title: Antibodies against neural, nuclear, cytoskeletal, and streptococcal epitopes in children and adults with Tourette's syndrome, Sydenham's chorea, and autoimmune disorders.
abstract: BACKGROUND
  Some cases of Tourette's syndrome (TS) are hypothesized to be caused by autoantibodies that develop in response to a preceding group A beta hemolytic streptococcal infection.
  
  
  METHODS
  To test this hypothesis, we looked for the presence ot total and IgG antibodies against neural, nuclear, cytoskeletal and streptococcal epitopes using indirect immunofluorescent assays and Western blot techniques in three patient groups: TS (n = 81), SC (n = 27), and a group of autoimmune disorders (n = 52) and in normal controls (n = 67). Subjects were ranked after titrations of autoantibodies from 0 to 227 according to their level of immunoreactivity.
  
  
  RESULTS
  TS patients had a significantly higher mean rank for total antineural and antinuclear antibodies, as well as antistreptolysin O titers. However, among children and adolescents, only the total antinuclear antibodies were increased in TS patients compared to age matched controls. Compared to SC patients, TS patients had a significantly lower mean rank for total and IgG class antineural antibodies, significantly lower IgG class anticytoskeletal antibodies, and a significantly higher rank for total antinuclear antibodies. Compared to a mixed group of autoimmune disorders, the TS patients had a significantly lower mean rank for total and IgG class antineural antibodies, total and IgG class antinuclear antibodies, IgG class anticytoskeletal antibodies, and a significantly higher rank for antistreptococcal antibodies.
  
  
  CONCLUSIONS
  TS patients had significantly higher levels of total antineural and antinuclear antibodies than did controls. Their relation to IgG class antineural and antinuclear antibodies, markers for prior streptococcal infection, and other clinical characteristics, especially chronological age, was equivocal.
authors.affiliation: Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06520-7900, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Morshed
authors.forename: S
authors.initials: S
authors.lastname: Parveen
authors.forename: J F
authors.initials: JF
authors.lastname: Leckman
authors.forename: M T
authors.initials: MT
authors.lastname: Mercadante
authors.forename: M H
authors.initials: MH
authors.lastname: Bittencourt Kiss
authors.forename: E C
authors.initials: EC
authors.lastname: Miguel
authors.forename: A
authors.initials: A
authors.lastname: Arman
authors.forename: Y
authors.initials: Y
authors.lastname: Yazgan
authors.forename: T
authors.initials: T
authors.lastname: Fujii
authors.forename: S
authors.initials: S
authors.lastname: Paul
authors.forename: B S
authors.initials: BS
authors.lastname: Peterson
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: R A
authors.initials: RA
authors.lastname: King
authors.forename: L
authors.initials: L
authors.lastname: Scahill
authors.forename: P J
authors.initials: PJ
authors.lastname: Lombroso
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000974:Antibodies, Antinuclear / Q000097:blood*; D000907:Antibodies, Bacterial / Q000097:blood*; D000989:Antistreptolysin / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000276:immunology*; D002648:Child; D002819:Chorea / Q000175:diagnosis / Q000276:immunology*; D003342:Corpus Striatum / Q000276:immunology; D003599:Cytoskeleton / Q000276:immunology; D003851:Deoxyribonucleases / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051381:Rats; D005879:Tourette Syndrome / Q000175:diagnosis / Q000276:immunology*
chemical_list: D000974:Antibodies, Antinuclear; D000907:Antibodies, Bacterial; D001323:Autoantibodies; D000989:Antistreptolysin; D003851:Deoxyribonucleases; C020069:deoxyribonuclease B