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The Genetics of Obsessive-Compulsive Disorder: An Immunologic Perspective

Published online by Cambridge University Press:  07 November 2014

Abstract

This article presents a rationale for the hypothesis that an autoimmune mechanism might be involved in the pathogenesis of some forms of obsessive-compulsive aborder (OCO). Existing clinical studies suggesting that some individuals with OCD may have an autoimmune-mediated disorder are briefly summarized. A case example where intravenous immunoglobulin G has been successfully used to treat an adult with OCD spectrum disorder is presented. Preclinical data demonstrating that fragments from the group Αβ hemolytic streptococcus cell wall M proteins can generate antibodies that bind to rat and human tissue are also presented.

Type
Feature Articles
Copyright
Copyright © Cambridge University Press 1999

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References

REFERENCES

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2.Holzer, JC, Goodman, WK, McDongle, CJ, et al.Obsessive-compulsive disorder with and without a chronic tic disorder: a comparison of symptoms in 70 patients. Br J Psychiatry. 1994;164:469473.CrossRefGoogle ScholarPubMed
3.McDougle, CJ, Goodman, WK, Leckman, JF, et al.Haloperidol addition in fluvoxamine-refractory obsessive compulsive disorder: a double-blind, placebo-controlled study in patients with and without tics. Arch Gen Psychiatry. 1994;51:302308.CrossRefGoogle ScholarPubMed
4.Leckman, JF, Pauls, DL, Cohen, DJ. Tic disorders. In: Bloom, FE, Kupler, DJ, eds. Psychopharmacohgy: The Fourth Generatbn of Progress. New York, NY: Raven Press; 1995:16651674.Google Scholar
5.Swedo, SE, Leonard, HL, Schapira, MB, et al.Syndenham's chorea: physical and psychological symptoms of St. Vitus dance. Pediatrics. 1993;91:706713.Google Scholar
6.Pauls, DL, Towbin, KE, Leckman, JF, et al.Gilles de la Tourette's syndrome and obsessive-compulsive disorder: evidence supporting a genetic relationship. Arch Gen Psychiatry. 1986;43:11801182.CrossRefGoogle ScholarPubMed
7.Swedo, SE, Leonard, HL, Kiesssling, LS. Speculations on antineuronal antibody-mediated neuropsychiatrie disorders of childhood. Pediatrics. 1994;93:323326.CrossRefGoogle Scholar
8.Allen, AJ, Leonard, HL, Swedo, SE. Case study: a new infection-triggered autoimmune subtype of pediatric OCD and Tourette's syndrome. J Am Acad Child Adolesc Psychiatry. 1995;34:307311.CrossRefGoogle ScholarPubMed
9.Swedo, SE. Sydenham's chorea: a model for childhood autoimmune neuropsychiatrie disorders. JAMA. 1994;2772:17881791.CrossRefGoogle Scholar
10.Husby, G, van de Rijn, I, Zabriskie, JB, et al.Antibodies reacting with cytoplasm of subthalamic and caudate nuclei neurons in chorea and acute rheumatic fever. J Exp Med. 1976;144:10941110.CrossRefGoogle ScholarPubMed
11.Wilcox, JA, Nasrallah, HA. Sydenham's chorea and psychosis. Neuropsychobiology. 1986;15:1314.CrossRefGoogle ScholarPubMed
12.Grimshaw, L. Obsessional disorder and neurological illness. J Neurol Neurosurg Psychiatry. 1964;27:229231.CrossRefGoogle ScholarPubMed
13.Freeman, JM, Aron, AM, Collard, JE, et al.The emotional correlates of Sydenham's chorea. Pediatrics. 1965;35:4249.CrossRefGoogle ScholarPubMed
14.Swedo, SE, Rapoport, JL, Cheslow, DL, et al.High prevalence of obsessive-compulsive symptoms in patients with Sydenham's chorea. Am J Psychiatry. 1989;146:246249.Google ScholarPubMed
15.Swedo, SE, Kilpatrick, K, Schapira, M, et al.Antineuronal antibodies in Sydenham's chorea and obsessive compulsive disorder. Pediatr Res. 1991;29:369a.Google Scholar
16.Beachey, EH, Seyer, JM, Dale, JB, et al.Type-specific protective immunity evoked by synthetic peptide of streptococcus pyogenes M protein. Macmillan Journals Ltd. 1981:13. Reprinted from Nature 1981;292:457459.CrossRefGoogle Scholar
17.Edwin, H, Beachey, E, Jerome, M, et al.Repeating covalent structure and protective immunogenicity of native and synthetic polypeptide fragments of type 24 streptococcal M protein. Mapping of protective and nonprotective epitopes with monoclonal antibodies. J Biol Chemistry. 1983;258:1325013257.Google Scholar
18.Dale, JB, Beachey, E. Multiple heart-cross-reactive epitopes of streptococcal M proteins. J Exp Med. 1985;161:113122.CrossRefGoogle ScholarPubMed
