{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:01:03Z","timestamp":1779206463425,"version":"3.51.4"},"reference-count":47,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2007,2,1]],"date-time":"2007-02-01T00:00:00Z","timestamp":1170288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biological Psychiatry"],"published-print":{"date-parts":[[2007,2]]},"DOI":"10.1016\/j.biopsych.2006.06.012","type":"journal-article","created":{"date-parts":[[2006,9,26]],"date-time":"2006-09-26T12:02:52Z","timestamp":1159272172000},"page":"273-278","source":"Crossref","is-referenced-by-count":101,"title":["Decreased Numbers of Regulatory T Cells Suggest Impaired Immune Tolerance in Children with Tourette Syndrome: A Preliminary Study"],"prefix":"10.1016","volume":"61","author":[{"given":"Ivana","family":"Kawikova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James F.","family":"Leckman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Kronig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lily","family":"Katsovich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra E.","family":"Bessen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Musie","family":"Ghebremichael","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred L.M.","family":"Bothwell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.biopsych.2006.06.012_bib1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/00004583-199503000-00015","article-title":"Case study: A new infection-triggered, autoimmune subtype of pediatric OCD and Tourette\u2019s syndrome","volume":"34","author":"Allen","year":"1995","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.clim.2005.02.018","article-title":"Functional analysis of highly defined, FACS-isolated populations of human regulatory CD4+ CD25+ T cells","volume":"115","author":"Baecher-Allan","year":"2005","journal-title":"Clin Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib3","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1002\/immu.200390024","article-title":"Isolation and functional characterization of regulatory CD25brightCD4+ T cells from the target organ of patients with rheumatoid arthritis","volume":"33","author":"Cao","year":"2003","journal-title":"Eur J Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib4","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1067\/mpd.2001.110325","article-title":"Group A streptococcal infections and tic disorders in an Italian pediatric population","volume":"138","author":"Cardona","year":"2001","journal-title":"J Pediatr"},{"key":"10.1016\/j.biopsych.2006.06.012_bib5","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1136\/jnnp.74.5.602","article-title":"Tourette\u2019s syndrome: A cross sectional study to examine the PANDAS hypothesis","volume":"74","author":"Church","year":"2003","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib6","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1212\/01.WNL.0000148481.80152.BF","article-title":"Activation of humoral immunity and eosinophils in neuromyelitis optica","volume":"63","author":"Correale","year":"2004","journal-title":"Neurology"},{"key":"10.1016\/j.biopsych.2006.06.012_bib7","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S0896-8411(03)00121-5","article-title":"Quantification of regulatory T cells in patients with systemic lupus erythematosus","volume":"21","author":"Crispin","year":"2003","journal-title":"J Autoimmun"},{"key":"10.1016\/j.biopsych.2006.06.012_bib8","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1128\/CMR.13.3.470-511.2000","article-title":"Pathogenesis of group A streptococcal infections","volume":"13","author":"Cunningham","year":"2000","journal-title":"Clin Microbiol Rev"},{"key":"10.1016\/j.biopsych.2006.06.012_bib9","doi-asserted-by":"crossref","first-page":"3913","DOI":"10.1128\/IAI.65.9.3913-3923.1997","article-title":"Molecular analysis of human cardiac myosin-cross-reactive B- and T-cell epitopes of the group A streptococcal M5 protein","volume":"65","author":"Cunningham","year":"1997","journal-title":"Infect Immun"},{"key":"10.1016\/j.biopsych.2006.06.012_bib10","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/j.1574-695X.1997.tb01009.x","article-title":"Analysis of human T cell responses to group A streptococci using fractionated Streptococcus pyogenes proteins","volume":"17","author":"Degnan","year":"1997","journal-title":"FEMS Immunol Med Microbiol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib11","doi-asserted-by":"crossref","first-page":"6435","DOI":"10.4049\/jimmunol.172.10.6435","article-title":"CD4+CD25bright regulatory T cells actively regulate inflammation in the joints of patients with the remitting form of juvenile idiopathic arthritis","volume":"172","author":"de Kleer","year":"2004","journal-title":"J Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib12","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1159\/000077915","article-title":"Rheumatic fever: From sore throat to autoimmune heart lesions","volume":"134","author":"Guilherme","year":"2004","journal-title":"Int Arch Allergy Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib13","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1007\/s00018-003-3320-4","article-title":"Neurobiology and neuroimmunology of Tourette\u2019s syndrome: An update","volume":"61","author":"Hoekstra","year":"2004","journal-title":"Cell Mol Life Sci"},{"key":"10.1016\/j.biopsych.2006.06.012_bib14","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1191\/0961203304lu2025oa","article-title":"Review