Antibodies to Strep Throat Bacteria Linked to Obsessive Compulsive Disorder in Mice ~ Columbia U

[mzmolly]

August 11, 2009, New York, NY—A new study by researchers at Columbia University Mailman School of Public Health’s Center for Infection and Immunity indicates that pediatric obsessive-compulsive disorder (OCD), Tourette syndrome and/or tic disorder may develop from an inappropriate immune response to the bacteria causing common throat infections. The mouse model findings, published online by Nature Publishing Group in this week’s Molecular Psychiatry, support the view that this condition is a distinct disorder, and represent a key advance in tracing the path leading from an ordinary infection in childhood to the surfacing of a psychiatric syndrome. The research provides new insights into identifying children at risk for autoimmune brain disorders and suggests potential avenues for treatment.

...

Using a mouse model of PANDAS, Mady Hornig, MD, associate professor of epidemiology at Columbia University Mailman School of Public Health, and colleagues demonstrate this suspected link between GABHS antibodies and the psychiatric symptoms of the disorder. Immunizing mice with an inactivated form of the bacteria, CII researchers found that the mice exhibited repetitive behaviors reminiscent of children with PANDAS. Injection of antibodies from the immunized mice into the bloodstream of non-immunized mice replicated these behaviors.

“These findings illustrate that antibodies alone are sufficient to trigger this behavioral syndrome,” said Dr. Hornig. “Our findings in this animal model support and may explain results of Swedo and colleagues in treating children with PANDAS using plasmapheresis or intravenous immunoglobulin (IVIg). They may also have implications for understanding, preventing or treating other disorders potentially linked to autoimmunity, including autism spectrum, mood, attentional, learning, and eating disorders.”

"This work provides strong corroboration for a link between exposure to infection, development of an autoimmune response, and the onset of repetitive behaviors and deficits in attention, learning, and social interaction," says CII Director W. Ian Lipkin, MD, John Snow Professor of Epidemiology, and professor of Neurology and Pathology at Columbia University. "Further investigations in this strep-triggered, autoimmune mouse model of PANDAS will promote the discovery of more effective interventions for these disabling disorders and guide the development of robust prevention strategies."

More at http://mailman.hs.columbia.edu/print/1927">LINK

[HysteryDiagnosis]

1. And finally the lights go on... been waiting for this for YEARS.

I had a pretty good feeling this was the case over a decade ago.


>>They may also have implications for understanding, preventing or treating other disorders potentially linked to autoimmunity, including autism spectrum, mood, attentional, learning, and eating disorders.”<<

[MineralMan]

6. You mean it isn't all caused by childhood vaccinations?

Now, we have to start all over again, I guess...:shrug:

[mzmolly]

8. Vaccination works by stimulating

an immune response. The mechanism in this case, is an immune reaction, so there COULD be a connection either way.

[MineralMan]

11. OK, but if the immune response is defective, then

the illness would also cause that response, so it wouldn't be the vaccine that was at fault. It would be the immune system of the affected individual. So, you get the illness and have the immune response anyhow. That's sort of the point of this discovery.

We are all exposed to multiple versions of the streptococcus bacterium. It is everywhere and there is no escaping it. The problem is an immune response or a reaction to the antibodies that is abnormal.

[mzmolly]

14. I agree.

Perhaps ultimately, further research will lead to vaccines against various bacteria that do not elicit the same kind of response? Or perhaps said research will lead to a regimen that involves antibiotic use after vaccination (in various cases) in order to prevent such outcomes.

[MineralMan]

16. I'm not sure how you'd do that, since the entire point of a vaccine

is to teach the body to produce antibodies to fight a specific bacterium or virus. Without the immune response caused by the vaccine, no immunity is gained.

Before immunization, people's bodies learned to respond to specific pathogens by being exposed directly to them. Sometimes they didn't survive the initial infection. Quite often, in some cases.

The entire point of vaccination or immunization is to elicit an immune response.

[mzmolly]

18. I'm not either frankly.

But, one never knows what future technology will provide. My initial thoughts were that a partial cell vaccine might behave a bit differently?

