Author(s)

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 D. Badgaiyan^14,15

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

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.

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

Blum, K. , Dennen, C. , Braverman, E. , Gupta, A. , Baron, D. , Downs, B. , Bagchi, D. , Thanos, P. , Pollock, M. , Khalsa, J. , Elman, I. , Bowirrat, A. and Badgaiyan, R. (2022) Hypothesizing That Pediatric Autoimmune Neuropsychiatric Associated Streptococcal (PANDAS) Causes Rapid Onset of Reward Deficiency Syndrome (RDS) Behaviors and May Require Induction of “Dopamine Homeostasis”. Open Journal of Immunology, 12, 65-75. doi: 10.4236/oji.2022.123004.