One controversy concerning Tourette Syndrome (TS) is whether the immune system is the cause of tics in a subgroup of children referred to as â€œPANDASâ€â€”those who have had repeated streptococcal throat infections. If PANDAS is the result of antibodies that attack the brain, then more B-cells (the cells that produce the antibodies) should be present in the spinal fluid that bathes the brain. It is important to know whether this is the case because new therapies are available for eliminating B-cells in the spinal fluid, and these therapies may be beneficial for TS. The objectives of this feasibility/pilot study are (1) to determine the identity (immunophenotype) of lymphocytes recruited into the spinal fluid and (2) to evaluate the B-cell as a marker for disease activity in TS. Ten children with PANDAS will be recruited from the Pediatric Movement Disorders Clinic and identified using established clinical and serological criteria. Tics, obsessive-compulsive disorder (OCD), and attention-deficit disorder (ADD/ADHD) will be rated using standardized scales. Lymphocyte subsets will be identified in both spinal fluid and peripheral blood, by state-of-theart flow cytometry. Results will be compared with lymphocyte subsets isolated from the spinal fluid and peripheral blood from children with non-autoimmune neurological disorders, who have been immunophenotyped in the same manner. Finding spinal fluid B-cells and linking them to neurological severity will provide a means for identifying at-risk children and provide a possible therapeutic target for innovative therapy. Michael R. Pranzatelli, M.D. Southern Illinois School of Medicine, Springfield, IL Award: $56,100 Tourette Association of America Inc. – Research Grant Award 2004-2005
CSF Lymphocyte Immunophenotyping in PANDAS
Institution Organization Name
Southern Illinois School of Med.
Pranzatelli, Michael, MD