Cannabinoid Therapies in PANDAS/PANS

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) describes a hypothesis that there exists a subset of children with rapid onset of obsessive-compulsive disorder (OCD) or tic disorders and these symptoms are caused by group A beta-hemolytic streptococcal (GABHS) infections.

Many genes involved in the mitochondrial ROS pathways have been implicated in PANS and PANDAS. Courtagen provides mtSEEK® mitochondrial  and nucSEEK® nuclear mitochondrial exome genetic testing. The below links tell the story of a patient with PANDAS.

The individual above is unrelated to LRRK2 but it provides an example of what a PANS patient experiences in the diagnostic odyssey.
This page will use this gene as an example as it is one of the most frequently mutated genes in PANDAS PANS population we sequence and a common theme is emerging which underscores ROS and inflammation. We must underscore that this association has NOT BEEN PUBLISHED and is still anecdotal and preliminary. Nonetheless, we have had several inquiries on the genetics of this disease and the trends we are seeing we believe should be public with appropriate caveats placed on their preliminary nature.

LRRK2 gene often mutated in PANDAS PANS

Papers describing this gene are listed below (some are behind paywalls).  LRRK2 is the most common gene mutated in Parkinsons. Most of these Parkinsons mutations are in a different region of the protein than what we find in PANDAS. The gene is unique in that it appears to have two peptides linked as one protein. Mutation in one domain may appear dominant while mutations in the other may appear haploinsufficient. The gene is involved in ROS management with host defense.

We do not make recommendations for treatment but we have seen a trend in Epilepsy and other neurological diseases where anti-oxidants like CBD or NAC are helpful for the disease. These are still in Phase 3 trials for Dravet syndrome and other forms of Epilepsy so these are again tentative links but there are publications in Epilepsy that now support the use of CBD in Epilepsy.

 Cannabidiol and NAC

PANS as a Mito Endocrine disorder