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Child's Nervous System

Published in:

01-07-2015 | Original Paper

Streptococcal infection and immune response in children with Tourette’s syndrome

Authors: Erzhen Li, Yiyan Ruan, Qian Chen, Xiaodai Cui, Lingyun Lv, Ping Zheng, Liwen Wang

Published in: Child's Nervous System | Issue 7/2015

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.

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Title: Streptococcal infection and immune response in children with Tourette’s syndrome
Authors: Erzhen Li
Yiyan Ruan
Qian Chen
Xiaodai Cui
Lingyun Lv
Ping Zheng
Liwen Wang
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 7/2015
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-015-2692-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Streptococcal infection and immune response in children with Tourette’s syndrome

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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