On the Connection Between Autoimmunity, tic Disorders and Obsessive-Compulsive Disorders: A Meta-Analysis on Anti-Streptolysin O Titres

Marco Pozzi, Paolo Pellegrino, Carla Carnovale, Valentina Perrone, Stefania Antoniazzi, Cristiana Perrotta, Sonia Radice, Emilio Clementi

Research output: Contribution to journalArticlepeer-review

Abstract

Anti-streptolysin O (ASO) titration is useful in the context of autoimmune pathologies, including specific cases of tic and obsessive-compulsive disorders occurring after streptococcal infections. There is currently a lack of consensus on the use of ASO titres; therefore we performed a meta-analysis to systematise available data and clarify the role of ASO titres in the context of neuropsychiatric disorders. A meta-analysis was performed on ASO titration in neuropsychiatric patients, including tic disorders and obsessive-compulsive disorders. Included studies reported numbers of positive subjects, depending on a chosen threshold, or detailed ASO titrations. Three hundred and twenty nine studies were identified, of which 13 were eligible for meta-analysis. Due to limited available data, only tic disorders were evaluated. The odds ratio of finding an abnormal ASO titre in patients was 3.22 (95 % C.I. 1.51–6.88) as compared to healthy controls and 16.14 (95 % C.I. 8.11–32.11) as compared to non-psychiatric patients. Studies using different thresholds were generally concordant. ASO titres were also compared quantitatively, finding an overall difference of the means of 70.50 U/ml (95 % C.I. 25.21–115.80) in favour of patients with tic disorders. Based on current evidence, tic disorders are associated with a significant increase in ASO titres, evident both in a threshold-level perspective and on a quantitative level. These results encourage the systematisation of ASO titration in the context of tic disorders.

Original languageEnglish
Pages (from-to)606-614
Number of pages9
JournalJournal of NeuroImmune Pharmacology
Volume9
Issue number5
DOIs
Publication statusPublished - Oct 24 2014

Keywords

  • Anti-streptolysin O titre
  • Group A β–haemolytic streptococci
  • Obsessive-compulsive disorders
  • PANDAS
  • tic disorders
  • Tourette’s syndrome

ASJC Scopus subject areas

  • Pharmacology
  • Immunology and Allergy
  • Immunology
  • Neuroscience (miscellaneous)
  • Medicine(all)

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