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

• Published in: Journal of neuroimmune pharmacology Vol. 9; no. 5; pp. 606 - 614
• Main Authors: Pozzi, Marco, Pellegrino, Paolo, Carnovale, Carla, Perrone, Valentina, Antoniazzi, Stefania, Perrotta, Cristiana, Radice, Sonia, Clementi, Emilio
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.12.2014; Springer Nature B.V
• Subjects: Antistreptolysin - blood; Antistreptolysin - immunology; Autoimmunity - physiology; Biomedical and Life Sciences; Biomedicine; Case-Control Studies; Cell Biology; Humans; Immunology; Invited Review; Meta-analysis; Neurosciences; Neuroses; Obsessive compulsive disorder; Obsessive-Compulsive Disorder - blood; Obsessive-Compulsive Disorder - immunology; Pharmacology/Toxicology; Streptococcus; Tic Disorders - blood; Tic Disorders - immunology; Virology; Anti-streptolysin O titre; Tourette’s syndrome; tic disorders; PANDAS; Obsessive-compulsive disorders; Group A β–haemolytic streptococci
• ISSN: 1557-1890; 1557-1904; 1557-1904
• DOI: 10.1007/s11481-014-9561-1

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.