Tourette syndrome (TS) associated with PediatricA utoimmune Neuropsychiatric DisordersA ssociated with the Streptococcus (PANDAS) is a recently described entity. The authors have previously shown an association between tics and TS and the presence of antibodies to neuronal cells and their membranes. Also we have presented evidence of partial absorption of these antibodies by prior incubation of the sera with fractions derived from group A streptococcal (GAS) isolates obtained from the 6 of 8 subjects' own throats. The M-protein is a virulence factor on the surface of the GAS used for typing and vaccine development. Anti-M-5 antibodies have been shown to be cross-reactive with cardiac myosin as well as other cardiac epitopes. Two sera positive for antibodies to membranes of HTB-10 neuroblastoma cells were pre-absorbed with M-24, M-5, or M-6 wild type proteins (Courtesy of James Dale, U. of Tenn.) all of which are rheumatogenic. Both sera were from patients who met criteria for TS-PANDAS. On Western blots of SDS-Page gels, similar immunoreactive bands were observed at 68-67 KD, 57-54 KD,and 49-48 KD. One of the sera also had bands at 122 KD and 113 KD, which were conserved across all three M-types. The data further support the association between prior streptococcal infections and TS observed in some patients, with multiple antibodies cross reacting with brain as well as cardiac epitopes.
