PANDAS on the Rise Due to the Increase in Group A Strep Infections
Published on 7 July, 2023
Since last September, at least five European countries (the UK, France, Ireland, the Netherlands, and Sweden) have reported a rise in invasive group A streptococcal infections (iGAS).
One key factor is likely to be due to increased exposure to strep A infections during the COVID-19 pandemic, leading to a drop in immunity.
Streptococcus A, otherwise known as Strep A, is a common bacterium found in the throat and on the skin. It can cause several different infections, including tonsilitis, pharyngitis, scarlet fever, impetigo, and pneumonia.
Professors Cleary and Agalliu from the universities of Minnesota and Colombia discovered that autoantibodies that are naturally formed to Strep A can migrate into the brain along the nerve that senses smell. The olfactory system bypasses the cellular barriers of the central nervous system and provides a direct portal from the nasal cavity to the olfactory bulb within the brain.(i)
There are proteins in the brain with similar receptors to Strep A, and these autoantibodies can cross-react with them and cause autoimmune disease.
The tissues that are particularly prone to this “friendly fire” are in the basal ganglia. They are tubulin (the scaffolding of neurons in the brain), lysoganglioside (especially important for modulating cell signalling), dopamine receptors, and several others. PANDAS, which stands for Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections, is a type of autoimmune basal ganglia encephalitis triggered when the autoantibodies to Group A strep have begun to exhibit this cross reactivity.
The physical and psychological symptoms are numerous:
“PANDAS is characterised not only by the acuity of OCD onset, but also by a complex constellation of co-occurring symptoms, including emotional lability, separation anxiety, adventitious movements [particularly tics and choreiform movements], developmental (behavioural) regression, cognitive decline, and somatic symptoms, including urinary urgency, frequency, and enuresis, as well as insomnia and sleep disruptions” (ii)
The Child Mind Institute claims that “Some 86 percent of acute onset OCD cases are linked to strep.”(iii)
PANS/PANDAS UK has put out a position statement with guidance on PANDAS and the recent increase in scarlet fever and invasive Group A Strep.
SARS-CoV-2/Covid has of course also exacerbated the situation. Several studies have evidenced the neurological involvement of SARS-CoV-2, and its tropism to the basal ganglia(iv). AONM held a webinar with Professor Craig Shimasaki on this subject that you can view HERE.
Neurological Lyme can also produce the same symptoms via a similar mechanism, as can even influenza (see image below).
Professor Craig Shimasaki, CEO of Moleculera Labs, which detects signs of this autoantibody attack in the blood, gave some webinars recently on this topic. You can view them here:
CAN INFECTIONS REALLY TRIGGER AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS?
Further Information
While there is still much to be learned about PANS/PANDAS, early diagnosis and treatment can help to manage symptoms and improve outcomes. If you are concerned that your child may be affected by PANS/PANDAS, be sure to speak with a healthcare provider for guidance and support. If you are not able to find a healthcare provider that understands either condition, please do not hesitate to contact us (or one of the associations in the Helpful Resource section) and we/they will endeavour to help guide you.
Helpful Resources
PANS/PANDAS: A Simple Overview
For more information and articles on PANS/PANDAS see HERE
The Academy of Nutritional Medicine is a partner of Moleculera Laboratory.
Both AONM and Moleculera Labs have information on their websites about the Cunningham Panel™ Test, this information can be found in the links below:
https://www.moleculeralabs.com/cunningham-panel-pandas-pans-testing/
https//www.aonm.org/cunninghampaneltests/
AONM have a PANS/PANDAS Webinar Series featuring experts such as Professor Craig Shimasaki, Dr. Jodie Dashore and Dr. Sam Yanuck.
You can find these videos and more both on our Website and also on our YouTube Channel where you will find many videos from experts in their field on a multitude of health subjects.
If you have any questions regarding the Cunningham Panel™ Test, please email info@aonm.org with subject heading ‘Cunningham Panel™ Query’. If you would like to subscribe to our newsletter and mailing list for any promotional offers and events such as live webinars and training for Practitioners, please send us your details via our Contact Page.
References:
Main Featured Image – Group A Strep and other infections can trigger an autoimmune response directed against the brain, resulting in the onset of multiple neuropsychiatric symptoms – https://www.moleculeralabs.com/pans-and-pandas-overview/
i. Dileepan T, Smith ED, Knowland D, Hsu M, Platt M, Bittner-Eddy P, Cohen B, Southern P, Latimer E, Harley E, Agalliu D, Cleary PP. Group A Streptococcus intranasal infection promotes CNS infiltration by streptococcal-specific Th17 cells. J Clin Invest. 2016 Jan;126(1):303-17; Dando SJ, Mackay-Sim A, Norton R, Currie BJ, St John JA, Ekberg JA, Batzloff M, Ulett GC, Beacham IR. Pathogens penetrating the central nervous system: infection pathways and the cellular and molecular mechanisms of invasion. Clin Microbiol Rev. 2014 Oct;27(4):691-726
ii. Chain Jennifer L., Alvarez Kathy, Mascaro-Blanco Adita, Reim Sean, Bentley Rebecca, Hommer Rebecca, Grant Paul, Leckman James F., Kawikova Ivana, Williams Kyle, Stoner Julie A., Swedo Susan E., Cunningham Madeleine W. “Autoantibody Biomarkers for Basal Ganglia Encephalitis in Sydenham Chorea and Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infections.” Frontiers In Psychiatry, vol. 11, 2020, p. 564; https://www.nimh.nih.gov/health/publications/panda
iii. https://childmind.org/guide/parents-guide-to-pans-and-pandas/
iv. https://onlinelibrary.wiley.com/doi/full/10.1111/ene.15217
