About PANS Clinic & Research Program
The Stanford PANS Program was established in 2012 to provide a comprehensive program to orchestrate groundbreaking research while providing tailored care for patients and their families. The Stanford Immune Behavioral Health (formerly PANS) Clinic is the first multi-disciplinary PANS clinic in the world. The goal of our service and research is to identify infections and immune system abnormalities that may affect psychiatric symptoms.
Our Clinical Care Mission
To develop a diverse team of clinicians that can provide expertise for the many facets of this condition including experts in: autoimmunity (rheumatologists), immunodeficiency (immunologists), neurotransmitters (psychiatrists and neurologists), infectious diseases, nutrition, food intolerance, and psychology.
Our goal is to rapidly integrate research discoveries to improve treatment strategies.
The cornerstones of our treatment are based on understanding inflammatory contributions (infectious, autoimmune, and autoinflammatory), paliating the clinical condition as the brain heals, and integrating the most effective and expedient pathways to rehabilitate from these presumed inflammatory insults.
Our Research Mission
1. To identify molecular pathways and environmental triggers (including changes to the microbiome) in patients with PANS in order to develop therapeutics which could treat and prevent neuropsychiatric deteriorations.
2. To discover better diagnostic methods and biomarkers for recognizing PANS early, potentially before the first full episode.
3. To identify resilience and vulnerability factors and traits that are associated with PANS prognosis in order to develop interventions which enhance resilience pathways and down regulate vulnerability pathways.
To achieve these goals, we are particularly interested in investigating the role of infection in triggering/worsening the curse of PANS, how immunodeficiency and autoimmunity may be involved, and the role of vascular abnormalities and inflammation in the basal ganglia and other relevant brain areas.
We have seen over 300 patients in our clinic, and have found a variety of potential infectious and immune drivers. We have also uncovered a genetic association that strongly points to autoimmune/inflammatory disorder. Additionally, 5-10% of our patients are found to have an immunodeficiency, 16% have an autoimmune marker, and >30% are found to have a concurrent autoimmune or inflammatory disease. Further characterization of genetic risk factors and immune deviations are being explored through collaborations with leading geneticists and immunologists.
Clincal Trials and Research Activities
Our goal is to enroll our patients into our clinical database so that we can learn about distinct patient subgroups and use the clinical data to gather work-up treatments within each PANS subgroup.
We are attempting to collect patient specimen to discover biomarkers which can help us understand the root cause of patient disease in each subgroup. To this end, we are conducting next generation analysis on patients and their families, and we are also planning to analyze specimen for microbiome data including genome subtraction techniques to look at microorganism DNA.
See Research for more details.
In the next one to three years, we would like to expand our clincal team, expand our clinical database and biorepository, and seek funding for more in depth genetic analyses and immunological characterization.
We have also received funding to conduct NIH-sponsored trials using plasma pheresis in a supgroup of patients. Our goal is to eventually place every patient on an appropriate trial in their disease subtype so that we can rapidly advance discovery of successful therapeutics.
For additional information, we also recommend visiting the following websites, which may be helpful to children with PANS and their primary care provider. These websites have the most up-to-date information regarding PANS:
- National Institute of Mental Health (NIMH) PANS/PANDAS
- PANS/PANDAS Physicians Network (PPN)
- PANDAS Network