. 2022 Sep;12(3):65-75.

doi: 10.4236/oji.2022.123004.

Hypothesizing That Pediatric Autoimmune Neuropsychiatric Associated Streptococcal (PANDAS) Causes Rapid Onset of Reward Deficiency Syndrome (RDS) Behaviors and May Require Induction of "Dopamine Homeostasis"

Kenneth Blum^{1

2

3

4

5

6

7}, Catherine A Dennen⁸, Eric R Braverman², Ashim Gupta⁹, David Baron¹, Bernard William Downs⁶, Debasis Bagchi^{6

10}, Panayotis Thanos¹¹, Maureen Pollock², Jag Khalsa¹², Igor Elman¹³, Abdalla Bowirrat⁷, Rajendra A Badgaiyan^{14

15}

Affiliations

¹ Center for Mental Health and Sports, Psychiatry, Western University Health Sciences, Pomona, USA.
² The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, USA.
³ Department Psychiatry, Boonshoff School of Medicine, Wright University, Dayton, USA.
⁴ Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
⁵ Department of Psychiatry, School of Medicine, University of Vermont, Burlington, USA.
⁶ Division of Nutrigenomics, Victory Nutrition International Inc., Bonita Springs, USA.
⁷ Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, Israel.
⁸ Department of Family Medicine, Jefferson Health Northeast, Philadelphia, USA.
⁹ Future Biologics, Lawrenceville, USA.
¹⁰ Department of Pharmaceutical Sciences, Texas Southern University, Houston, USA.
¹¹ Department of Psychology & Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, University at Buffalo, Buffalo, USA.
¹² Department of Microbiology, Immunology, and Tropical Medicine, School of Medicine, George Washington University, Washington DC, USA.
¹³ Cambridge Health Alliance, Harvard Medical School, Cambridge, USA.
¹⁴ Department of Psychiatry, Ichan School of Medicine at Mount Sinai, New York, USA.
¹⁵ Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Health Science Center, San Antonio, USA.

PMID: 36407790
PMCID: PMC9670240
DOI: 10.4236/oji.2022.123004

Hypothesizing That Pediatric Autoimmune Neuropsychiatric Associated Streptococcal (PANDAS) Causes Rapid Onset of Reward Deficiency Syndrome (RDS) Behaviors and May Require Induction of "Dopamine Homeostasis"

Kenneth Blum et al. Open J Immunol. 2022 Sep.

. 2022 Sep;12(3):65-75.

doi: 10.4236/oji.2022.123004.

Authors

Affiliations

¹ Center for Mental Health and Sports, Psychiatry, Western University Health Sciences, Pomona, USA.
² The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, USA.
³ Department Psychiatry, Boonshoff School of Medicine, Wright University, Dayton, USA.
⁴ Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
⁵ Department of Psychiatry, School of Medicine, University of Vermont, Burlington, USA.
⁶ Division of Nutrigenomics, Victory Nutrition International Inc., Bonita Springs, USA.
⁷ Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, Israel.
⁸ Department of Family Medicine, Jefferson Health Northeast, Philadelphia, USA.
⁹ Future Biologics, Lawrenceville, USA.
¹⁰ Department of Pharmaceutical Sciences, Texas Southern University, Houston, USA.
¹¹ Department of Psychology & Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, University at Buffalo, Buffalo, USA.
¹² Department of Microbiology, Immunology, and Tropical Medicine, School of Medicine, George Washington University, Washington DC, USA.
¹³ Cambridge Health Alliance, Harvard Medical School, Cambridge, USA.
¹⁴ Department of Psychiatry, Ichan School of Medicine at Mount Sinai, New York, USA.
¹⁵ Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Health Science Center, San Antonio, USA.

PMID: 36407790
PMCID: PMC9670240
DOI: 10.4236/oji.2022.123004

Abstract

Pediatric autoimmune neuropsychiatric disorders associated with group A streptococcal infections (PANDAS) is a concept that is used to characterize a subset of children with neuropsychiatric symptoms, tic disorders, or obsessive-compulsive disorder (OCD), whose symptoms are exacerbated by group A streptococcal (GAS) infection. PANDAS has been known to cause a sudden onset of reward deficiency syndrome (RDS). RDS includes multiple disorders that are characterized by dopaminergic signaling dysfunction in the brain reward cascade (BRC), which may result in addiction, depression, avoidant behaviors, anxiety, tic disorders, and/or OCD. According to research by Blum et al., the dopamine receptor D2 (DRD2) gene polymorphisms are important prevalent genetic determinants of RDS. The literature demonstrates that infections like Borrelia and Lyme, as well as other infections like group A beta-hemolytic streptococcal (GABHS), can cause an autoimmune reaction and associated antibodies target dopaminergic loci in the mesolimbic region of the brain, which interferes with brain function and potentially causes RDS-like symptoms/behaviors. The treatment of PANDAS remains controversial, especially since there have been limited efficacy studies to date. We propose an innovative potential treatment for PANDAS based on previous clinical trials using a pro-dopamine regulator known as KB220 variants. Our ongoing research suggests that achieving "dopamine homeostasis" by precision-guided DNA testing and pro-dopamine modulation could result in improved therapeutic outcomes.

Keywords: Borrelia; CANS; Dopamine Homeostasis; Group A Beta-Hemolytic Streptococcal (GABHS); Lyme; Molecular Mimicry; PANDAS; Pro-Dopamine Regulation; Reward Deficiency Syndrome.

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Conflict of interest statement

Conflicts of Interest The authors declare no conflicts of interest regarding the publication of this paper.

Figures

**Figure 1.**
Hypothesizing that Pediatric Autoimmune Neuropsychiatric Associated Streptococcal (PANDAS) Causes Rapid Onset of (RDS) Behaviors and May Require Induction of “Dopamine Homeostasis”.

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Hypothesizing That Pediatric Autoimmune Neuropsychiatric Associated Streptococcal (PANDAS) Causes Rapid Onset of Reward Deficiency Syndrome (RDS) Behaviors and May Require Induction of "Dopamine Homeostasis"

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Hypothesizing That Pediatric Autoimmune Neuropsychiatric Associated Streptococcal (PANDAS) Causes Rapid Onset of Reward Deficiency Syndrome (RDS) Behaviors and May Require Induction of "Dopamine Homeostasis"

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