Untangling PANDAS & PANS: Conversations about Infection-Associated, Immune-Mediated Neuropsychiatric Disorders
Hello and welcome to Untangling PANDAS & PANS, a podcast about two relatively unknown medical disorders characterized by the sudden and dramatic onset of obsessions and compulsions, vocal or motor tics, or restricted eating behavior -- and a whole host of other symptoms -- following strep or other bacterial or viral infection. Sometimes overnight. I have the privilege of interviewing some of the top researchers and clinicians in the rapidly growing field of Infection-Associated, Immune-Mediated Neuropsychiatric Disorders. That’s a mouthful of words that encompasses the strangely named disorders, PANDAS and PANS.
My name is Dr. Susan Manfull. I am a social psychologist, the Executive Director of The Alex Manfull Fund, and the mother of Alex Manfull, who died at 26 years old due to PANDAS, a neuropsychiatric disorder my husband and I knew next to nothing about, certainly not that our daughter could die from it.
PANDAS is an acronym for “Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus.” This disorder, first defined in 1998 at the National Institute of Mental Health, describes the acute and dramatic onset of obsessions and compulsions and/or motor or vocal tics as well as a whole host of neuropsychiatric symptoms in temporal association to a Group A streptococcal infection. PANS, which stands for Pediatric Acute-onset Neuropsychiatric Syndrome, refers to a similar symptom presentation -- with obsessions and compulsions or restricted eating being the cardinal symptoms -- due to a broader category of triggers (typically bacterial or viral infections). Both are thought to stem from a dysregulated immune system, probably leading to an over-production of autoantibodies and concomitant excess brain inflammation, particularly in the basal ganglia.
Symptoms vary from person to person and range in severity from mild to severe, and generally have a relapsing and remitting course. With early recognition and correct treatment, these disorders can be successfully treated. Today, it is no longer viewed as a diagnosis limited to the pediatric population.
Please stay tuned after each episode to listen to a one-minute public service announcement about PANDAS & PANS and The Alex Manfull Fund. To learn more, please visit our website: TheAlexManfullFund.org.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.
Untangling PANDAS & PANS: Conversations about Infection-Associated, Immune-Mediated Neuropsychiatric Disorders
S3 E21: My Eclectic Conversation with Fulvio D'Acquisto, PhD: From Carl Rogers to Immuno-Moodulin
What if sudden OCD, tics, and food restriction after an infection aren’t “all in the head,” but start with immune cells carrying a biochemical message to the brain? We sit down with Dr. Fulvio d'Acquisto—immunologist, psychotherapist, and founder of affective immunology—to trace the language between emotions, living conditions, and the immune system, and why that conversation can erupt into neuropsychiatric symptoms in PANDAS and PANS.
Fulvio introduces Immuno-moodulin (iMood), a small protein produced by T cells, found in higher levels in people with OCD and elevated in PANDAS/PANS. He explains how iMood behaves like an intrinsically disordered protein: it can cluster in blood, cross into the brain, and temporarily disrupt neural communication—then disassemble as triggers fade. That dynamic process mirrors real life: flares during infections, relief during remission, and stubborn persistence in complex cases. We unpack why peripheral therapies—antibiotics, IVIG, and plasmapheresis—can reshape central symptoms, and why response varies based on disease staging rather than a one-size-fits-all pathway.
We also explore the bigger map: proteomics that can distinguish PANDAS from controls with striking accuracy, autoimmune conditions that cluster with specific psychiatric diagnoses, and a cautionary tale where “schizophrenia” resolved after immune therapy revealed underlying lupus. Along the way, Fulvio reframes inflammation as a repair system gone repetitive, not an enemy to be extinguished at all costs. And beyond the lab, we talk belonging—how shared meals, genuine dialogue, and community aren’t soft add-ons but active inputs that steady immunity and help people reclaim identity, empathy, and meaning.
If you’re curious about immune-brain crosstalk, novel protein targets, and why conversation can be medicine, this deep dive offers science you can hold and stories you’ll remember. Subscribe, share with someone who needs hope, and leave a review to help more families and clinicians find this work.
Disclaimer: The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the views or positions of any entities they represent.
Credits: Music by Kingsley Durant from his "Convertible" album
To learn more about PANDAS and PANS and The Alex Manfull Fund, visit our website: TheAlexManfullFund.org
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