{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:14:10Z","timestamp":1783469650715,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sapienza University","award":["RM12117A8221EC0E"],"award-info":[{"award-number":["RM12117A8221EC0E"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), unlike pediatric acute-onset neuropsychiatric syndrome (PANS), is triggered by infections. This study aimed to assess the differences in low-grade endotoxemia and oxidative stress between these conditions. A cross-sectional study compared serum levels of soluble NOX2-dp (sNOX-2-dp), isoprostanes, lipopolysaccharide (LPS), and zonulin in 30 PANDAS, 21 PANS, and 30 control (CT) children matched for age and gender. Zonulin was used to assess gut permeability. Patients with PANDAS showed significantly higher serum levels of sNOX2-dp, isoprostanes, LPS, and zonulin than PANS and controls, while no significant differences were found between PANS and controls. sNOX2-dp correlated with isoprostanes (Rs = 0.708; p &lt; 0.001), LPS (Rs = 0.584; p &lt; 0.001), and zonulin (Rs = 0.662; p &lt; 0.001). Multiple regression identified isoprostanes (\u03b2 = 0.599; p &lt; 0.001) and zonulin (\u03b2 = 0.295; p = 0.01) as independent predictors of sNOX2-dp (R2 = 81%). PANDAS and PANS showed distinct profiles of LPS, zonulin, NOX2, and isoprostanes. Future research should explore therapies targeting endotoxemia and oxidative stress for potential clinical benefits.<\/jats:p>","DOI":"10.3390\/ijms26136336","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T06:56:54Z","timestamp":1751353014000},"page":"6336","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Oxidative Stress and Low-Grade Endotoxemia in Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Insights from a Cross-Sectional Study"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7602-5065","authenticated-orcid":false,"given":"Chiara Maria","family":"Tot\u00e8","sequence":"first","affiliation":[{"name":"Department of Clinical Internal, Anaesthetic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Capponi","sequence":"additional","affiliation":[{"name":"Department of Mother-Child, Urological Science, La Sapienza University, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Salvatori","sequence":"additional","affiliation":[{"name":"Department of Mother-Child, Urological Science, La Sapienza University, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Zicari","sequence":"additional","affiliation":[{"name":"Department of Mother-Child, Urological Science, La Sapienza University, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana Alessia","family":"Guido","sequence":"additional","affiliation":[{"name":"Department of Mother-Child, Urological Science, La Sapienza University, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5059-6082","authenticated-orcid":false,"given":"Giulia","family":"Brindisi","sequence":"additional","affiliation":[{"name":"Department of Mother-Child, Urological Science, La Sapienza University, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8067-4114","authenticated-orcid":false,"given":"Laura","family":"Iantorno","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anaesthetic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-3059","authenticated-orcid":false,"given":"Simona","family":"Bartimoccia","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, LT, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1708-272X","authenticated-orcid":false,"given":"Francesco","family":"Baratta","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anaesthetic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0739-0534","authenticated-orcid":false,"given":"Maurizio","family":"Forte","sequence":"additional","affiliation":[{"name":"IRCCS Neuromed, 86077 Pozzilli, IS, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1591-5118","authenticated-orcid":false,"given":"Vittorio","family":"Picchio","sequence":"additional","affiliation":[{"name":"IRCCS Neuromed, 86077 Pozzilli, IS, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1190-9733","authenticated-orcid":false,"given":"Mariaelena","family":"Malvasi","sequence":"additional","affiliation":[{"name":"Department of Sense Organs, Sapienza University of Rome, 00185 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4675-6059","authenticated-orcid":false,"given":"Simone","family":"Aloisio","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience, Sapienza University of Rome, Viale dell\u2019Universit\u00e0 30, 00185 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5431-6399","authenticated-orcid":false,"given":"Elena","family":"Pacella","sequence":"additional","affiliation":[{"name":"Department of Sense Organs, Sapienza University of Rome, 00185 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-7455","authenticated-orcid":false,"given":"Pasquale","family":"Pignatelli","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anaesthetic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Violi","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anaesthetic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, RM, Italy"},{"name":"IRCCS Neuromed, 86077 Pozzilli, IS, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6216-9595","authenticated-orcid":false,"given":"Roberto","family":"Carnevale","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and 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