Author: Brandon Copping
Though the acronym for this condition might seem rather cute at first, this disorder has lifelong impacts on the lives of those who have it. As a fairly recently discovered, and still hotly contested, condition, PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a very interesting kind of autoimmune disorder. Unlike most autoimmune diseases that we hear about regularly, such as lupus or rheumatoid arthritis, that can cause death or permanent disfigurement, PANDAS tends to be slightly more subtle in its expression and can often be mistaken for simply being just one of the disorders it can cause. Before I go into the major themes of PANDAS research and the innovations in the field that have helped significantly advance our knowledge of the condition, I first want to give a brief overview of what we currently understand it to be. PANDAS is the onset of a few different neuropsychiatric disorders including, but not limited to: OCD, ADHD, and Tourette’s Syndrome. As can be seen from the acronym, these disorders present during youth, most often before puberty, right around the time the individual is or just was suffering from an infection by Group A beta-hemolytic Streptococcus (GABHS) bacteria. It is believed that the body’s immune response to the infection goes overboard, as is the case in all autoimmune disorders, and causes neuroinflammation leading to the onset of one or of the aforementioned conditions. As PANDAS is a very newly described condition, first hypothesized in the mid 1990’s, its existence is still a point of contention among researches and doctors. However, as more research is being done, more evidence is being found in favor of PANDAS being real. While researching this condition, I have decided to organize the papers into four categories: general overviews (since the disease is still so new and not well understood), analysis of risk factors, proposed and experimentally determined mechanism of the condition, and possible treatments. Since many of the papers contain a bit of more than one category, I have been organizing them by what category I feel fits them best or which category I feel they contribute best to.
Most of the major innovations in the research of PANDAS has come from studies trying to determine what the mechanism of action for the disorder and why the conditions it presents as, such as Tourette’s syndrome, are being brought about in a different manner than if they were not caused by PANDAS. One major finding was the discovery that some of the antibodies produced to fight the Streptococcus infection are able to cross the blood-brain barrier and attack neurotransmitter receptors in areas such as the basal ganglia thus causing inflammation and leading to the development of the various neuropsychiatric disorders. What makes the mechanism of this disease slightly more challenging to determine is that not only does it often present in a very similar way to non-PANDAS caused disorders, but its existence is still contested so that reduces the availability of properly diagnosed participants for any kind of study. However, another major innovation in the field has been the use of animal models, such as rats, that have been found to exhibit the same kind of autoimmune response to GABHS infections. This has allowed researchers to study the disease much more freely and has also helped to prove its very existence. As time goes on and more research is done, we may one day know the true mechanism of how PANDAS occurs and be able to properly treat it since currently there are no well-documented cures or treatments that are PANDAS-specific and not already-in-use treatments for the various conditions that PANDAS can cause.
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