8 psychosocial interventions and 7 immune markers.
  • Findings: Interventions led to a 14.7% improvement in beneficial immune function and 18% reduction in harmful immune activity.
  • Most effective: CBT and combined/multiple interventions, especially those targeting proinflammatory markers.
  • Lasting effects: Benefits persisted at least 6 months post-treatment and held across age, sex, and treatment duration.
  • Conclusion: Psychosocial interventions reliably improve immune function and may be a useful public health strategy.
Hypoferritinemia and iron deficiency in youth with pediatric acute-onset neuropsychiatric syndrome

Chan, A., Karpel, H., Spartz, E. et al. Hypoferritinemia and iron deficiency in youth with pediatric acute-onset neuropsychiatric syndrome. Pediatr Res 89, 1477–1484 (2021). https://doi.org/10.1038/s41390-020-1103-3

Conclusion: Hypoferritinemia and iron deficiency appear to be more common in PANS patients. More research is needed to confirm and understand this association.

  • 79 subjects (mean age of PANS onset of 8.7 years)
  • Hypoferritinemia was observed in 27% and three quarters occurred during a PANS flare
  • PANS patients with hypoferritinemia had worse global impairment, more comorbid inflammatory diseases, and exhibited a chronic course of PANS illness than those without
  • The estimated prevalence of iron deficiency was 3–8% in the PANS cohort, 1.4–2.0-fold higher than in the age- and sex-matched U.S. population.
  • Hypoferritinemia was commonly observed during a disease flare but not associated with dietary or demographic factors.
  • In patients with PANS and iron deficiency, clinicians should consider possibility of inflammation as the cause especially if iron deficiency cannot be explained by diet and blood loss.
Two-Tier Lyme Disease Serology Test Results Can Vary According to the Specific First-Tier Test Used

Alexandra B Maulden, Aris C Garro, Fran Balamuth, Michael N Levas, Jonathan E Bennett, Desiree N Neville, John A Branda, Lise E Nigrovic, for Pedi Lyme Net, Two-Tier Lyme Disease Serology Test Results Can Vary According to the Specific First-Tier Test Used, Journal of the Pediatric Infectious Diseases Society, Volume 9, Issue 2, June 2020, Pages 128–133, https://doi.org/10.1093/jpids/piy133

Significant variations in two-tier Lyme disease test results were observed in many children, depending on the specific first-tier test utilized. When dealing with children with a strong clinical suspicion of Lyme disease and an initially negative test result, clinicians should contemplate retesting for Lyme disease.

Autoantibody Biomarkers for Basal Ganglia Encephalitis in Sydenham Chorea and Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infections

Chain Jennifer L., Alvarez Kathy, Mascaro-Blanco Adita, Reim Sean, Bentley Rebecca, Hommer Rebecca, Grant Paul, Leckman James F., Kawikova Ivana, Williams Kyle, Stoner Julie A., Swedo Susan E., Cunningham Madeleine W. Autoantibody Biomarkers for Basal Ganglia Encephalitis in Sydenham Chorea and Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infections. Jnl Frontiers in Psychiatry. Vol.11, 2020. DOI.10.3389/fpsyt.2020.00564   

See Dr. Susan Swedo on new research on Autoantibody Biomarkers for Basal Ganglia Encephalitis for PANDAS and SC

 

Antibodies From Children With PANDAS Bind Specifically to Striatal Cholinergic Interneurons and Alter Their Activity

Antibodies From Children With PANDAS Bind Specifically to Striatal Cholinergic Interneurons and Alter Their Activity Jian Xu, Rong-Jian Liu, Shaylyn Fahey, Luciana Frick, James Leckman, Flora Vaccarino, Ronald S. Duman, Kyle Williams, Susan Swedo, and Christopher Pittenger. Am Jrnl of Psychiatry 16 Jun 2020 https://doi.org/10.1176/appi.ajp.2020.19070698

See ASPIRE’s interview with Christopher Pittenger, MD, PhD, FAPA, FANA on this study.

Chronic Fatigue Symptoms in Children with Abrupt Early-onset OCD And/or PANS

Avis Chan 1, Angeline Truong 2, Bahare Farhadian 3, Theresa Willett 2, Melissa Silverman 1, Paula Tran 1, Margo Thienemann 2 and Jennifer Frankovich4, 1Stanford University School of Medicine, Palo Alto, 2Stanford University School of Medicine, Palo Alto, California, 3Stanford Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children’s Hospital, Palo Alto, 4Stanford

The 2020 Pediatric Rheumatology Symposium, originally scheduled for April 29 – May 2, was postponed due to COVID-19; therefore, abstracts were not presented as scheduled.

Conclusion: Our study shows that CFS/ME occurs in 1 in 6 patients with AEO-OCD. The prevalence rate is much higher than the general adolescent population (1 in 100-200). This underscores the need to systematically assess fatigue in this group of patients. Future studies should determine possible shared biological underpinnings between AEO-OCD/PANS and CFS/ME.

Read Full Abstract.

Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging

Zheng J, Frankovich J, McKenna ES, et al. Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging. JAMA Netw Open. 2020;3(5):e204063. doi:10.1001/jamanetworkopen.2020.4063

In this case-control study of 34 consecutive patients with pediatric acute-onset neuropsychiatric syndrome who had 3 Tesla magnetic resonance imaging, all assessed brain regions, particularly the deep gray matter (eg, the thalamus, basal ganglia, and amygdala), had statistically significantly increased mean diffusivity compared with 64 control participants. These diffusion abnormalities are consistent with the cardinal clinical symptoms of these patients, including obsessions, compulsions, emotional dysregulation, and sleep disturbances.

Meaning  Diffusion-weighted magnetic resonance imaging may offer valuable quantitative information to assist with the diagnostic workup of pediatric acute-onset neuropsychiatric syndrome.

Leah’s Story

Leah’s Story

In August of 2014 our daughter, Leah, was 6 years old.  We had just returned home from a month-long trip to Illinois to visit family.  When we arrived home in Arizona, she suddenly (overnight) developed a fear of vomit.