of ACR hematologic criteria in systemic lupus erythematosus","volume":"13","author":"Kao","year":"2004","journal-title":"Lupus"},{"key":"10.1016\/j.biopsych.2006.06.012_bib15","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1097\/00004583-199707000-00021","article-title":"Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): Initial reliability and validity data","volume":"36","author":"Kaufman","year":"1997","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib16","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1542\/peds.92.1.39","article-title":"Antineuronal antibodies in movement disorders","volume":"92","author":"Kiessling","year":"1993","journal-title":"Pediatrics"},{"key":"10.1016\/j.biopsych.2006.06.012_bib17","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1172\/JCI0213605","article-title":"Multiple immuno-regulatory defects in type-1 diabetes","volume":"109","author":"Kukreja","year":"2002","journal-title":"J Clin Invest"},{"key":"10.1016\/j.biopsych.2006.06.012_bib18","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1542\/peds.113.4.883","article-title":"The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) etiology for tics and obsessive-compulsive symptoms: Hypothesis or entity?","volume":"113","author":"Kurlan","year":"2004","journal-title":"Pediatrics"},{"key":"10.1016\/j.biopsych.2006.06.012_bib19","doi-asserted-by":"crossref","first-page":"12115","DOI":"10.1073\/pnas.91.25.12115","article-title":"Group A streptococci efficiently invade human respiratory epithelial cells","volume":"91","author":"LaPenta","year":"1994","journal-title":"Proc Natl Acad Sci U S A"},{"key":"10.1016\/j.biopsych.2006.06.012_bib20","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1016\/S0140-6736(02)11526-1","article-title":"Tourette\u2019s syndrome","volume":"360","author":"Leckman","year":"2002","journal-title":"Lancet"},{"key":"10.1016\/j.biopsych.2006.06.012_bib21","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.biopsych.2004.12.004","article-title":"Increased serum levels of interleukin-12 and tumor necrosis factor-alpha in Tourette\u2019s syndrome","volume":"57","author":"Leckman","year":"2005","journal-title":"Biol Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib22","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1097\/00004583-198907000-00015","article-title":"The Yale Global Tic Severity Scale: Initial testing of a clinician-rated scale of tic severity","volume":"28","author":"Leckman","year":"1989","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib23","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1097\/00004583-200209000-00007","article-title":"Assessment of symptom exacerbations in a longitudinal study of children with Tourette\u2019s syndrome or obsessive-compulsive disorder","volume":"41","author":"Lin","year":"2002","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib24","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1002\/mds.10522","article-title":"Striatal microinfusion of Tourette syndrome and PANDAS sera: Failure to induce behavioral changes","volume":"19","author":"Loiselle","year":"2004","journal-title":"Mov Disord"},{"key":"10.1016\/j.biopsych.2006.06.012_bib25","doi-asserted-by":"crossref","first-page":"5150","DOI":"10.1073\/pnas.0408995102","article-title":"Leptin increase in multiple sclerosis associates with reduced number of CD4+CD25+ regulatory T cells","volume":"102","author":"Matarese","year":"2005","journal-title":"Proc Natl Acad Sci U S A"},{"key":"10.1016\/j.biopsych.2006.06.012_bib26","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1542\/peds.2004-2058","article-title":"Association between streptococcal infection and obsessive-compulsive disorder, Tourette\u2019s syndrome, and tic disorder","volume":"116","author":"Mell","year":"2005","journal-title":"Pediatrics"},{"key":"10.1016\/j.biopsych.2006.06.012_bib27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0165-1781(00)00125-6","article-title":"Increased anti-streptococcal antibodies in patients with Tourette\u2019s syndrome","volume":"94","author":"Muller","year":"2000","journal-title":"Psychiatry Res"},{"key":"10.1016\/j.biopsych.2006.06.012_bib28","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jneuroim.2004.12.014","article-title":"Platelet-activating factor receptor gene polymorphism in Japanese patients with multiple sclerosis","volume":"161","author":"Osoegawa","year":"2005","journal-title":"J Neuroimmunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib29","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0022-3999(02)00586-X","article-title":"An update on the genetics of Gilles de la Tourette syndrome","volume":"55","author":"Pauls","year":"2003","journal-title":"J Psychosom Res"},{"key":"10.1016\/j.biopsych.2006.06.012_bib30","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/S0140-6736(98)12297-3","article-title":"Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood","volume":"354","author":"Perlmutter","year":"1999","journal-title":"Lancet"},{"key":"10.1016\/j.biopsych.2006.06.012_bib31","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.smim.2003.12.003","article-title":"Naturally-occurring CD4+CD25+ immunoregulatory T cells: Central players in the arena of peripheral tolerance","volume":"16","author":"Piccirillo","year":"2004","journal-title":"Semin Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib32","doi-asserted-by":"crossref","first-page":"6711","DOI":"10.4049\/jimmunol.166.11.6711","article-title":"Immunological