Streptococcal infection and immune response in children with Tourette's syndrome.

Abstract

BACKGROUND:

Streptococcal infection and basal ganglia inflammation are hypothesized to be involved in Tourette's syndrome (TS). There is a need for effective therapies for managing TS. We studied streptococcal infection and immunity in TS following immunomodulator (pidotimod) therapy.

METHODS:

Blood samples from 58 patients with TS and 128 age-matched healthy controls enabled measurement of antistreptolysin O (ASO), T cells, natural killer (NK) cells, interleukin-6 (IL-6) and interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α). Forty-four patients with abnormal T cell numbers were divided into two groups and treated with pidotimod granules (pidotimod group, n = 20) or pidotimod plus dopaminergic receptor antagonists (combination group, n = 24). Yale Global Tic Severity Scale (YGTSS) scores and immunologic indices were assessed after treatment.

RESULTS:

An ASO >1:200 was found in 22.4% of children with TS, 7.5% of controls, and 38.9% of children with both TS and attention deficit hyperactivity disorder (ADHD) compared to 15.0% of children with TS alone (P < 0.05). Children with TS showed decreased CD3(+) and CD4(+) T cells, CD4(+)/CD8(+) ratio, IL-6 and IL-8, increased NKC and TNF-α (P < 0.05) as compared to controls. ASO-positive children with TS had lower CD4(+) T cells as compared to ASO-negative children with TS, and lower IL-6 and IL-8 levels as compared to controls (P < 0.05). After 8 weeks of pidotimod treatment, IL-8 was increased compared to either tiapride hydrochloride or haloperidol and pidotimod (P < 0.05).

CONCLUSIONS:

Streptococcal infection in TS patients is associated with immune and cytokine dysfunction, which can be potentially managed with immunomodulator therapy.

• Authors: Erzhen Li, Yiyan Ruan, Qian Chen, Xiaodai Cui, Lingyun Lv, Ping Zheng, Liwen Wang
• Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (Childs Nerv Syst) Vol. 31 Issue 7 Pg. 1157-63 (Jul 2015) ISSN: 1433-0350 [Electronic] Germany
• PMID: 25930720 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Cytokines

Topics

• Adolescent
• Case-Control Studies
• Child
• Child, Preschool
• Cytokines (metabolism)
• Female
• Follow-Up Studies
• Humans
• Male
• Retrospective Studies
• Severity of Illness Index
• Streptococcal Infections (etiology)
• T-Lymphocytes (metabolism, pathology)
• Tourette Syndrome (complications, immunology, therapy)