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So M, Dziuban EJ, Pedati CS, Holbrook JR, Claussen AH, O'Masta B, Maher B, Cerles AA, Mahmooth Z, MacMillan L, Kaminski JW, Rush M. Childhood Physical Health and Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Modifiable Factors. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:316-336. [PMID: 35947281 PMCID: PMC10032176 DOI: 10.1007/s11121-022-01398-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 10/15/2022]
Abstract
Although neurobiologic and genetic factors figure prominently in the development of attention deficit/hyperactivity disorder (ADHD), adverse physical health experiences and conditions encountered during childhood may also play a role. Poor health is known to impact the developing brain with potential lifelong implications for behavioral issues. In attempt to better understand the relationship between childhood physical health and the onset and presence of ADHD symptoms, we summarized international peer-reviewed articles documenting relationships between a select group of childhood diseases or health events (e.g., illnesses, injuries, syndromes) and subsequent ADHD outcomes among children ages 0-17 years. Drawing on a larger two-phase systematic review, 57 longitudinal or retrospective observational studies (1978-2021) of childhood allergies, asthma, eczema, head injury, infection, or sleep problems and later ADHD diagnosis or symptomatology were identified and subjected to meta-analysis. Significant associations were documented between childhood head injuries, infections, and sleep problems with both dichotomous and continuous measures of ADHD, and between allergies with dichotomous measures of ADHD. We did not observe significant associations between asthma or eczema with ADHD outcomes. Heterogeneity detected for multiple associations, primarily among continuously measured outcomes, underscores the potential value of future subgroup analyses and individual studies. Collectively, these findings shed light on the importance of physical health in understanding childhood ADHD. Possible etiologic links between physical health factors and ADHD are discussed, as are implications for prevention efforts by providers, systems, and communities.
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Affiliation(s)
- Marvin So
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA.
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
| | - Eric J Dziuban
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Caitlin S Pedati
- Virginia Beach Department of Public Health, Virginia Beach, VA, USA
| | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA
| | - Angelika H Claussen
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA
| | | | - Brion Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Jennifer W Kaminski
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E88, Atlanta, GA, 30341, USA
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Wilson C, Gattuso JJ, Hannan AJ, Renoir T. Mechanisms of pathogenesis and environmental moderators in preclinical models of compulsive-like behaviours. Neurobiol Dis 2023; 185:106223. [PMID: 37423502 DOI: 10.1016/j.nbd.2023.106223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023] Open
Abstract
Obsessive-compulsive and related disorders (OCRD) is an emergent class of psychiatric illnesses that contributes substantially to the global mental health disease burden. In particular, the prototypical illness, obsessive-compulsive disorder (OCD), has a profoundly deleterious effect on the quality of life of those with lived experience. Both clinical and preclinical studies have investigated the genetic and environmental influences contributing to the pathogenesis of obsessive-compulsive and related disorders. Significant progress has been made in recent years in our understanding of the genetics of OCD, along with the critical role of common environmental triggers (e.g., stress). Some of this progress can be attributed to the sophistication of rodent models used in the field, particularly genetic mutant models, which demonstrate promising construct, face, and predictive validity. However, there is a paucity of studies investigating how these genetic and environmental influences interact to precipitate the behavioural, cellular, and molecular changes that occur in OCD. In this review, we assert that preclinical studies offer a unique opportunity to carefully manipulate environmental and genetic factors, and in turn to interrogate gene-environment interactions and relevant downstream sequelae. Such studies may serve to provide a mechanistic framework to build our understanding of the pathogenesis of complex neuropsychiatric disorders such as OCD. Furthermore, understanding gene-environment interactions and pathogenic mechanisms will facilitate precision medicine and other future approaches to enhance treatment, reduce side-effects of therapeutic interventions, and improve the lives of those suffering from these devastating disorders.
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Affiliation(s)
- Carey Wilson
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Australia
| | - James J Gattuso
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Australia
| | - Anthony J Hannan
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Thibault Renoir
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia.
