no ASO rise in titers following strep.../and NDMA test

[dcmom]

Ok- I will stop being lazy

Here is some research by Buster. It gives great info on titers in relation to pandas and/or strep. It also refers to the study arial and I mentioned. Hope this helps.

 

I think for all parents who have been here less than one year, if you have not done so, there is a lot of great info pinned to the top of the pandas forum. Also, a pretty exhaustive collection of studies and information is at the website pandasnetwork.org. Reading through all of this info will help you immensely.

 

 

 

By Buster:

 

 

 

I've gotten a lot of questions regarding ASO titers and there seems to be some confusion about titers and PANDAS. Hope the following helps:

 

1) Is PANDAS a reaction to elevated ASO or AntiDNAseB titers?

The research indicates no. ASO and AntiDNAseB are responses (antibodies) to exotoxins from Group A Beta-Hemolytic Streptococci. PANDAS is thought to be a reaction to another antibody that's created in response to the streptococci. The theory from Cunningham and Kirvan is that there is a monoclonal antibody that is created that targets a particular carbohydrate sequence on the streptococci. This monoclonal antibody is supressed in most people but for some reason it is not supressed in PANDAS kids.

 

2) What amount of streptococcus is necessary to cause a detectable rise in ASO and AntiDNAseB?

This is unknown. Some people respond with high antibody counts while others have low counts. It is just not understood. Studies in 2003 by Shet and Kaplan indicate that ASO rises in 53% of patients with culturable strep, AntiDNAseB rises in 45% of patients with culturable strep, and either ASO or AntiDNAseB rises in 60% of patients with culturable strep (i.e., 40% don't have such a rise).

 

3) Does an elevated ASO or AntiDNAseB indicate a persistant strep infection?

Apparently not. Some people keep high AntiDNAseB for years. The rate of fall is just not known.

 

4) Is a high ASO or AntiDNAseB bad?

It is unclear, it indicates the body is still producing antibodies to antigens from strep, but PANDAS is likely related to a different antibody and it is not at all clear if the rise/fall of this antibody is linked to the ASO or AntiDNAseB titer.

 

5) Is there a test for this antibody associated with PANDAS?

Not yet. There remains considerable debate about the antibody and whether the antibody causes inflammation or just interference with basal ganglia function. Swedo and others thought the debate over PANDAS would end when the antibody was discovered. Unfortunately, others have not properly repeated Kirvan and Cunningham's experiment and others have had difficulty correctly identifying PANDAS patients.

 

 

Regards,

 

Buster