Differential binding of antibodies in PANDAS patients to cholinergic interneurons in the striatum

SUMMARY

“Differential binding of antibodies in PANDAS patients to cholinergic interneurons in the striatum” explores a potential autoimmune mechanism in patients diagnosed with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS). Building on evidence from Sydenham’s chorea, which similarly involves cross-reactive antibodies, the researchers used an in vivo mouse model to identify whether antibodies from PANDAS patients target specific neurons in the brain.

They infused serum from PANDAS cases involved in a recent IVIG trial directly into the striatum of mice and found that antibodies from these patients strongly bound to approximately 80% of cholinergic interneurons—compared to less than 50% in controls—while showing no elevated binding to GABAergic interneuron populations.

Importantly, this elevated binding resolved alongside symptom improvement after intravenous immunoglobulin (IVIG) treatment, supporting the idea of an antibody-mediated process. This finding aligns with prior research linking striatal dysfunction to tics and OCD and adds novel evidence that cholinergic interneurons may be a key target in PANDAS pathophysiology.

LINK TO PAPER: https://doi.org/10.1016/j.bbi.2017.12.004