Oxidative stress and gut-derived lipopolysaccharides in children affected by Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

Abstract

Background: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to evaluate serum NOX2 levels, as well as 8-iso-prostaglandin F2α (iso-PGF2α) and lipopolysaccharide (LPS) of PANDAS patients. Methods: a cross sectional study was performed to compare serum levels of soluble NOX2-dp (sNOX-2-dp), isoprostanes and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used as intestinal permeability assay. Results: compared with CT, PANDAS children had increased values of sNOX-2-dp, 8-iso-PGF2-alpha and LPS. Simple linear regression analysis showed that sNOX2-dp was significantly correlated with serum LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and iso-PGF2α (Rs=0.704; p<0.001). Serum LPS significantly correlated with zonulin (Rs=0.610; p<0.001), and iso-PGF2α (Rs=0.591; p=0.001). Finally, a multiple linear regression analysis was performed to define the independent predictors of sNOX-2-dp. Serum isoprostanes and zonulin resulted as the only independent predictive variables associated with sNOX2-dp (R2=68%). Conclusion: this study shows that children affected by PANDAS have high circulating levels of sNOX2-dp, isoprostanes and of LPS that could be potentially implicated in the process of neuroinflammation.