19.Dale, JB, Beachey, EH. Sequence of myosin-crossreactive epitopes of streptococcal M protein. J Exp Med. 1986;164:17851790.CrossRefGoogle ScholarPubMed
20.Sargent, SJ, Beachey, EH, Corbett, CE, et al.Sequence of protective epitopes of streptococcal M proteins shared with cardiac sarcolemmal membranes. J Immunol. 1987;139:12851290.CrossRefGoogle ScholarPubMed
21.Kraus, W, Beachey, EH. Renal autoimmune epitope of group A streptococci specified by M protein tetrapeptide Ile-Arg-Leu-Arg. Proc Natl Acad Sci USA. 1988;85:45164520.CrossRefGoogle Scholar
22.Bronze, MS, Dale, JB. Epitopes of streptococcal M proteins that evoke antibodies that cross-react with human brain. J Immunol. 1993;151:28202828.CrossRefGoogle ScholarPubMed
23.Regelmann, WE, Talbot, R, Cairns, L, et al.Distribution of cells bearing “rheumatic” antigens in peripheral blood of patients with rheumatic fever/rheumatic heart disease. J Rheumatol. 1989;16:931935.Google ScholarPubMed
24.Gibofsky, A, Khanna, A, Suh, E, et al.The genetics of rheumatic fever: relationship to streptococcal infection and autoimmune disease. J Rheumatol. 1991;18(suppl 30):15.Google Scholar
25.Kiessling, LS, Marcotte, AC, Culpepper, L. Antineuronal antibodies in movement disorders. Pediatrics. 1993;92:3943.CrossRefGoogle ScholarPubMed
26.Zabriskie, JB, Lavenchy, D, Williams, RC Jr, et al.Rheumatic fever-associated b cell alloantigens as identified by monoclonal antibodies. Arthritis Rheum. 1985;28:10471051.CrossRefGoogle ScholarPubMed
27.Kemeny, E, Husby, G, Williams, RC Jr, et al.Tissue distribution of antigen(s) defined by monoclonal antibody D8/17 reacting with b lymphocytes of patients with rheumatic heart disease. Clin Immunol Immunopathol. 1994;72:3543.CrossRefGoogle ScholarPubMed
28.Khanna, AK, Buskirk, DR, Williams, RC Jr, et al.Presence of a non-HLA b cell antigen in rheumatic fever patients and their families as defined by a monoclonal antibody. J Clin Invest. 1989;83:17101716.CrossRefGoogle ScholarPubMed
29.Swedo, SE, Leonard, HL, Mittleman, BB, et al.Identification of children with pediatric autoimmune neuropsychiatrie disorders associated with streptococcal infections by a marker associated with rheumatic fever. Am J Psychiatry. 1997;154:110112.Google Scholar
30.Murphy, TK, Goodman, WK, Fudge, MW, et al.B lymphocyte antigen D8/17: a peripheral marker for childhood-onset obsessive-compulsive disorder and Tourette's syndrome. Am J Psychiatry. 1997;154:402407.Google ScholarPubMed
31.Hollander, E, DelGiudice-Asch, G, Simon, L, et al.B lymphocyte antigen D8/17 and repetitive behaviors in autism. Am J Psychiatry. 1999;156:317320.CrossRefGoogle ScholarPubMed
32.Colony, HS, Malamud, N. Sydenham's chorea: a clinicopathologic study. Neurology. 1956;6:672676.CrossRefGoogle ScholarPubMed
33.Ziegler, LH. The neuropathological findings in a case of acute Sydenham's chorea. J New Ment Dis. 1927;65:273281.CrossRefGoogle Scholar
34.Goldman, S, Amron, D, Szliwowski, HB, et al.Reversible striatal hypermetabolism in a case of Sydenham's chorea. Mov Disord. 1993;8:355358.CrossRefGoogle Scholar
35.Kienzle, GD, Berger, RK, Chun, RW, et al.Sydenham chorea: MR manifestations in two cases. AJNR. 1991;12:7376.Google ScholarPubMed
36.Heye, N, Jergas, M, Hötzinger, H, et al.Sydenham chorea: clinical, EEG, MRI and SPECT findings in the early stage of the disease. J Neurol. 1993;240:121123.CrossRefGoogle ScholarPubMed
37.Singer, HS, Reiss, AL, Brown, JE, et al.Volumetrie MRI changes in basal ganglia of children with Tourette syndrome. Neurobgy. 1993;43:950956.Google Scholar
38.Peterson, MD, Riddle, MA, Cohen, DJ, et al.Reduced basal ganglia volumes in Tourette syndrome using three-dimensional reconstruction techniques from magnetic resonance images. Neurobgy. 1993;43:941949.Google ScholarPubMed
39.Kiessling, LS, Marcotte, AC, Culpepper, L. Antineuronal antibodies: tics and obsessive-compulsive symptoms. DEBP. 1994;15(6):421425.Google ScholarPubMed
40.Swedo, SE, Leonard, HL, Garvey, M, et al.Pediatric autoimmune neuropsychiatrie disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998;155:264271.CrossRefGoogle Scholar
41.Swedo, SE, Leonard, HL, Kiessling, LS. Commentaries: speculations on antineuronal antibody-mediated neuropsychiatrie disorders of childhood. Pediatrics. 1994;93:323326.CrossRefGoogle Scholar