Immunological alterations in adult obsessive-compulsive disorder

Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Italy.
Biological Psychiatry (Impact Factor: 10.26). 10/1999; 46(6):810-4. DOI: 10.1016/S0006-3223(98)00371-0
Source: PubMed


Some recent findings suggest the involvement of autoimmune mechanisms in childhood onset of obsessive-compulsive disorder (OCD), on the basis of a parallel drawn with Sydenham's chorea, a manifestation of rheumatic fever. A monoclonal antibody called D8/D17 characterizing a B-lymphocyte antigen, present in almost all patients with rheumatic fever, has been found also in children affected by OCD, Tourette syndrome, and chronic tics to a greater degree than in healthy control subjects. The few observations of disturbances of some immunologic parameters in adult OCD patients, prompted the authors to investigate and compare subsets of peripheral immunological cells for differences in adult patients with OCD and healthy control subjects.
Twenty patients suffering from OCD, with no comorbidity for other psychiatric disorders, were compared with a similar group of healthy control subjects. The immune subsets were measured by flow cytometry.
The CD8+ lymphocytes were significantly increased and CD4+ lymphocytes significantly decreased in OCD patients, while the other cells did not differ between the two groups. No correlation was found between immunologic and clinical parameters.
These data indicate that patients with adult OCD showed increased CD8+, i.e., suppressor T lymphocytes, and decreased CD4+, which identify helper T lymphocytes, as compared with a similar group of healthy control subjects. The findings appear peculiar to patients with OCD and are suggestive of an immunologic imbalance, which might be related to the stress deriving from the frustrating situation determined by the disorder itself.

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    • "Despite the strong association between OCD and neuroinflammation, only few studies have examined cytokine abnormalities in OCD. However, findings from these studies are inconsistent; while few studies reported altered levels of cytokines (Brambilla et al., 1997; Denys et al., 2004; Fluitman et al., 2010; Konuk et al., 2007; Monteleone et al., 1998) others reported absence of difference compared to controls (Maes et al., 1994; Weizman et al., 1996; Marazziti et al., 1999; Carpenter et al., 2002). A meta-analysis of proinflammatory cytokines in OCD identified confounding effect of medication and comorbid depression on cytokine levels and recommended future studies examining immune abnormalities in OCD should control for these confounding factors (Gray and Bloch, 2012); elevated cytokine levels are "
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    ABSTRACT: Growing evidence in the last decade suggest significant role of immune alterations in the pathogenesis of obsessive-compulsive disorder (OCD). Cytokines, mediators of inflammation, alter the neurotransmitter concentration and result in a hyposerotonergic and hyperglutamatergic state implicated in pathogenesis of OCD. However, only few studies have examined cytokine abnormalities in OCD with inconsistent results possibly due to confounding effects of medications and comorbid anxiety-depression. We examined 20 comorbidity free, drug free OCD patients and 20 age and sex matched healthy controls. Clinical severity was assessed using Yale Brown Obsessive Compulsive Scale, Hamilton anxiety rating scale, Hamilton depression rating scale and Clinical Global Impression. Levels of different cytokines, Interleukin (IL)-2, IL-4, IL-6, IL-10, Tumor necrosis factor (TNF)-α and Interferon (IFN)-γ were assessed using Cytometric Bead Array. OCD patients had significantly greater plasma levels of IL-2, IL-4, IL-6, IL-10 and TNF-α levels than controls but not IFN-γ. Reanalysis of data with only drug naïve patients (excluding 4 drug free patients) did not alter the results. Presence of these abnormalities in drug-naïve patients suggests the possible role of cytokines in the pathogenesis of OCD. Study findings have potential clinical utility in development of novel therapeutic options targeting cytokine aberrations in OCD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    07/2015; 229(3). DOI:10.1016/j.psychres.2015.07.009
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    • "Findings on immunological alterations in adult OCD are even more limited and scattered although this condition, when compared with other anxiety or mood disorders, seems to be characterised by an increased rate of recurrent infections and other diseases suggestive of impaired immune functioning (Dinn, et al., 2001). Previously, a significant increase of CD8 + and a significant decrease of CD4 + lymphocytes have been observed in patients with OCD when compared with healthy control subjects (Marazziti, et al., 1999). Moreover, patients with OCD showed altered levels of IL-1 β and TNF-α, as well as a relationship between IL-6 levels or receptors and the severity of the disorder (Brambilla, et al., 1997). "
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    ABSTRACT: Recent data have shown the presence of immunological alterations in adult patients suffering from obsessive-compulsive disorder (OCD). The objective of this study was to examine the possible effects of 12 months of treatment with different serotonergic drugs, such as clomipramine and selective serotonin reuptake inhibitors (SSRIs) on peripheral immunological cells of 18 OCD patients. Both the absolute number and percent of CD4+, CD8+, CD3+, CD19+ and CD56+ cells were measured in peripheral blood before and after treatment by means of a Facstar Flow Sorter apparatus. At baseline, all patients showed a significant increase of CD8+ and decrease of CD4+ lymphocytes when compared with a similar group of healthy control subjects; after the treatment, CD8+ and CD4+ cells, respectively, decreased and increased significantly, and the CD4+/CD8+ ratio increased, when compared with baseline values, in parallel with the clinical improvement. These data suggest that the alterations of immune cells reported in patients with OCD at baseline may be reverted by treatment with SRIs and should be considered a state-dependent marker, perhaps related to a condition of stress.
    Journal of Psychopharmacology 09/2008; 23(5):567-73. DOI:10.1177/0269881108089605 · 3.59 Impact Factor
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    • "Similarly, Tourette syndrome and related disorders have been associated with immune imbalances [18] [44] [64] [65] [66] suggesting an immune component in the etiology of Tourette syndrome. Antibodies have been found in Tourette syndrome patients to phospholipids [67], putamen [68], and other neural and brain epitopes [69]. "

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