Autoantibodies in patients with obsessive-compulsive disorder: a systematic review

Abstract

Obsessive-compulsive disorder (OCD) is a frequent and debilitating mental illness. Although efficacious treatment options are available, treatment resistance rates are high. Emerging evidence suggests that biological components, especially autoimmune processes, may be associated with some cases of OCD and treatment resistance. Therefore, this systematic literature review summarizing all case reports/case series as well as uncontrolled and controlled cross-sectional studies investigating autoantibodies in patients with OCD and obsessive-compulsive symptoms (OCS) was performed. The following search strategy was used to search PubMed: “(OCD OR obsessive-compulsive OR obsessive OR compulsive) AND (antib* OR autoantib* OR auto-antib* OR immunoglob* OR IgG OR IgM OR IgA)”. Nine case reports with autoantibody-associated OCD/OCS were identified: five patients with anti-neuronal autoantibodies (against N-methyl-D-aspartate-receptor [NMDA-R], collapsin response mediator protein [CV2], paraneoplastic antigen Ma2 [Ma2], voltage gated potassium channel complex [VGKC], and “anti-brain” structures) and four with autoantibodies associated with systemic autoimmune diseases (two with Sjögren syndrome, one with neuropsychiatric lupus, and one with anti-phospholipid autoantibodies). Six patients (67%) benefited from immunotherapy. In addition, eleven cross-sectional studies (six with healthy controls, three with neurological/psychiatric patient controls, and two uncontrolled) were identified with inconsistent results, but in six studies an association between autoantibodies and OCD was suggested. In summary, the available case reports suggest an association between OCD and autoantibodies in rare cases, which has been supported by initial cross-sectional studies. However, scientific data is still very limited. Thus, further studies on autoantibodies investigated in patients with OCD compared with healthy controls are needed.

Clinicolaboratory characteristics of pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections: A cross-sectional study

“…When a true GABHS infection occurs, Anti Dnase B and ASO levels rise somewhat but stay below the upper limit of normal titers, which is overlooked in the absence of intentional monitoring. The opposite is also true: choosing an antibody titer that is too low can lead to unidentifiable discrepancies between PANDAS patients and healthy controls [34,35].…”

Exploring the role of interleukin-1β and interleukin-6 in the pathophysiology of obsessive-compulsive disorder

“…Obsessive-compulsive disorder (OCD) is a highly disabling neuropsychiatric disorder with a prevalence rate of 2-3% worldwide [1][2][3][4][5]. OCD is characterized by repetitive unwanted intrusive thoughts, sensations, feelings, impulses, or ideas (obsessions) that exaggerate concerns about danger, harm, or hygiene, followed by ritualized repeated behaviors or mental acts (compulsions) [2,6].…”

“…Recently, immune system alterations or dysfunctions have attracted growing interest among researchers as potential risk predictors or pathophysiological factors for OCD development [12][13][14][15][16][17]. The prevalence of co-morbidity with OCD is high for several disorders, including the presence of auto-antibodies against neuronal structures like basal ganglia structures [3,4]. The concentrations of pro-inflammatory cytokines in samples of peripheral and CNS were found to be significantly enhanced in OCD patients compared to healthy controls (HCs) [17][18][19][20][21][22][23][24].…”