Aristo Vojdani, PhD, MSc, CLS - Environmental Triggers of PANDAS


Topic: Environmental Triggers of PANDAS / OCD / ANDAS by Aristo Vojdani, PhD, MSc, CLS

Conference: Neurodegeneration: The Impact of Environmental Insult - Grand Rapids, MI - October 4 - 8, 2017

Summary: Neurological Effects of airborne gases: xylene, hydrogen sulfate and others.

Learning Objectives:
Learning Objectives:
1. To understand the role of environmental triggers in the induction of OCD, PANDAS, and ANDAS
2. To learn that Group A Streptococcus is not the only infectious agent that contributes to OCD, PANDAS, and ANDAS
3. To observe that many food components cross-react with D1, D2, and NMDA receptor, and therefore may contribute to the symptomatologies of PANDAS
4. To understand about the importance of measuring levels of antibodies against pathogens, food antigens, and neuronal antigens in the blood, and how it can help practitioners manage the treatment of patients with PANDAS

The group of behavior and movement disorders known as pediatric autoimmune neuropsychiatric disorders associated with streptococci (PANDAS) has an association with infections and the immune response against them. PANDAS is a subset of the condition called obsessive-compulsive disorder (OCD) and tic disorders. The main symptoms of PANDAS are motor and vocal tics and obsessive-compulsive behavior. In OCD, PANDAS and the adult version, ANDAS, the onset and development of neuropsychiatric symptoms is preceded by infection with Group A Streptococcus (GAS).
Group A Streptococcus (GAS) or Streptococcus or Streptococcus pyogenes, is a pathogen that causes a wide variety of significant human diseases. Starting out as a throat infection, Streptococcus can present as self-limiting infections of the pharynx and skin in some individuals, while others experience more serious manifestations resulting in behavioral disorders and neuroautoimmunity. In a subgroup of patients with OCD, PANDAS and ANDAS, antibody response may play a role in the development of neuropsychiatric abnormalities due to mimicry and other mechanisms.
Molecular mimicry between streptococcal M protein and human tissue antigens is not the only mechanism for the induction of autoimmunity. Streptococcal antigens have the capacity to bind to a number of human serum proteins. This occurs due to the expression of a variety of receptors on GAS that can bind to these blood proteins. Perhaps this binding of GAS antigens to blood proteins may serve as an additional mechanism in the pathogenesis of autoimmune diseases, including rheumatic diseases, nephropathy, phospholipid syndrome and others. Recent research has shown how streptococcal infection can facilitate the migration of GAS-specific Th17 cells from the nasal-associated lymphoid tissue (NALT) into the brain. This can lead to serum IgG deposition, microglial activation, and loss of excitatory synaptic proteins, while no bacteria can be detected in central nervous system tissue.
This strong immune reaction against streptococcal antigens has become the basis for immunological assays for the detection of GAS. The use of these immunological assays are becoming important for the diagnosis of various disorders associated with these infectious agents.

Time: 59 mins.

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