IVIG response in PANS correlates with reduction in pro-inflammatory monocytes and neuropsychiatric measures

SUMMARY

“IVIG response in pediatric acute- onset neuropsychiatric syndrome correlates with reduction in pro- inflammatory monocytes and neuropsychiatric measures” explores the effects of intravenous immunoglobulin (IVIG) treatment in pediatric acute-onset neuropsychiatric syndrome (PANS), a disorder characterized by sudden-onset neuropsychiatric symptoms, often triggered by infection. Increasing evidence suggests that immune dysregulation and inflammation play a crucial role in PANS pathophysiology, with monocytes being implicated in the inflammatory response.

In the open label study, researchers evaluated 10 children diagnosed with moderate-to-severe PANS to determine the impact IVIG on inflammatory markers, particularly monocytes, and correlate changes with psychiatric symptom improvement. These patients received a unique treatment protocol of six infusions of IVIG (Octagam 5%, Octapharma) every 3 weeks with post treatment follow-up.

Blood samples and validated psychometric scales completed at visits 1 (pre-treatment), 7 and 8, showed a significant reduction in pro-inflammatory monocytes post-IVIG, alongside measurable improvements in neuropsychiatric symptoms, suggesting an immune-modulatory role of IVIG. The results of this study are in line with prior reports of the effects of IVIG on reducing symptoms in PANS/PANDAS patients. This is the first study to show a decrease in pro-inflammatory monocytes and dendritic cells in PANS patients after the completion of IVIG treatment. These findings support the hypothesis that immune dysregulation contributes to PANS and provides evidence for IVIG’s role in treating the condition.

LINK TO PAPER: https://pmc.ncbi.nlm.nih.gov/articles/PMC11484259/