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Karshikoff B, Lekander M, Lasselin J. Editorial: Vulnerability and protective factors for inflammation-associated somatoform and mental disorders. Brain Behav Immun 2022; 106:227-230. [PMID: 36055543 DOI: 10.1016/j.bbi.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Bianka Karshikoff
- Department of Social Sciences, University of Stavanger, Stavanger, Norway; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Julie Lasselin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
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Karlsson H, Sjöqvist H, Brynge M, Gardner R, Dalman C. Childhood infections and autism spectrum disorders and/or intellectual disability: a register-based cohort study. J Neurodev Disord 2022; 14:12. [PMID: 35151261 PMCID: PMC8903600 DOI: 10.1186/s11689-022-09422-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/26/2022] [Indexed: 12/13/2022] Open
Abstract
Objective To explore the associations between childhood infections and subsequent diagnoses of autism spectrum disorder (ASD), intellectual disability (ID), and their co-occurrence. Methods The association between specialized care for any infection, defined by ICD-codes, and later ASD or ID was investigated in a register-based cohort of 556,732 individuals born 1987–2010, resident in Stockholm County, followed from birth to their 18th birthday or December 31, 2016. We considered as potential confounders children’s characteristics, family socioeconomic factors, obstetric complications, and parental histories of treatment for infection and psychiatric disorders in survival analyses with extended Cox regression models. Residual confounding by shared familial factors was addressed in sibling analyses using within-strata estimation in Cox regression models. Sensitivity analyses with the exclusion of congenital causes of ASD/ID and documented risk for infections were also performed. Results Crude estimates indicated that infections during childhood were associated with later ASD and ID with the largest risks observed for diagnoses involving ID. Inclusion of covariates, exclusion of congenital causes of ASD/ID from the population, and sibling comparisons highlighted the potential for confounding by both heritable and non-heritable factors, though risks remained in all adjusted models. In adjusted sibling comparisons, excluding congenital causes, infections were associated with later “ASD without ID” (HR 1.24, 95%CI 1.15–1.33), “ASD with ID” (1.57, 1.35–1.82), and “ID without ASD” (2.01, 1.76–2.28). Risks associated with infections varied by age at exposure and by age at diagnosis of ASD/ID. Conclusions Infections during childhood may contribute to a later diagnosis of ID and ASD. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-022-09422-4.
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Raposo-Lima C, Pereira IM, Marques F, Morgado P. Elevated levels of neutrophil gelatinase-associated lipocalin among OCD patients: an exploratory study. BMC Psychiatry 2021; 21:272. [PMID: 34039300 PMCID: PMC8152153 DOI: 10.1186/s12888-021-03289-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disease that is characterized by its clinical heterogeneity and complex pathophysiology. This complexity comes from the diversity of pathophysiological factors that have been proposed to be involved in the natural history of the disorder. Many theories on OCD pathology support inflammation as a pathophysiological factor, although studies are not consistent on the presence of a pro-inflammatory state among OCD patients. However, some pre-clinical animal studies suggest lipocalin-2 (LCN2), an analogous form of the acute-phase pro-inflammatory protein neutrophil gelatinase-associated lipocalin (NGAL), may be involved in in the regulation of the stress response, which is thought to be disrupted in OCD. METHODS Twenty-one OCD patients and 19 healthy subjects participated in this exploratory study. Levels of NGAL were assessed in the peripherous blood of all participants. Severity of disease was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). RESULTS OCD patients exhibited significantly higher levels of NGAL when compared to healthy control subjects. No correlation was found between elevated levels of NGAL and severity of symptoms. CONCLUSIONS This is the first study to report elevated levels of NGAL among OCD patients, adding evidence for a possible role of immune dysregulation in the pathophysiology of OCD.
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Affiliation(s)
- Catarina Raposo-Lima
- grid.10328.380000 0001 2159 175XLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães Portugal
| | - Inês Miguel Pereira
- grid.10328.380000 0001 2159 175XLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães Portugal
| | - Fernanda Marques
- grid.10328.380000 0001 2159 175XLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal. .,ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal. .,Clinical Academic Center-Braga (2CA), Hospital de Braga, Braga, Portugal.
