title: Altered immunoglobulin profiles in children with Tourette syndrome.
abstract: BACKGROUND
  Post-infectious autoimmunity and immune deficiency have been implicated in the pathogenesis of Tourette syndrome (TS). We asked here whether B cell immunity of patients with TS differs from healthy subjects.
  
  
  METHODS
  In two independent cross-sectional samples, we compared serum levels of IgG1, IgG2, IgG3, IgG4, IgM, IgA, and IgE in 21 patients with TS from Yale University (17 males, 4 females, 8-16 years) versus 21 healthy controls (13 males, 8 females, 7-17 years); and in 53 patients with TS from Groningen University (45 males, 8 females, 6-18 years) versus 53 healthy controls (22 males, 31 females, 6-18 years), respectively. We also investigated correlations between Ig concentrations and symptom severity. In 13 additional patients (9 males, 4 females, age range 9-14), we established Ig profiles at time points before, during, and after symptom exacerbations.
  
  
  RESULTS
  IgG3 levels were significantly lower in Yale patients compared to healthy children (medians 0.28 versus 0.49 mg/ml, p=.04), while levels of IgG2, IgG4, and IgM in patients were lower at trend-level significance (p≤.10). Decreased IgG3 (medians 0.45 versus 0.52 mg/ml; p=.05) and IgM (medians 0.30 versus 0.38 mg/ml; p=.04) levels were replicated in the Groningen patients. Ig levels did not correlate with symptom severity. There was a trend-level elevation of IgG1 during symptom exacerbations (p=.09).
  
  
  CONCLUSIONS
  These pilot data indicate that at least some patients with TS have decreased serum IgG3, and possibly also IgM levels, though only few subjects had fully expressed Ig immunodeficiency. Whether these changes are related to TS pathogenesis needs to be investigated.
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands. N.Bos-Veneman@Accare.nl
authors.forename: Netty G P
authors.initials: NG
authors.lastname: Bos-Veneman
authors.forename: Renske
authors.initials: R
authors.lastname: Olieman
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Tobiasova
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Hoekstra
authors.forename: Lily
authors.initials: L
authors.lastname: Katsovich
authors.forename: Alfred L M
authors.initials: AL
authors.lastname: Bothwell
authors.forename: James F
authors.initials: JF
authors.lastname: Leckman
authors.forename: Ivana
authors.initials: I
authors.lastname: Kawikova
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood* / Q000276:immunology; D008297:Male; D010865:Pilot Projects; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D005879:Tourette Syndrome / Q000097:blood* / Q000276:immunology
chemical_list: D007136:Immunoglobulins