Pediatric autoimmune neuropsychiatric disorders associated with group A streptococcal infections (PANDAS) is a concept that is used to characterize a subset of children with neuropsychiatric symptoms, tic disorders, o...Pediatric autoimmune neuropsychiatric disorders associated with group A streptococcal infections (PANDAS) is a concept that is used to characterize a subset of children with neuropsychiatric symptoms, tic disorders, or obsessive-compulsive disorder (OCD), whose symptoms are exacerbated by group A streptococcal (GAS) infection. PANDAS has been known to cause a sudden onset of reward deficiency syndrome (RDS). RDS includes multiple disorders that are characterized by dopaminergic signaling dysfunction in the brain reward cascade (BRC), which may result in addiction, depression, avoidant behaviors, anxiety, tic disorders, and/or OCD. According to research by Blum et al., the dopamine receptor D2 (DRD2) gene polymorphisms are important prevalent genetic determinants of RDS. The literature demonstrates that infections like Borrelia and Lyme, as well as other infections like group A beta-hemolytic streptococcal (GABHS), can cause an autoimmune reaction and associated antibodies target dopaminergic loci in the mesolimbic region of the brain, which interferes with brain function and potentially causes RDS-like symptoms/behaviors. The treatment of PANDAS remains controversial, especially since there have been limited efficacy studies to date. We propose an innovative potential treatment for PANDAS based on previous clinical trials using a pro-dopamine regulator known as KB220 variants. Our ongoing research suggests that achieving “dopamine homeostasis” by precision-guided DNA testing and pro-dopamine modulation could result in improved therapeutic outcomes.展开更多
Background: In this study, we aimed to evaluate the benefit of performing of tonsillectomy in patients with raised serum ASO titre only in absence or presence of group A beta heamolytic streptococci (GABHS) in throat ...Background: In this study, we aimed to evaluate the benefit of performing of tonsillectomy in patients with raised serum ASO titre only in absence or presence of group A beta heamolytic streptococci (GABHS) in throat swab. Materials and methods: In this prospective cohort study, 196 patients below the age of 14 were suffering from non-specific streptococcal infections, without fulfilling the clinical parameters used for the diagnosis of chronic tonsillitis 156 patients had a raised ASO titre above 200 iu/ml. Throat swab culture was performed in all patients. Results: The results showed that out of the 156 patients, 52 had positive throat swab for GABHS. All of the patients underwent tonsillectomy. Follow-up of the patients for one year after the operation, 88% of the first group with high ASO titre and positive throat swab showed improvement of symptoms;25% of the second group with high ASO titre and negative throat swab showed improvement of symptoms. Conclusion: Our study shows that isolation of GABHS from the patients tonsils by throat swab along with high ASO titre may be an indication of tonsillectomy in absence of any other indications.展开更多
文摘Pediatric autoimmune neuropsychiatric disorders associated with group A streptococcal infections (PANDAS) is a concept that is used to characterize a subset of children with neuropsychiatric symptoms, tic disorders, or obsessive-compulsive disorder (OCD), whose symptoms are exacerbated by group A streptococcal (GAS) infection. PANDAS has been known to cause a sudden onset of reward deficiency syndrome (RDS). RDS includes multiple disorders that are characterized by dopaminergic signaling dysfunction in the brain reward cascade (BRC), which may result in addiction, depression, avoidant behaviors, anxiety, tic disorders, and/or OCD. According to research by Blum et al., the dopamine receptor D2 (DRD2) gene polymorphisms are important prevalent genetic determinants of RDS. The literature demonstrates that infections like Borrelia and Lyme, as well as other infections like group A beta-hemolytic streptococcal (GABHS), can cause an autoimmune reaction and associated antibodies target dopaminergic loci in the mesolimbic region of the brain, which interferes with brain function and potentially causes RDS-like symptoms/behaviors. The treatment of PANDAS remains controversial, especially since there have been limited efficacy studies to date. We propose an innovative potential treatment for PANDAS based on previous clinical trials using a pro-dopamine regulator known as KB220 variants. Our ongoing research suggests that achieving “dopamine homeostasis” by precision-guided DNA testing and pro-dopamine modulation could result in improved therapeutic outcomes.
文摘Background: In this study, we aimed to evaluate the benefit of performing of tonsillectomy in patients with raised serum ASO titre only in absence or presence of group A beta heamolytic streptococci (GABHS) in throat swab. Materials and methods: In this prospective cohort study, 196 patients below the age of 14 were suffering from non-specific streptococcal infections, without fulfilling the clinical parameters used for the diagnosis of chronic tonsillitis 156 patients had a raised ASO titre above 200 iu/ml. Throat swab culture was performed in all patients. Results: The results showed that out of the 156 patients, 52 had positive throat swab for GABHS. All of the patients underwent tonsillectomy. Follow-up of the patients for one year after the operation, 88% of the first group with high ASO titre and positive throat swab showed improvement of symptoms;25% of the second group with high ASO titre and negative throat swab showed improvement of symptoms. Conclusion: Our study shows that isolation of GABHS from the patients tonsils by throat swab along with high ASO titre may be an indication of tonsillectomy in absence of any other indications.