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Mora S, Martín-González E, Prados-Pardo Á, Flores P, Moreno M. Increased Compulsivity in Adulthood after Early Adolescence Immune Activation: Preclinical Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4684. [PMID: 33924858 PMCID: PMC8125663 DOI: 10.3390/ijerph18094684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 12/17/2022]
Abstract
Immune activation during early developmental stages has been proposed as a contributing factor in the pathogenesis of neuropsychiatric conditions such as obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, and autism in both human and animal studies. However, its relationship with the vulnerability to inhibitory control deficit, which is a shared feature among those conditions, remains unclear. The present work studied whether postnatal immune activation during early adolescence, combined with exposure to early-life adverse events, could lead to adult vulnerability to impulsive and/or compulsive behaviors. Male Wistar rats were exposed to lipopolysaccharide (LPS) in early adolescence at postnatal day 26 (PND26). During peripuberal period, half of the animals were exposed to a mild stress protocol. In adulthood, behavioral assessment was performed with the aid of the sustained attentional 5-choice serial reaction time (5-CSRT) task, schedule-induced polydipsia (SIP), and open-field locomotor activity and novelty reactivity. Rats exposed to LPS showed more compulsive responses than their control counterparts on 5-CSRT task, although no differences were observed in SIP or locomotor responses. Our study contributes to the knowledge of the relationship between immune activation and inhibitory control deficit. Future studies should aim to disentangle how, and to what extent, immune activation impacts behavior, and to understand the role of early life mild stress.
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Affiliation(s)
- Santiago Mora
- Department of Psychology and Health Research Centre, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain; (E.M.-G.); (Á.P.-P.); (P.F.)
| | | | | | | | - Margarita Moreno
- Department of Psychology and Health Research Centre, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain; (E.M.-G.); (Á.P.-P.); (P.F.)
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Mora S, Martín-González E, Prados-Pardo Á, Moreno J, López MJ, Pilar-Cuellar F, Castro E, Díaz Á, Flores P, Moreno M. Increased vulnerability to impulsive behavior after streptococcal antigen exposure and antibiotic treatment in rats. Brain Behav Immun 2020; 89:675-688. [PMID: 32798664 DOI: 10.1016/j.bbi.2020.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 12/13/2022] Open
Abstract
RATIONALE The inflammation induced by Group A Streptococcus (GAS) infection has been viewed as a vulnerability factor in mental disorders characterized by inhibitory control deficits, such as attention-deficit/hyperactivity disorder or obsessive-compulsive disorder. Antibiotic treatment reduces GAS symptoms; however, its effects on impulsivity have not been fully assessed. OBJECTIVES We investigated whether GAS exposure during early adolescence might be a vulnerability factor for adult impulsivity, if antibiotic treatment acts as a protective factor, and whether these differences are accompanied by changes in the inflammatory cytokine frontostriatal regions. METHODS Male Wistar rats were exposed to the GAS antigen or to vehicle plus adjuvants at postnatal day (PND) 35 (with two boosts), and they received either ampicillin (supplemented in the drinking water) or water alone from PND35 to PND70. Adult impulsivity was assessed using two different models, the 5-choice serial reaction time task (5-CSRT task) and the delay discounting task (DDT). The levels of interleukin-6 (IL-6) and IL-17 were measured in the prefrontal cortex (PFc), and the tumor necrosis factor α levels (TNFα) were measured in the PFc and nucleus accumbens (NAcc). RESULTS GAS exposure and ampicillin treatment increased the waiting impulsivity by a higher number of premature responses when the animals were challenged by a long intertrial interval during the 5-CSRT task. The GAS exposure revealed higher impulsive choices at the highest delay (40 s) when tested by DDT, while coadministration with ampicillin prevented the impulsive choice. GAS exposure and ampicillin reduced the IL-6 and IL-17 levels in the PFc, and ampicillin treatment increased the TNFα levels in the NAcc. A regression analysis revealed a significant contribution of GAS exposure and TNFα levels to the observed effects. CONCLUSIONS GAS exposure and ampicillin treatment induced an inhibitory control deficit in a different manner depending on the form of impulsivity measured here, with inflammatory long-term changes in the PFc and NAcc that might increase the vulnerability to impulsivity-related neuropsychiatric disorders.