I also mentioned (in my recently edited reply) that it might be prudent to start antibiotic therapy in vulnerable children after vaccination. Of course the key is in identifying who may be vulnerable. Perhaps those with a family history of mental illness and/or autoimmune issues?

[Chemisse]

21. Or perhaps they will be more frugal with the vaccines at such an early age

Maybe timing affects the response. Just as children can acquire allergies by eating certain foods too early, perhaps they have an inappropriate response if deluged with antigens too soon or all at once.

[mzmolly]

26. Could be.

:hi:

[HysteryDiagnosis]

10. Well, I don't know... you guys are going to force me to get out my

notes from the Autism Research Institute from several years ago... I can see it coming.

Look at the date on this paper.

http://www.ncbi.nlm.nih.gov/pubmed/9464208?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=67

Am J Psychiatry 1998 Apr;155(4):578.
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases.

[MineralMan]

12. Good find. This is going to be a fruitful area for research, but it's

going to have to work on whatever defect in the immune response or reaction to the antibodies. There's no way to eliminate strep bacteria.

[HysteryDiagnosis]

13. I believe there is an issue with friendly fire... perhaps the antibodies

are fragging neurotransmitter receptor sites, I do know that at least one company in the U.S. produces a product that helps to more fully form glyforms on cell surfaces thus facilitating better immunocompetence. There are those who believe this is bull. I know for a fact that it is not.

[mzmolly]

15. Can you share more info on the company and the product

you mention? I believe you're right about the specific mechanism. Here is more info from the OCD foundation.

http://www.ocfoundation.org/uploadedFiles/MainContent/Find_Help/PANDAS%20Fact%20Sheet.pdf

I'm reading a book now called Saving Sammy about a woman whose son had OCD and was essentially cured with antibiotics. Below is a video of the Mom and Son on NBC.

http://www.youtube.com/watch?v=50bQtkfiHvs

[HysteryDiagnosis]

17. Mmmmm not supposed todo that... a generic term for what

they produce is glyconutrient. You may google to your heart's content. They do make a "gummy bear" for kids so be sure to look for that.

[mzmolly]

19. Thanks.

:hi:

[mzmolly]

28. Adding this (from Hucks link) to the record:

"Streptococci are not the only infectious agents implicated in Tourette syndrome, other pathogens putatively
involved include Borrelia burgdorferi and Mycoplasma pneumoniae <51>. A recent study has shown that antibody
test reactions for Mycoplasma pneumoniae differ significantly in patients with Tourette syndrome and healthy
controls (59% vs.3%) <51>. Even though most reports involve GABHS, these data suggest that the autoimmune process
underlying post-infective autoimmune neuropsychiatric symptoms may be triggered not only by streptococci but also by
other infectious agents."

...

In addition, there may be a genetic vulnerability:

"An individual's vulnerability to infection-triggered autoimmune disorders depends crucially on genetics.
Family-based studies support a genetic predisposition to rheumatic fever <54>. Rheumatic fever is an inflammatory
disease that can involve heart, joints, skin and brain. Sydenham's chorea is the most frequent neurological
manifestation of rheumatic fever and is characterized by rapid, uncoordinated jerking movements affecting primarily
face, feet and hands. Rheumatic fever is believed to be caused by antibody cross-reactivity. This cross-reactivity is
a Type II hypersensitivity reaction often referred to as molecular mimicry <54>. Substantial evidence argues for
molecular mimicry also in Sydenham's chorea, and anti-GABHS antibodies could cross-react with neuronal tissue <54>."

http://archive.biomedcentral.com/content/pdf/1745-0179-4-13.pdf

[mike_c]

2. fascinating....

eom

[Kceres]

3. Seems like I saw something like this on "60 Minutes" or "Dateline" years ago.

Perhaps the link was not as great back then. Plus, I've always had the feeling that different streps were culprits behind many chronic maladies. Time will tell.

[GreenPartyVoter]

4. I have a bipolar disorder, colitis, and eating issues. Makes me wonder how

much they are all connected and if they were all triggered by the same thing.

