TITLE:
The First Pilot Epigenetic Type Improvement of Neuropsychiatric Symptoms in a Polymorphic Dopamine D2 (-DRD2/ANKK (Taq1A)), OPRM1 (A/G), DRD3 (C/T), and MAOA (4R) Compromised Preadolescence Male with Putative PANDAS/CANS: Positive Clinical Outcome with Precision-Guided DNA Testing and Pro-Dopamine Regulation (KB220) and Antibacterial Therapies
AUTHORS:
Kenneth Blum, Igor Elman, David Han, Colin Hanna, David Baron, Ashim Gupta, Shan Kazmi, Jag Khalsa, Debasis Bagchi, Thomas McLaughlin, Rajendra D. Badgaiyan, Edward J. Modestino, Drew Edwards, Catherine A. Dennen, Eric R. Braverman, Abdalla Bowirrat, Keerthy Sunder, Kevin Murphy, Nicole Jafari, Foojan Zeine, Paul R. Carney, Mark S. Gold, Kai-Uwe Lewandowski, Alireza Sharafshah, Aryeh R. Pollack, Panayotis K. Thanos
KEYWORDS:
PANDAS, CANS, Genetic Addiction Risk Testing (GARS), Pro-Dopamine Regulation, Hypodopaminergia, Polymorphisms, Antibacterial Therapy, Infections
JOURNAL NAME:
Open Journal of Immunology,
Vol.14 No.3,
September
27,
2024
ABSTRACT: Pediatric autoimmune neuropsychiatric disorders associated with or without streptococcal and other bacterial infections (PANDAS/CANS) are emerging as a featured pediatric disorder. Although there is some controversy regarding treatment approaches, especially related to the behavioral sequelae, we have hypothesized in other published work that it is characterized by the rapid onset of Reward Deficiency Syndrome (RDS) in children. We propose utilizing a multi-systems biological approach involving the coupling of genetic addiction risk testing and pro-dopamine regulation (KB220/POLYGEN®) to help induce “dopamine homeostasis” in patients with PANDAS, especially those with known DNA-induced hypodopaminergia. This case study examines a 12-year-old Caucasian male with no prior psychiatric issues who presented with a sudden onset of severe anxiety, depression, emotional liability, and suicidal ideation. The patient underwent genotyping and the genetic addiction risk score (GARS) testing, which revealed risk polymorphisms in the dopamine D2 (-DRD2/ANKK (Taq1A), OPRM1 (A/G), DRD3 (C/T), and MAOA (4R) genes. These polymorphisms have been linked to hypodopaminergia. The patient was subsequently placed on research ID-KB220ZPBMPOLY (POLYGEN®), and albeit the possibility of bias, based upon self and parental assessment, a marked rapid improvement in psychiatric symptoms was observed. In the second phase of treatment (102 days utilizing KB220), the patient received standard antibody testing, which was positive for Lyme. Antibacterial therapy started immediately, and KB220z was discontinued to provide a wash-out period. A monotonic trend analysis was performed on each outcome measure, and a consistently decreasing trend was observed utilizing antibacterial therapy. Our recommendation, albeit only one case, is to utilize and further research a combined therapeutic approach, involving precision-guided DNA testing and pro-dopamine regulation along with antibacterial therapy, as well as glutathione to address offensive enhanced cytokines, in patients with suspected PANDAS/CANS.