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Affiliation(s)
- Santiago Mora
- Department of Psychology and Health Research Centre, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain
| | - Elena Martín-González
- Department of Psychology and Health Research Centre, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain
| | - Ángeles Prados-Pardo
- Department of Psychology and Health Research Centre, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain
| | - Joaquín Moreno
- Department of Biology and Geology, CeiA3 and CIAMBITAL, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain
| | - María José López
- Department of Biology and Geology, CeiA3 and CIAMBITAL, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain
| | - Fuencisla Pilar-Cuellar
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Santander, Spain; Institute of Biomedicine and Biotechnology of Cantabria (IBBTEC), University of Cantabria-CSIC-SODERCAN, 39011 Santander, Spain; Department of Physiology and Pharmacology, University of Cantabria, 39011 Santander, Spain
| | - Elena Castro
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Santander, Spain; Institute of Biomedicine and Biotechnology of Cantabria (IBBTEC), University of Cantabria-CSIC-SODERCAN, 39011 Santander, Spain; Department of Physiology and Pharmacology, University of Cantabria, 39011 Santander, Spain
| | - Álvaro Díaz
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Santander, Spain; Institute of Biomedicine and Biotechnology of Cantabria (IBBTEC), University of Cantabria-CSIC-SODERCAN, 39011 Santander, Spain; Department of Physiology and Pharmacology, University of Cantabria, 39011 Santander, Spain
| | - Pilar Flores
- Department of Psychology and Health Research Centre, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain
| | - Margarita Moreno
- Department of Psychology and Health Research Centre, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain.
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Martino D, Johnson I, Leckman JF. What Does Immunology Have to Do With Normal Brain Development and the Pathophysiology Underlying Tourette Syndrome and Related Neuropsychiatric Disorders? Front Neurol 2020; 11:567407. [PMID: 33041996 PMCID: PMC7525089 DOI: 10.3389/fneur.2020.567407] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/20/2020] [Indexed: 12/20/2022] Open
Abstract
Objective: The goal of this article is to review the past decade's literature and provide a critical commentary on the involvement of immunological mechanisms in normal brain development, as well as its role in the pathophysiology of Tourette syndrome, other Chronic tic disorders (CTD), and related neuropsychiatric disorders including Obsessive-compulsive disorder (OCD) and Attention deficit hyperactivity disorder (ADHD). Methods: We conducted a literature search using the Medline/PubMed and EMBASE electronic databases to locate relevant articles and abstracts published between 2009 and 2020, using a comprehensive list of search terms related to immune mechanisms and the diseases of interest, including both clinical and animal model studies. Results: The cellular and molecular processes that constitute our "immune system" are crucial to normal brain development and the formation and maintenance of neural circuits. It is also increasingly evident that innate and adaptive systemic immune pathways, as well as neuroinflammatory mechanisms, play an important role in the pathobiology of at least a subset of individuals with Tourette syndrome and related neuropsychiatric disorders In the conceptual framework of the holobiont theory, emerging evidence points also to the importance of the "microbiota-gut-brain axis" in the pathobiology of these neurodevelopmental disorders. Conclusions: Neural development is an enormously complex and dynamic process. Immunological pathways are implicated in several early neurodevelopmental processes including the formation and refinement of neural circuits. Hyper-reactivity of systemic immune pathways and neuroinflammation may contribute to the natural fluctuations of the core behavioral features of CTD, OCD, and ADHD. There is still limited knowledge of the efficacy of direct and indirect (i.e., through environmental modifications) immune-modulatory interventions in the treatment of these disorders. Future research also needs to focus on the key molecular pathways through which dysbiosis of different tissue microbiota influence neuroimmune interactions in these disorders, and how microbiota modification could modify their natural history. It is also possible that valid biomarkers will emerge that will guide a more personalized approach to the treatment of these disorders.
