IL-17 in serum and cerebrospinal fluid of pediatric patients with acute neuropsychiatric disorders: Implications for PANDAS and PANS

• Published in: European journal of paediatric neurology Vol. 54; pp. 1 - 7
• Main Authors: Foiadelli, Thomas, Loddo, Nicolò, Sacchi, Lucia, Santi, Viola, D'Imporzano, Giulia, Spreafico, Eugenia, Orsini, Alessandro, Ferretti, Alessandro, De Amici, Mara, Testa, Giorgia, Marseglia, Gian Luigi, Savasta, Salvatore
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2025
• Subjects: Acute psychiatric disorder; Adolescent; Autoimmune Diseases - blood; Autoimmune Diseases - cerebrospinal fluid; Biomarkers - blood; Biomarkers - cerebrospinal fluid; Cerebral spinal fluid; Child; Child, Preschool; Female; Humans; Interleukin; Interleukin-17 - blood; Interleukin-17 - cerebrospinal fluid; Male; Obsessive-Compulsive Disorder - blood; Obsessive-Compulsive Disorder - cerebrospinal fluid; Pediatrics; Retrospective Studies; Streptococcal Infections - blood; Streptococcal Infections - cerebrospinal fluid; Streptococcal Infections - complications; Streptococcus; T-helper 17; Pediatrics; Acute psychiatric disorder; Streptococcus; T-helper 17; Interleukin; Cerebral spinal fluid
• ISSN: 1090-3798; 1532-2130; 1532-2130
• DOI: 10.1016/j.ejpn.2024.11.004

Acute neuropsychiatric disorders are heterogeneous conditions resulting from interaction between genetic and environmental features. Among these, post infectious forms like Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are common. Preclinical studies suggest a role of CNS T-helper-17/interleukin-17 (IL-17) inflammatory mediated response in the pathogenesis of these disorders. We analyze serum and cerebral-spinal fluid (CSF)-IL-17 concentrations in a cohort of patients with acute neuropsychiatric disease. We retrospectively included patients <14 years with acute neuropsychiatric symptoms from 2016 to 2020. IL-17 was determined on serum and CSF by means of quantitative sandwich enzyme immunoassay technique, and values were compared to serum and CSF controls. Variables were identified using univariate analysis with Pearson's regression test and X2 test. 58 subjects were included (67.8 % males, average age: 8.5 years). 50.8 % were classified as PANDAS, 11.8 % as PANS. Mean concentrations of serum IL-17 were higher in the study group compared to controls (p < 0.0001). We observe a trend of increasing IL-17 in post-pubertal children both on serum (p = 0.05) and on CSF (p = 0.04). Coupled IL-17 concentration were higher in the CSF than in serum (p = 0.003), with a marked significance in the PANDAS and PANS group (p < 0.001). IL-17 is elevated in children and adolescents with acute neuropsychiatric conditions, both on serum and CSF. IL-17 could be involved in the pathogenesis of acute neuropsychiatric disorders in childhood. Further studies are necessary to validate its potential role as a diagnostic or prognostic biomarker. •The role of neuroinflammation in Acute Neuropsychiatric Disorders is still unclear.•Serum IL-17 is higher in Acute Neuropsychiatric Disorders compared to controls.•IL-17 is higher in CSF than in serum in patients with PANDAS and PANS.•IL-17 might have a role in the pathogenesis of Acute Neuropsychiatric Disorders.