三个慢性强迫症病例报告说,在治疗rituximab后,健康和功能得到改善
Maike Gallwitz1, Isa Lindqvist1, Jan Mulder2
1Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden.
Molecular psychiatry
|September 20, 2024
概括
自身免疫性强迫症 (OCD) 可能对rituximab治疗有反应. 三名患有重症,耐治疗的强迫症患者在接受这种免疫疗法后,在2.5年内表现出持续的症状和功能改善.
科学领域:
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
- 精神病学是一个精神病学.
背景情况:
- 强迫症 (OCD) 病例的一个子组可能具有免疫病因,称为自身免疫性强迫症.
- 了解这些复杂病例的临床过程和治疗反应对于推进治疗策略至关重要.
研究的目的:
- 详细介绍三名患有潜在自身免疫性强迫症的重病患者的纵向临床过程.
- 评估在治疗耐药性强迫症病例中非标签式rituximab治疗的有效性和可行性.
主要方法:
- 三名患有严重强迫症和疑似免疫干扰的患者每六个月接受一次Rituximab输液.
- 临床结果使用简要精神病学评分尺度和耶鲁-布朗强迫症库存尺度进行评估.
- 脑脊液 (CSF) 的分析包括针对抗体的间接免疫组织化学和针对生物标志物的探索性蛋白质组学.
主要成果:
- 这三名患者在症状负担 (67-100%的减轻) 和功能 (44-92%的减轻) 显著和持续改善超过2.5年.
- 患者在CSF中表现出新的抗神经元抗体,以及高水平的sCD27和补充通路激活标记物.
- 之前的治疗方法包括抗抑郁药,抗焦虑药,神经敏药和CBT是无效的.
结论:
- 瑞图西马布治疗在精神病学环境中对某些自身免疫性强迫症患者是可行的和有效的.
- 临床表型和CSF生物标志物可以预测慢性,耐治疗的强迫症中rituximab的反应.
- 这些病例历史支持自免疫性强迫症的建议标准,并为未来的治疗试验设计提供信息.
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