[mzmolly]

9. Perhaps.

"PANDAS is not the only immune system disease that may initially cause OCD to appear suddenly. Other disorders may need to be ruled out. They include: Lyme Disease, Thyroid Disease, Celiac Disease, Lupus, Sydenham Chorea, Kawasaki’s Disease, and acute Rheumatic Fever."

http://www.ocfoundation.org/uploadedFiles/MainContent/Find_Help/PANDAS%20Fact%20Sheet.pdf

[MineralMan]

5. Very interesting. However, virtually every human has antibodies

against Streptococcus bacteria. If it causes a problem in some, I'd think it was something reacting to those antibodies that exists in some people but not in others.

Identifying the root is a good thing. Now, how will they counteract this, since strep is everywhere?

[mzmolly]

7. Apparently it's an autoimmune

response? The illness causes the body to essentially attack part of the brain.

"PANDAS is caused by the body’s immune system reaction to strep, not the infection itself. When an infection happens, the body’s immune system makes proteins to fight the bacteria. These proteins are called antibodies. It is believed that PANDAS may be similar to another disorder called Sydenham’s chorea, where antibodies to strep infections can attach to some nerve endings in the brain and cause symptoms to appear."

http://www.ocfoundation.org/uploadedFiles/MainContent/Find_Help/PANDAS%20Fact%20Sheet.pdf

[HuckleB]

20. And it's one study that might lead to something, and it might not.

Thousands of studies such as this one led to dead ends, while some led to a more clear understanding of what was happening in future studies, and a few led to better treatments.

As far as PANDAS goes... this is a good review on where we're at...

What every psychiatrist should know about PANDAS: a review
http://archive.biomedcentral.com/content/pdf/1745-0179-4-13.pdf

or

http://archive.biomedcentral.com/1745-0179/4/13

[mzmolly]

22. The study you note is a year older than

the study I mention above. So, I don't think it's an accurate reflection of "where we're at".

[HuckleB]

23. The "study" I note is a review of all the studies available.

Your single study regarding mice is a footnote in the bigger picture.

[mzmolly]

25. The studies available at that time,

yes. The mice study at Columbia takes the research a step further which your article encourages in its conclusion. The authors in your study of the studies ;) also suggest that "upper respiratory infections" period - may play a role. The study I noted piggy backs this review nicely.

From the conclusion:

"The presence of anti-brain antibodies in a subset of patients with OCD, the promising
results from immunomodulatory treatment in PANDAS and the possible association between some upper
respiratory infections and the sudden onset of OCD, suggest a supportive role for immune triggers in some OCD
subtypes. A research area that deserves further investigation regards the possible differences in the psychopathological
characteristics of autoimmune-induced and nonautoimmune-induced OCD. Our findings in this review
apart from confirming PANDAS as a distinct clinical entity, suggest that PANDAS is a useful research field that
could open new insights into the pathogenesis of OCD, even in adults."

Thanks for posting that. It's an interesting review. :hi: Pardon my initial snarky reply. I incorrectly assumed you were poo-pooing the science above.

[HuckleB]

30. I know what the conclusion.

And I know that the mice study doesn't add much more than a drop in the bucket, as I noted.

Unfortunately, too many people fail to see the full picture.

[mzmolly]

33. Agreed. Too many people do fail to see

the big picture.

[HuckleB]

36. And your mice study is still just a drop in the bucket.

[mzmolly]

38. Which is all it can be given there are too few

studies in this regard.

[HuckleB]

42. There may be too few...

... but the review I posted indicates there are more than you want to acknowledge. You seem to be intent on pursuing the path described in this piece, as you continually give more weight to the few pieces of evidence that support your preconceived notions, while ignoring the greater evidence that goes against your notions. Again, that seems to me to be dishonest, whether with intent or simply because you are failing to test your own preconceptions as critically as you claim to test those of others.

http://www.theness.com/neurologicablog/?p=1609

[mzmolly]

43. Just saw your BS reply and thought I'd kick this with a reply. The review YOU posted states:

"The presence of anti-brain antibodies in a subset of patients with OCD, the promising
results from immunomodulatory treatment in PANDAS and the possible association between some upper
respiratory infections and the sudden onset of OCD, suggest a supportive role for immune triggers in some OCD
subtypes. A research area that deserves further investigation regards the possible differences in the psychopathological
characteristics of autoimmune-induced and nonautoimmune-induced OCD. Our findings in this review
apart from confirming PANDAS as a distinct clinical entity, suggest that PANDAS is a useful research field that
could open new insights into the pathogenesis of OCD, even in adults."

