Obsessive-Compulsive Disorder: Autoimmunity and Neuroinflammation

Abstract

Purpose of Review

Here, we propose to review the immuno-inflammatory hypothesis in OCD given the concurrent incidence of autoimmune comorbidities, infectious stigma, and raised levels of inflammatory markers in a significant subset of patients. A better understanding of the immune dysfunction in OCD may allow stratifying the patients in order to design personalized pharmaco/psychotherapeutic strategies.

Recent Findings

A persistent low-grade inflammation involving both innate and adaptive immune system with coexisting autoimmune morbidities and stigma of infectious events has been prominently observed in OCD. Hence, specific treatments targeting inflammation/infection are a feasible alternative in OCD.

Summary

This review highlights that OCD is associated with low-grade inflammation, neural antibodies, and neuro-inflammatory and auto-immune disorders. In some subset of OCD patients, autoimmunity is likely triggered by specific bacterial, viral, or parasitic agents with overlapping surface epitopes in CNS. Hence, subset-profiling in OCD is warranted to benefit from distinct immune-targeted treatment modalities.

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Acknowledgments

The editors would like to thank Dr. Leonardo Fontenelle for taking the time to review this manuscript.

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Correspondence to Nora Hamdani.

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Mona Gerentes, Krishnamoorthy Rajagopal, Ryad Tamouza, and Nora Hamdani each declare no potential conflicts of interest.

Antoine Pelissolo is a section editor for Current Psychiatry Reports.

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Gerentes, M., Pelissolo, A., Rajagopal, K. et al. Obsessive-Compulsive Disorder: Autoimmunity and Neuroinflammation. Curr Psychiatry Rep 21, 78 (2019). https://doi.org/10.1007/s11920-019-1062-8

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Keywords

  • Autoimmunity
  • Infections
  • Inflammation
  • OCD