{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:36:54Z","timestamp":1779881814077,"version":"3.53.1"},"reference-count":35,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,6,1]]},"abstract":"<jats:p>OBJECTIVE. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections is hypothesized to be a poststreptococcal autoimmune disorder. If clinical exacerbations are triggered by a streptococcal infection that activates cross-reacting antibodies against neuronal tissue or alters the production of cytokines, then a longitudinal analysis would be expected to identify a correlation between clinical symptoms and a change in autoimmune markers.<\/jats:p><jats:p>PATIENTS AND METHODS. Serial serum samples were available on 12 children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections participating in a prospective blinded study: 2 samples before an exacerbation point, 1 during the clinical exacerbation, and 2 after the exacerbation. Six subjects had a well-defined clinical exacerbation in association with a documented streptococcal infection, and 6 had a clinical exacerbation without an associated streptococcal infection. All of the serum samples were assayed for antibodies against human postmortem caudate, putamen, and prefrontal cortex; commercially prepared antigens; and complex sugars. Cytokines were measured by 2 different methodologies.<\/jats:p><jats:p>RESULTS. No correlation was identified between clinical exacerbations and autoimmune markers, including: enzyme-linked immunosorbent assay measures of antineuronal antibodies; Western immunoblotting with emphasis on brain region proteins located at 40, 45, and 60 kDa or their corresponding identified antigens; competitive inhibition enzyme-linked immunosorbent assay to evaluate lysoganglioside GM1 antibodies; and measures of inflammatory cytokines. No differences were identified between individuals with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections with or without exacerbations triggered by streptococcal infections.<\/jats:p><jats:p>CONCLUSIONS. The failure of immune markers to correlate with clinical exacerbations in children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections raises serious concerns about the viability of autoimmunity as a pathophysiological mechanism in this disorder.<\/jats:p>","DOI":"10.1542\/peds.2007-2658","type":"journal-article","created":{"date-parts":[[2008,6,2]],"date-time":"2008-06-02T14:15:50Z","timestamp":1212416150000},"page":"1198-1205","source":"Crossref","is-referenced-by-count":82,"title":["Serial Immune Markers Do Not Correlate With Clinical Exacerbations in Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections"],"prefix":"10.1542","volume":"121","author":[{"given":"Harvey S.","family":"Singer","sequence":"first","affiliation":[{"name":"Departments of Neurology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Gause","sequence":"additional","affiliation":[{"name":"Departments of Neurology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Morris","sequence":"additional","affiliation":[{"name":"Departments of Neurology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Lopez","sequence":"additional","affiliation":[{"name":"Pharmacology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"and the Tourette Syndrome Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2008,6,1]]},"reference":[{"key":"2021120905450638600_R1","doi-asserted-by":"crossref","unstructured":"Snider LA, Swedo SE. 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