Quick PANDAS summary

[Buster]

I decided to pull this to a new thread...

 

 

The best research at this point indicates that PANDAS is a subgroup of children with OCD/tics where there is :

1. an immune response to GABHS by B-cells creating an anti-neuronal antibody (see http://www.pandasnetwork.org/Cunningham.NMpaper%5b1%5d.pdf )
   
2. a failure of the immune system (T-reg/B-reg) to stop the anti-neuronal antibody (see http://www.journals.elsevierhealth.com/per...0804-3/abstract )
   
3. a breach of the blood-brain barrier that allows the antibody to interact with neuronal tissue (see http://www.jimmunol.org/cgi/reprint/178/11/7412 )
   

• Antibiotics can help to prevent an infection that might lead to #1 (see http://intramural.nimh.nih.gov/pdn/pubs/pub-9.pdf )
  
• PEX and IVIG can both help to address #2 (see http://iai.asm.org/cgi/content/abstract/64/12/5395 )
  
• Macrolide antibiotics are anti-inflammatory and can help #3 : see http://jac.oxfordjournals.org/cgi/reprint/55/1/10
  
• Advil is anti-inflammatory and can help with #3 : see http://www.jneuroinflammation.com/content/...2-2094-1-21.pdf
  
• IVIG is highly anti-inflammatory and helps #3 : see http://www.sciencemag.org/cgi/content/abstract/320/5874/373
  

On the blood-brain barrier, there is some work that indicates that the exotoxins of GABHS itself can change the permeability of the blood-brain barrier. It isn't known if this is through inflammation or some other mechanism: (see http://iai.asm.org/cgi/reprint/21/3/753.pdf and http://www.neurology.org/cgi/content/abstract/54/7/1433 ). Of interest, there was a recent paper that indicates that IVIG neutralizes the exotoxins and super-antigens of GABHS : see http://iai.asm.org/cgi/content/abstract/64/12/5395

 

Finally, there are a few studies that if it isn't PANDAS (i.e., isn't autoimmune) then the treatments above don't work because there aren't any antibodies to go after (see http://www.ncbi.nlm.nih.gov/pubmed/11026187 )

 

 

 

Buster