IL-17 in serum and cerebrospinal fluid of pediatric patients with acute neuropsychiatric disorders: Implications for PANDAS and PANS

IF 2.3 3区医学 Q3 CLINICAL NEUROLOGY

European Journal of Paediatric Neurology Pub Date : 2024-11-12 DOI:10.1016/j.ejpn.2024.11.004

Foiadelli Thomas , Loddo Nicolò , Sacchi Lucia , Viola Santi , D'Imporzano Giulia , Eugenia Spreafico , Orsini Alessandro , Ferretti Alessandro , De Amici Mara , Testa Giorgia , Marseglia Gian Luigi , Savasta Salvatore

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引用次数: 0

Abstract

Background

Acute neuropsychiatric disorders are heterogeneous conditions resulting from interaction between genetic and environmental features. Among these, post infectious forms like Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are common. Preclinical studies suggest a role of CNS T-helper-17/interleukin-17 (IL-17) inflammatory mediated response in the pathogenesis of these disorders. We analyze serum and cerebral-spinal fluid (CSF)-IL-17 concentrations in a cohort of patients with acute neuropsychiatric disease.

Methods

We retrospectively included patients <14 years with acute neuropsychiatric symptoms from 2016 to 2020. IL-17 was determined on serum and CSF by means of quantitative sandwich enzyme immunoassay technique, and values were compared to serum and CSF controls. Variables were identified using univariate analysis with Pearson's regression test and X² test.

Results

58 subjects were included (67.8 % males, average age: 8.5 years). 50.8 % were classified as PANDAS, 11.8 % as PANS. Mean concentrations of serum IL-17 were higher in the study group compared to controls (p < 0.0001). We observe a trend of increasing IL-17 in post-pubertal children both on serum (p = 0.05) and on CSF (p = 0.04). Coupled IL-17 concentration were higher in the CSF than in serum (p = 0.003), with a marked significance in the PANDAS and PANS group (p < 0.001).

Conclusion

IL-17 is elevated in children and adolescents with acute neuropsychiatric conditions, both on serum and CSF. IL-17 could be involved in the pathogenesis of acute neuropsychiatric disorders in childhood. Further studies are necessary to validate its potential role as a diagnostic or prognostic biomarker.

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急性神经精神疾病儿科患者血清和脑脊液中的 IL-17：对 PANDAS 和 PANS 的影响

背景急性神经精神障碍是遗传和环境特征相互作用导致的一种异质性疾病。其中，小儿急性发作神经精神综合征（PANS）和链球菌感染相关的小儿自身免疫性神经精神障碍（PANDAS）等感染后形式很常见。临床前研究表明，中枢神经系统 T 辅助细胞-17/白细胞介素-17（IL-17）炎症介导的反应在这些疾病的发病机制中起着重要作用。我们分析了急性神经精神疾病患者队列中的血清和脑脊液（CSF）-IL-17浓度。方法我们回顾性纳入了2016年至2020年期间出现急性神经精神症状的<14岁患者。采用定量夹心酶联免疫分析技术测定血清和脑脊液中的IL-17，并将其值与血清和脑脊液对照组进行比较。通过单变量分析、皮尔逊回归检验和 X2 检验确定变量。50.8%被归类为 PANDAS，11.8%被归类为 PANS。与对照组相比，研究组血清 IL-17 的平均浓度更高（p < 0.0001）。我们观察到，青春期后儿童血清（p = 0.05）和脑脊液（p = 0.04）中的 IL-17 均呈上升趋势。CSF中的IL-17耦合浓度高于血清（p = 0.003），在PANDAS和PANS组中具有显著意义（p < 0.001）。IL-17可能与儿童急性神经精神疾病的发病机制有关。有必要进行进一步研究，以验证其作为诊断或预后生物标志物的潜在作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Paediatric Neurology 医学-临床神经学

CiteScore

6.30

自引率

3.20%

发文量

115

审稿时长

81 days

期刊介绍： The European Journal of Paediatric Neurology is the Official Journal of the European Paediatric Neurology Society, successor to the long-established European Federation of Child Neurology Societies. Under the guidance of a prestigious International editorial board, this multi-disciplinary journal publishes exciting clinical and experimental research in this rapidly expanding field. High quality papers written by leading experts encompass all the major diseases including epilepsy, movement disorders, neuromuscular disorders, neurodegenerative disorders and intellectual disability. Other exciting highlights include articles on brain imaging and neonatal neurology, and the publication of regularly updated tables relating to the main groups of disorders.