title: Identification of pyruvate kinase as an antigen associated with Tourette syndrome.
abstract: Immune responses to beta-hemolytic streptococcal infections are hypothesized to trigger tic disorders and early-onset obsessive-compulsive disorder (OCD) in some pediatric populations. Here we identify the M1 isoform of the glycolytic enzyme, pyruvate kinase (PK) as an autoimmune target in Tourette syndrome and associated disorders. Antibodies to PK reacted strongly with surface antigens of infectious strains of streptococcus, and antibodies to streptococcal M proteins reacted with PK. Moreover, immunoreactivity to PK in patients with exacerbated symptoms who had recently acquired a streptococcal infection was 7-fold higher compared to patients with exacerbated symptoms and no evidence of a streptococcal infection. These data suggest that PK can function as an autoimmune target and that this immunoreactivity may be associated with Tourette syndrome, OCD, and associated disorders.
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA. janice.kansy@utsouthwestern.edu
authors.forename: Janice W
authors.initials: JW
authors.lastname: Kansy
authors.forename: Liliya
authors.initials: L
authors.lastname: Katsovich
authors.forename: Kevin S
authors.initials: KS
authors.lastname: McIver
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pick
authors.forename: John B
authors.initials: JB
authors.lastname: Zabriskie
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Lombroso
authors.forename: James F
authors.initials: JF
authors.lastname: Leckman
authors.forename: James A
authors.initials: JA
authors.lastname: Bibb
mesh_terms: D000293:Adolescent; D000595:Amino Acid Sequence; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D000941:Antigens / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D001323:Autoantibodies / Q000097:blood*; D001921:Brain / Q000201:enzymology / Q000276:immunology; D002648:Child; D003429:Cross Reactions; D006801:Humans; D007150:Immunohistochemistry; D008137:Longitudinal Studies; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008969:Molecular Sequence Data; D011446:Prospective Studies; D011770:Pyruvate Kinase / Q000235:genetics* / Q000276:immunology* / Q000378:metabolism; D051381:Rats; D016036:Seroepidemiologic Studies; D013290:Streptococcal Infections / Q000453:epidemiology / Q000276:immunology; D020323:Tics / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D005879:Tourette Syndrome / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D000941:Antigens; D001323:Autoantibodies; D011770:Pyruvate Kinase