Immunopathogenic Mechanisms in Tourette Syndrome: A Critical Review
Identifieur interne : 000408 ( Pmc/Checkpoint ); précédent : 000407; suivant : 000409Immunopathogenic Mechanisms in Tourette Syndrome: A Critical Review
Auteurs : Davide Martino [Italie] ; Russell C. Dale [Australie] ; Donald L. Gilbert [États-Unis] ; Gavin Giovannoni [Royaume-Uni] ; James F. Leckman [États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2009.
Abstract
Tourette syndrome (TS) has a multifactorial etiology, in which genetic, environmental, immunological and hormonal factors interact to establish vulnerability. This review: (i) summarizes research exploring the exposure of TS patients to immune-activating environmental factors, and (ii) focuses on recent findings supporting a role of the innate and adaptive immune systems in the pathogenesis of TS and related disorders. A higher exposure prior to disease onset to group A β-haemolytic streptococcal (GABHS) infections in children with tics and obsessive-compulsive (OC) symptoms has been documented, although their influence upon the course of disease remains uncertain. Increased activation of immune responses in TS is suggested by changes in gene expression profiles of peripheral immune cells, relative frequency of lymphocyte subpopulations, and synthesis of immune effector molecules. Increased activity of cell-mediated mechanisms is suggested by the increased expression of genes controlling natural killer and cytotoxic T cells, increased plasma levels of some pro-inflammatory cytokines which correlate with disease severity, and increased synthesis of antineuronal antibodies. Important methodological differences might account for some inconsistency among results of studies addressing autoantibodies in TS. Finally, a general predisposition to autoimmune responses in TS patients is indicated by the reduced frequency of regulatory T cells, which induce tolerance towards self-antigens. Although the pathogenic role of immune activation in TS has not been definitively proven, a pathophysiological model is proposed to explain the possible effect of immunity upon dopamine transmission regulation and the generation of tics.
Url:
DOI: 10.1002/mds.22504
PubMed: 19353683
PubMed Central: 3972005
Affiliations:
- Australie, Italie, Royaume-Uni, États-Unis
- Angleterre, Connecticut, Grand Londres, Ohio
- Londres, Sydney
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PMC:3972005Le document en format XML
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<front><div type="abstract" xml:lang="en"><p id="P1">Tourette syndrome (TS) has a multifactorial etiology, in which genetic, environmental, immunological and hormonal factors interact to establish vulnerability. This review: (i) summarizes research exploring the exposure of TS patients to immune-activating environmental factors, and (ii) focuses on recent findings supporting a role of the innate and adaptive immune systems in the pathogenesis of TS and related disorders. A higher exposure prior to disease onset to group A β-haemolytic streptococcal (GABHS) infections in children with tics and obsessive-compulsive (OC) symptoms has been documented, although their influence upon the course of disease remains uncertain. Increased activation of immune responses in TS is suggested by changes in gene expression profiles of peripheral immune cells, relative frequency of lymphocyte subpopulations, and synthesis of immune effector molecules. Increased activity of cell-mediated mechanisms is suggested by the increased expression of genes controlling natural killer and cytotoxic T cells, increased plasma levels of some pro-inflammatory cytokines which correlate with disease severity, and increased synthesis of antineuronal antibodies. Important methodological differences might account for some inconsistency among results of studies addressing autoantibodies in TS. Finally, a general predisposition to autoimmune responses in TS patients is indicated by the reduced frequency of regulatory T cells, which induce tolerance towards self-antigens. Although the pathogenic role of immune activation in TS has not been definitively proven, a pathophysiological model is proposed to explain the possible effect of immunity upon dopamine transmission regulation and the generation of tics.</p>
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<title-group><article-title>Immunopathogenic Mechanisms in Tourette Syndrome: A Critical Review</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Martino</surname>
<given-names>Davide</given-names>
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Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy</aff>
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Discipline of Paediatrics and Child Health, Children’s Hospital at Westmead, University of Sydney, Sydney, Australia</aff>
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Division of Neurology, Cincinnati Children’s Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio, USA</aff>
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Queen Mary University London, Neuroimmunology Unit, Neuroscience Centre, Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, London, United Kingdom</aff>
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Departments of Psychiatry, Pediatrics and Psychology, Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA</aff>
<author-notes><corresp id="FN1"><label>*</label>
Correspondence to: Dr. Davide Martino, Department of Neurological and Psychiatric Sciences, University of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy <email>davidemartino@virgilio.it</email>
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<permissions><copyright-statement>© 2009 Movement Disorder Society</copyright-statement>
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<abstract><p id="P1">Tourette syndrome (TS) has a multifactorial etiology, in which genetic, environmental, immunological and hormonal factors interact to establish vulnerability. This review: (i) summarizes research exploring the exposure of TS patients to immune-activating environmental factors, and (ii) focuses on recent findings supporting a role of the innate and adaptive immune systems in the pathogenesis of TS and related disorders. A higher exposure prior to disease onset to group A β-haemolytic streptococcal (GABHS) infections in children with tics and obsessive-compulsive (OC) symptoms has been documented, although their influence upon the course of disease remains uncertain. Increased activation of immune responses in TS is suggested by changes in gene expression profiles of peripheral immune cells, relative frequency of lymphocyte subpopulations, and synthesis of immune effector molecules. Increased activity of cell-mediated mechanisms is suggested by the increased expression of genes controlling natural killer and cytotoxic T cells, increased plasma levels of some pro-inflammatory cytokines which correlate with disease severity, and increased synthesis of antineuronal antibodies. Important methodological differences might account for some inconsistency among results of studies addressing autoantibodies in TS. Finally, a general predisposition to autoimmune responses in TS patients is indicated by the reduced frequency of regulatory T cells, which induce tolerance towards self-antigens. Although the pathogenic role of immune activation in TS has not been definitively proven, a pathophysiological model is proposed to explain the possible effect of immunity upon dopamine transmission regulation and the generation of tics.</p>
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