title: On the connection between autoimmunity, tic disorders and obsessive-compulsive disorders: a meta-analysis on anti-streptolysin O titres.
abstract: Anti-streptolysin O (ASO) titration is useful in the context of autoimmune pathologies, including specific cases of tic and obsessive-compulsive disorders occurring after streptococcal infections. There is currently a lack of consensus on the use of ASO titres; therefore we performed a meta-analysis to systematise available data and clarify the role of ASO titres in the context of neuropsychiatric disorders. A meta-analysis was performed on ASO titration in neuropsychiatric patients, including tic disorders and obsessive-compulsive disorders. Included studies reported numbers of positive subjects, depending on a chosen threshold, or detailed ASO titrations. Three hundred and twenty nine studies were identified, of which 13 were eligible for meta-analysis. Due to limited available data, only tic disorders were evaluated. The odds ratio of finding an abnormal ASO titre in patients was 3.22 (95% C.I. 1.51-6.88) as compared to healthy controls and 16.14 (95% C.I. 8.11-32.11) as compared to non-psychiatric patients. Studies using different thresholds were generally concordant. ASO titres were also compared quantitatively, finding an overall difference of the means of 70.50 U/ml (95% C.I. 25.21-115.80) in favour of patients with tic disorders. Based on current evidence, tic disorders are associated with a significant increase in ASO titres, evident both in a threshold-level perspective and on a quantitative level. These results encourage the systematisation of ASO titration in the context of tic disorders.
authors.affiliation: Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, LC, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzi
authors.forename: Paolo
authors.initials: P
authors.lastname: Pellegrino
authors.forename: Carla
authors.initials: C
authors.lastname: Carnovale
authors.forename: Valentina
authors.initials: V
authors.lastname: Perrone
authors.forename: Stefania
authors.initials: S
authors.lastname: Antoniazzi
authors.forename: Cristiana
authors.initials: C
authors.lastname: Perrotta
authors.forename: Sonia
authors.initials: S
authors.lastname: Radice
authors.forename: Emilio
authors.initials: E
authors.lastname: Clementi
mesh_terms: D000989:Antistreptolysin / Q000097:blood* / Q000276:immunology; D015551:Autoimmunity / Q000502:physiology*; D016022:Case-Control Studies; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000097:blood* / Q000276:immunology; D013981:Tic Disorders / Q000097:blood* / Q000276:immunology
chemical_list: D000989:Antistreptolysin
references.citation: Biol Psychiatry. 2004 Jan 1;55(1):61-8
references.pmid: 14706426
references.citation: J Exp Med. 1976 Oct 1;144(4):1094-110
references.pmid: 789810
references.citation: Psychiatry Res. 2000 Apr 24;94(1):43-9
references.pmid: 10788676
references.citation: Turk J Pediatr. 2009 Jul-Aug;51(4):317-24
references.pmid: 19950837
references.citation: Sleep. 2009 Aug;32(8):979-83
references.pmid: 19725248
references.citation: J Infect Dis. 1971 May;123(5):490-501
references.pmid: 5115179
references.citation: Neurology. 1998 Jun;50(6):1618-24
references.pmid: 9633702
references.citation: Dev Med Child Neurol. 2011 Oct;53(10):951-7
references.pmid: 21679362
references.citation: J Neurol. 2009 Jul;256(7):1103-8
references.pmid: 19288046
references.citation: Balkan J Med Genet. 2012 Dec;15(2):61-6
references.pmid: 24052733
references.citation: J Pediatr. 2012 Feb;160(2):314-9
references.pmid: 21868033
references.citation: Pediatr Neurol. 2004 Feb;30(2):107-10
references.pmid: 14984902
references.citation: Brain Dev. 2013 Aug;35(7):670-4
references.pmid: 23142103
references.citation: Am J Psychiatry. 1997 Mar;154(3):402-7
references.pmid: 9054790
references.citation: Arch Dis Child Educ Pract Ed. 2014 Dec;99(6):231-8
references.pmid: 24482289
references.citation: J Child Adolesc Psychopharmacol. 2011 Apr;21(2):177-82
references.pmid: 21486169
references.citation: Biol Psychiatry. 2001 Oct 15;50(8):566-77
references.pmid: 11690591
references.citation: Clin Vaccine Immunol. 2009 Feb;16(2):172-5
references.pmid: 19052157
references.citation: Pediatrics. 2008 Jun;121(6):1188-97
references.pmid: 18519489
references.citation: J Child Adolesc Psychopharmacol. 2013 May;23(4):302-4
references.pmid: 23647138
references.citation: J Am Acad Child Adolesc Psychiatry. 2005 Nov;44(11):1145-50
references.pmid: 16239863
references.citation: J Neurol Neurosurg Psychiatry. 2003 May;74(5):602-7
references.pmid: 12700302
references.citation: J Child Neurol. 2006 Sep;21(9):747-53
references.pmid: 16970879
references.citation: J Neuroimmunol. 2009 Sep 29;214(1-2):118-24
references.pmid: 19628285
references.citation: J Child Adolesc Psychopharmacol. 2010 Aug;20(4):333-40
references.pmid: 20807071
references.citation: Indian J Med Res. 2004 May;119 Suppl:186-90
references.pmid: 15232192
references.citation: Tremor Other Hyperkinet Mov (N Y). 2013 Sep 25;3:
references.pmid: 24106651
references.citation: J Pediatr. 2001 Jan;138(1):71-5
references.pmid: 11148515
references.citation: Indian J Psychiatry. 2012 Oct;54(4):375-7
references.pmid: 23372243
references.citation: Indian J Hum Genet. 2013 Apr;19(2):196-201
references.pmid: 24019622
references.citation: Am J Psychiatry. 1998 Feb;155(2):264-71
references.pmid: 9464208
references.citation: Arch Pediatr Adolesc Med. 2002 Apr;156(4):356-61
references.pmid: 11929370
references.citation: Pediatr Neurol. 2004 Aug;31(2):119-21
references.pmid: 15301831
references.citation: Pediatrics. 1993 Jul;92(1):39-43
references.pmid: 8516083
references.citation: J Child Neurol. 2010 May;25(5):614-5
references.pmid: 20207613
references.citation: J Child Adolesc Psychopharmacol. 2000 Summer;10(2):133-45
references.pmid: 10933123
references.citation: Arch Gen Psychiatry. 2000 Apr;57(4):364-72
references.pmid: 10768698
references.citation: J Neuroimmunol. 2013 Nov 15;264(1-2):106-13
references.pmid: 24080310
references.citation: Pediatrics. 1993 Apr;91(4):706-13
references.pmid: 8464654
references.citation: J Neuropsychiatry Clin Neurosci. 2011 Fall;23(4):391-8
references.pmid: 22231309
references.citation: J Mol Neurosci. 2012 Sep;48(1):219-24
references.pmid: 22638859
references.citation: J Neurol Sci. 2009 Jan 15;276(1-2):45-8
references.pmid: 18823914
references.citation: Pediatrics. 2004 Jun;113(6):e578-85
references.pmid: 15173540
references.citation: J Am Acad Child Adolesc Psychiatry. 2011 Feb;50(2):108-118.e3
references.pmid: 21241948
references.citation: Pediatrics. 1998 Jan;101(1 Pt 1):86-8
references.pmid: 9417157