This page is a small collection of some of the research that helped me make sense of the complex puzzle of autoimmunity, neuroinflammation, and environmental triggers like mold and leaky gut.
They lay the groundwork for understanding not only the mechanisms behind PANS/PANDAS, but also why integrative approaches, like addressing gut health and environmental toxins, are more than just “alternative.”
This is just the start of my list, more to come…
Universities
PANS/PANDAS & Autoimmunity
Swedo SE, et al. (1998). Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 155(2):264–271. This foundational study by Dr. Susan Swedo formally introduced PANDAS and described the core clinical features in children following strep infection.
Chang K, Frankovich J, Cooperstock, et al. (2015) Clinical evaluation of youth with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): recommendations from the 2013 PANS Consensus Conference. J Child Adolesc Psychopharmacol. 25(1):3–13. A consensus paper developed by leading clinicians and researchers outlining how to evaluate a child with suspected PANS.
Cooperstock M, et al. (2017) Management of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Part II—Use of Immunomodulatory Therapies. J Child Adolesc Psychopharmacol. 27(7):574–593. Addresses immune-targeted therapies like IVIG, steroids, and plasmapheresis in the treatment of moderate to severe cases.
Cunningham MW. (2012). Molecular mimicry, autoimmunity, and infection: the cross-reactive antigens of group A streptococci and their sequelae. Microbiol Spectr. 1(1). Details how strep infections can trigger autoimmune responses, including against the basal ganglia — the core mechanism behind PANDAS.
Swedo SE, Leckman JF, Rose NR. (2012). From research subgroup to clinical syndrome: modifying the PANDAS criteria to describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatr Therapeut. Suppl 6. A landmark review explaining the expansion from PANDAS to PANS and the broadening of diagnostic understanding.
Leaky gut & Autoimmunity
Fasano, A. (2020) All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. Dr. Fasano’s groundbreaking research explains how intestinal permeability (leaky gut) plays a role in triggering autoimmune conditions. This has major implications for PANS/PANDAS, where immune dysfunction and chronic inflammation are central. His work connects environmental triggers, gut barrier dysfunction, and the onset of neurological symptoms — forming the scientific basis for gut healing protocols often used in holistic PANS/PANDAS treatment plans.
Mold & Mycotoxins
Shoemaker, R, et al. (2010) NeuroQuant and volumetric MRI findings in patients with chronic neurotoxic exposure. Health. 2(3): 256–261. Shoemaker’s work explores how environmental toxins — particularly from water-damaged buildings — can cause brain inflammation and immune dysregulation. Many children with PANS-like symptoms also meet criteria for CIRS, especially when mold is a known trigger.
Ratnaseelan, A, et al. (2018). Effects of Mycotoxins on Neuropsychiatric Symptoms and Immune Processes Clinical Therapeutics, Volume 40, Issue 6, Pages 903–917.This review explores how exposure to mycotoxins can affect the central nervous system and immune system, potentially leading to anxiety, depression, cognitive dysfunction, and neuroinflammation.
Kraft S., et al. (2021) Mold, Mycotoxins and a Dysregulated Immune System: A Combination of Concern? International Journal of Molecular Sciences Review. This comprehensive review outlines how mycotoxins can impair immune regulation, increase systemic inflammation, and contribute to the development or exacerbation of autoimmune conditions.