and biochemical characterization of streptococcal pyrogenic exotoxins I and J (SPE-I and SPE-J) from Streptococcus pyogenes","volume":"166","author":"Proft","year":"2001","journal-title":"J Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib33","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1046\/j.1365-2249.2003.02203.x","article-title":"Bacterial superantigens","volume":"133","author":"Proft","year":"2003","journal-title":"Clin Exp Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib34","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.4049\/jimmunol.155.3.1151","article-title":"Immunologic self-tolerance maintained by activated T cells expressing IL-2 receptor alpha-chains (CD25)","volume":"155","author":"Sakaguchi","year":"1995","journal-title":"J Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib35","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1097\/00004583-199706000-00023","article-title":"Children\u2019s Yale-Brown Obsessive Compulsive Scale: Reliability and validity","volume":"36","author":"Scahill","year":"1997","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib36","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1038\/35100573","article-title":"From T to B and back again: Positive feedback in systemic autoimmune disease","volume":"1","author":"Shlomchik","year":"2001","journal-title":"Nat Rev Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib37","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1086\/421949","article-title":"Group A streptococcal pharyngitis serotype surveillance in North America, 2000\u20132002","volume":"39","author":"Shulman","year":"2004","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.biopsych.2006.06.012_bib38","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1212\/WNL.50.6.1618","article-title":"Antibodies against human putamen in children with Tourette syndrome","volume":"50","author":"Singer","year":"1998","journal-title":"Neurology"},{"key":"10.1016\/j.biopsych.2006.06.012_bib39","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1212\/01.wnl.0000183223.69946.f1","article-title":"Serum autoantibodies do not differentiate PANDAS and Tourette syndrome from controls","volume":"65","author":"Singer","year":"2005","journal-title":"Neurology"},{"key":"10.1016\/j.biopsych.2006.06.012_bib40","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1038\/sj.mp.4001542","article-title":"PANDAS: Current status and directions for research","volume":"9","author":"Snider","year":"2004","journal-title":"Mol Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib41","doi-asserted-by":"crossref","first-page":"4123","DOI":"10.4049\/jimmunol.172.7.4123","article-title":"CD4+CD25+ regulatory T cells control the severity of viral immunoinflammatory lesions","volume":"172","author":"Suvas","year":"2004","journal-title":"J Immunol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib42","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1084\/jem.20030171","article-title":"CD4+CD25+ T cells regulate virus-specific primary and memory CD8+ T cell responses","volume":"198","author":"Suvas","year":"2003","journal-title":"J Exp Med"},{"key":"10.1016\/j.biopsych.2006.06.012_bib43","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1176\/ajp.155.2.264","article-title":"Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: Clinical description of the first 50 cases","volume":"155","author":"Swedo","year":"1998","journal-title":"Am J Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib44","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1542\/peds.93.2.323","article-title":"Speculations on antineuronal antibody-mediated neuropsychiatric disorders of childhood","volume":"93","author":"Swedo","year":"1994","journal-title":"Pediatrics"},{"issue":"2","key":"10.1016\/j.biopsych.2006.06.012_bib45","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1176\/ajp.146.2.246","article-title":"High prevalence of obsessive-compulsive symptoms in patients with Sydenham\u2019s chorea","volume":"146","author":"Swedo","year":"1989","journal-title":"Am J Psychiatry"},{"key":"10.1016\/j.biopsych.2006.06.012_bib46","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1001\/archneur.62.2.210","article-title":"Blood gene expression profiling of neurologic diseases: A pilot microarray study","volume":"62","author":"Tang","year":"2005","journal-title":"Arch Neurol"},{"key":"10.1016\/j.biopsych.2006.06.012_bib47","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.it.2004.07.003","article-title":"Platelets: Signaling cells in the immune continuum","volume":"25","author":"Weyrich","year":"2004","journal-title":"Trends Immunol"}],"container-title":["Biological Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0006322306008043?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0006322306008043?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T23:54:54Z","timestamp":1683590094000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0006322306008043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,2]]},"references-count":47,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2007,2]]}},"alternative-id":["S0006322306008043"],"URL":"https:\/\/doi.org\/10.1016\/j.biopsych.2006.06.012","relation":{},"ISSN":["0006-3223"],"issn-type":[{"value":"0006-3223","type":"print"}],"subject":[],"published":{"date-parts":[[2007,2]]}}}