Stop spinning and suggesting that I made any claims about the MAJORITY of people with OCD.

[mzmolly]

29. Adding perhaps the most important footnote:

OCD and tic disorders affect a significant portion of the population. More than 25% of adults and over 3% of children manifest some features of these disorders. Until now, scientists have been unable to convincingly document the association between the appearance of antibodies directed against Group A beta-hemolytic streptoccoccus (GABHS) in peripheral blood and the onset of the behavioral and motor aspects of the disorder."

I look forward to more research.

[HuckleB]

31. And yet PANDAS is not really a part of the picture for most of those people.

[mzmolly]

32. How do you know that?

There is no data that I'm aware of that backs up your assertion. Regardless, if one person suffers who does not, it's one too many.

[HuckleB]

35. What data begins to back up an assertion that PANDAS has anything to do with OCD for most people?

None. Zero. Zilch.

You're continued illogical spins are doing nothing but amazing me, as you show how far you'll go to defend your preconceived notions.

Evidence is not something you care about, so please stop pretending that it is.

[mzmolly]

39. The point is we need more data before your assertion

can be made with any degree of integrity. I didn't make an assertion that PANDAS effects "most" people with OCD.

[HuckleB]

41. The point is the opposite.

At this point, the abundance of evidence indicates that PANDAS is not an issue for the majority of people with OCD symptoms.

Yet, you ignore that, and pretend that isn't the reality. That's disingenuous, to say the least.

[mzmolly]

44. Who decided this conversation was only about the so called "majority"

of people with OCD? YOU'RE the only one being disingenuous here, not me.

[Jim__]

24. Interesting. Thanks for posting - n/t

[mzmolly]

27. My pleasure.

:hi:

[mzmolly]

34. Mycoplasma pneumoniae infection and obsessive-compulsive disease: a case report.

Ercan TE, Ercan G, Severge B, Arpaozu M, Karasu G.

Maltepe University Medical Faculty, Department of Pediatrics, Ataturk Cad. Cam Sok. No 3, Maltepe, Istanbul, Turkey. [e-mail]

It has been demonstrated that obsessive-compulsive disease and/or tic syndromes in children may be triggered by an antecedent infection especially with group A beta-hemolytic streptococci, and this subgroup of children has been designated by the acronym PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections). Other infectious agents such as viruses and bacteria have also been reported to be associated with the acute onset or dramatic exacerbation of obsessive-compulsive disease or Tourette syndrome, and another acronym, PITAND (pediatric infection-triggered autoimmune neuropsychiatric disorder) has appeared in the literature. The involvement of other infectious agents such as Mycoplasma pneumoniae has been described in single case reports. We describe a case of a 5.5-year-old boy who suddenly developed obsessive-compulsive disease symptoms during a M. pneumoniae pneumonia. After treatment with oral clarithromycin, all his obsessive-compulsive disease symptoms disappeared. To our knowledge, this is the first report that shows the association between Mycoplasma pneumoniae infection and obsessive-compulsive disease.

http://www.ncbi.nlm.nih.gov/pubmed/18079308

[leftyladyfrommo]

37. Wow. I have OCD. I also have never had strep throat - I don't think.

My brother got it all the time so I was around the germs a lot.

[mzmolly]

40. Here is some interesting info from P.A.N.D.A.S Network

http://www.pandasnetwork.org/index.html Peek around a bit at the website. From what I've read, PANDAS will not necessarily result in typical strep symptoms. PANDAS is thought to be autoimmune in nature.

The family history table is interesting. http://www.pandasnetwork.org/fhtable.html