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Affiliation(s)
- Davide Martino
- Department of Clinical Neurosciences & Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Isaac Johnson
- Child Study Center, Yale University, New Haven, CT, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - James F. Leckman
- Child Study Center, Yale University, New Haven, CT, United States
- Departments of Psychiatry, Pediatrics and Psychology, Yale University, New Haven, CT, United States
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Loffredo L, Spalice A, Salvatori F, De Castro G, Guido CA, Zicari AM, Ciacci P, Battaglia S, Brindisi G, Ettorre E, Nocella C, Salvatori G, Duse M, Violi F, Carnevale R. Oxidative stress and gut-derived lipopolysaccharides in children affected by paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. BMC Pediatr 2020; 20:127. [PMID: 32188439 PMCID: PMC7079429 DOI: 10.1186/s12887-020-02026-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/11/2020] [Indexed: 12/15/2022] Open
Abstract
Background Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to evaluate serum NOX2 levels, as well as 8-iso-prostaglandin F2α (8-iso-PGF2α) and lipopolysaccharide (LPS) of PANDAS patients. Methods In this study we wanted to compare serum levels of soluble NOX2-dp (sNOX-2-dp), iso-PGF2α and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used as intestinal permeability assay. Results Compared with CT, PANDAS children had increased serum levels of sNOX-2-dp, 8-iso-PGF2α and LPS. Bivariate analysis showed that serum sNOX2-dp was significantly correlated with LPS (Rs = 0.359; p = 0.005), zonulin (Rs = 0.444; p < 0.001) and 8-iso-PGF2α (Rs = 0.704; p < 0.001). Serum LPS significantly correlated with zonulin (Rs = 0.610; p < 0.001), and 8-iso-PGF2α (Rs = 0.591; p = 0.001). Finally, a multiple linear regression analysis showed that serum 8-iso-PGF2α and zonulin were the only independent variables associated with sNOX2-dp (R2 = 68%). Conclusion This study shows that children affected by PANDAS have high circulating levels of sNOX2-dp, isoprostanes and of LPS that could be involved in the process of neuroinflammation.
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Affiliation(s)
- Lorenzo Loffredo
- Department of Clinical, Internal, Anaesthetic and Cardiovascular Sciences, Sapienza University of Rome, I Clinica Medica, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Alberto Spalice
- Department of Pediatrics, Sapienza University of Rome, Rome, 00161, Italy
| | | | - Giovanna De Castro
- Department of Pediatrics, Sapienza University of Rome, Rome, 00161, Italy
| | | | - Anna Maria Zicari
- Department of Pediatrics, Sapienza University of Rome, Rome, 00161, Italy
| | - Paolo Ciacci
- Department of Clinical, Internal, Anaesthetic and Cardiovascular Sciences, Sapienza University of Rome, I Clinica Medica, Viale del Policlinico 155, 00161, Rome, Italy
| | - Simona Battaglia
- Department of Clinical, Internal, Anaesthetic and Cardiovascular Sciences, Sapienza University of Rome, I Clinica Medica, Viale del Policlinico 155, 00161, Rome, Italy
| | - Giulia Brindisi
- Department of Pediatrics, Sapienza University of Rome, Rome, 00161, Italy
| | - Evaristo Ettorre
- Department of Clinical, Internal, Anaesthetic and Cardiovascular Sciences, Sapienza University of Rome, I Clinica Medica, Viale del Policlinico 155, 00161, Rome, Italy
| | - Cristina Nocella
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | | | - Marzia Duse
- Department of Pediatrics, Sapienza University of Rome, Rome, 00161, Italy
| | - Francesco Violi
- Department of Clinical, Internal, Anaesthetic and Cardiovascular Sciences, Sapienza University of Rome, I Clinica Medica, Viale del Policlinico 155, 00161, Rome, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Mediterranea Cardiocentro, Naples, Italy
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