B lymphocyte antigen D8/17: a peripheral marker for childhood-onset obsessive-compulsive disorder and Tourette's syndrome?
OBJECTIVE
It has been hypothesized that Sydenham's chorea, a major manifestation of rheumatic fever, may provide a medical model for obsessive-compulsive disorder and associated conditions, such as Tourette's syndrome. Monoclonal antibody D8/17 identifies a B lymphocyte antigen with expanded expression in nearly all patients with rheumatic fever and is thought to be a trait marker for susceptibility to this complication of group A streptococcal infection. The authors investigated whether D8/17 expression is greater than normal in some forms of obsessive-compulsive disorder and Tourette's syndrome.


METHODS
By immunofluorescence techniques, 31 patients with childhood-onset obsessive-compulsive disorder and/or Tourette's syndrome or chronic tic disorder and 21 healthy comparison subjects were evaluated for percentage of D8/17-positive B cells. None had rheumatic fever or Sydenham's chorea. Levels of antineuronal antibodies and streptococcal antibodies were also determined.


RESULTS
The average percentage of B cells expressing the D8/17 antigen was significantly higher in the patients (mean = 22%, SD = 5%) than in the comparison subjects (mean = 9%, SD = 2%). When classified categorically, all patients but only one comparison subject were D8/17 positive. No difference between groups in the presence of antineuronal antibodies or high streptococcal titers was found.


CONCLUSIONS
Patients with childhood-onset obsessive-compulsive disorder or Tourette's syndrome had significantly greater B cell D8/17 expression than comparison subjects despite the absence of documented Sydenham's chorea or rheumatic fever. These findings suggest that D8/17 may serve as a marker for susceptibility among some forms of childhood-onset obsessive-compulsive disorder and Tourette's syndrome, as well as rheumatic fever or Sydenham's chorea.
Murphy
T K
TK
Department of Psychiatry, University of Florida College of Medicine, USA. TMurphy@college.med.ufl.edu
Goodman
W K
WK
Fudge
M W
MW
Williams
R C
RC
Ayoub
E M
EM
Dalal
M
M
Lewis
M H
MH
Zabriskie
J B
JB
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal; D000917:Antibody Formation; D000941:Antigens / Q000276:immunology*; D001402:B-Lymphocytes / Q000276:immunology*; D015415:Biomarkers; D001921:Brain / Q000276:immunology; D002648:Child; D002819:Chorea / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D009474:Neurons / Q000276:immunology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000276:immunology*; D012213:Rheumatic Fever / Q000276:immunology; D013291:Streptococcus / Q000276:immunology; D005879:Tourette Syndrome / Q000175:diagnosis / Q000276:immunology*
D000911:Antibodies, Monoclonal; D000941:Antigens; D015415:Biomarkers