B-LYMPHOCYTE ANTIGEN D8 17 - A PERIPHERAL MARKER FOR CHILDHOOD-ONSET OBSESSIVE-COMPULSIVE DISORDER AND TOURETTES-SYNDROME/

Objective: It has been hypothesized that Sydenham's chorea, a major ma nifestation of rheumatic fever, may provide a medical model for obsess ive-compulsive disorder and associated conditions, such as Tourette's syndrome. Monoclonal antibody D8/17 identifies a B lymphocyte antigen with expanded expression in nearly all patients with rheumatic fever a nd is thought to be a trait marker for susceptibility to this complica tion of group A streptococcal infection. The authors investigated whet her D8/17 expression is greater than normal in some forms of obsessive -compulsive disorder and Tourette's syndrome. Method: By immunofluores cence techniques, 31 patients with childhood-onset obsessive-compulsiv e disorder and/or Tourette's syndrome or chronic tic disorder and 21 h ealthy comparison subjects were evaluated for percentage of D8/17-posi tive B cells. None had rheumatic fever or Sydenham's chorea. Levels of antineuronal antibodies and streptococcal antibodies were also determ ined. Results: The average percentage of B cells expressing the D8/17 antigen was significantly higher in the patients (mean=22%, SD=5%) tha n in the comparison subjects (mean=9%, SD=2%). When classified categor ically, all patients but only one comparison subject were D8/17 positi ve. No difference between groups in the presence of antineuronal antib odies or high streptococcal titers was found. Conclusions: Patients wi th childhood-onset obsessive-compulsive disorder or Tourette's syndrom e had significantly greater B cell D8/17 expression. than comparison s ubjects despite the absence of documented Sydenham's chorea or rheumat ic fever. These findings suggest that D8/17 may serve as a marker for susceptibility among some forms of childhood-onset obsessive-compulsiv e disorder and Tourette's syndrome, as well as rheumatic fever or Syde nham's chorea.