Byline: H. Luleyap, Dilge. Onatoglu, M. Yilmaz, Davut. Alptekin, Aysegul. Tahiroglu, Salih. Cetiner, Ayfer. Pazarbasi, Ilker. Unal, Ayse. Avci, Gamze. Comertpay
Objectives: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a newly defined disease in neuropsychiatry and occurs with an autoimmune mechanism after Group A Beta Hemolytic Streptococcus (GABHS) infection. Tumor necrosis factor (TNF), encoded by TNF-a gene has an important role in the apoptotic mechanisms of autoimmune diseases. Recently, TNF-a polymorphisms and autoimmune/psychiatric disorders have been reported to be related. In this regard, we focused on to investigate a possible relation between the TNF-a gene promoter region−308 G/A and − 850 C/T polymorphisms and PANDAS. Materials and Methods: In this study, ages of PANDAS patient and control groups were ranging from 4 years to 12-year-old. "Patient group" includes childhood onset PANDAS patients ( n = 42) and "control group" includes healthy children ( n = 58). Diagnoses have been carried out according to Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) criteria with Affective Disorders and Schizophrenia-Present and Lifetime (KSAD-S-PL) and Children Yale-Brown Obsessive Compulsive Scale Moreover, PANDAS criteria established by the American National Psychiatry Institute have been employed for diagnoses. For identifying polymorphisms; Polymerase Chain Reaction, Restriction Fragment Length Polymorphism and Polyacrylamid Gel Electrophoresis were used. Results and Discussion: For −308 polymorphism, 37 of 42 PANDAS patients' results and for −850 C/T polymorphism, 38 of 42 PANDAS patients' results were obtained. According to our statistical analysis there is a positive relationship between PANDAS patients for −308 G/A polymorphism but not for −850 C/T polymorphism. There is no positive relationship between −308 G/A polymorphism and antistrep-tolysin O (ASO) titers and no relationship between −850 C/T polymorphism and ASO titers. We found, however, positive relationship between genders of patients (boys) and the disease. According to our results, we propose that the AA polymorphism of −308 G/A polymorphism can be used as a molecular indicator for PANDAS.
Obsessive-compulsive disorder (OCD), tic disorders, a subgroup of childhood-onset OCDs called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal (PANDAS) are pre-pubertal onset autoimmune neuropsychiatric disorders associated with the basal ganglia abnormalities in which antibodies produced against Group A Beta Hemolytic Streptococcus (GABHS) infections cross react with neuron epitopes. [sup] Therefore, these disorders are referred as post-streptococcal movement disorders. [sup],,,,, OCD and tic disorders may be triggered by stress, anxiety, and illnesses (for example; GABHS infections). [sup] GABHS infections, comorbidities, and tics are characteristic features in the etiology of OCD, PANDAS, and Sydenham's chorea. [sup], Due to the damage of basal ganglia in a period of days to weeks following a GABHS infection, tics, and obsessive compulsive symptoms occur in patients. [sup] The association between Sydenham's chorea and streptococcus was first stated by Taranta and Stollerman in 1956 however, association between OCD and Sydenham's chorea was discovered by some workers. [sup], In the following decades, clinicians, and researchers continued to perform studies for neuropsychiatric disorders. [sup], Recent studies suggest that 50-80% of OCD cases have a childhood onset. [sup],,,,,,,, Childhood onset OCD...