pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to evaluate serum NOX2 levels, as well as 8-iso-prostaglandin F2α (iso-PGF2α) and lipopolysaccharide (LPS) of PANDAS patients. Methods: a cross sectional study was performed to compare serum levels of soluble NOX2dp (sNOX-2-dp), isoprostanes and LPS in 60 consecutive subjects,

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... luding 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used as intestinal permeability assay. Results: compared with CT, PANDAS children had increased values of sNOX-2-dp, 8-iso-PGF2-alpha and LPS. Simple linear regression analysis showed that sNOX2-dp was significantly correlated with serum LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and iso-PGF2α (Rs=0.704; p<0.001). Serum LPS significantly correlated with zonulin (Rs=0.610; p<0.001), and iso-PGF2α (Rs=0.591; p=0.001). Finally, a multiple linear regression analysis was performed to define the independent predictors of sNOX-2-dp. Serum isoprostanes and zonulin resulted as the only independent predictive variables associated with sNOX2-dp (R2=68%). Conclusion: this study shows that children affected by PANDAS have high circulating levels of sNOX2-dp, isoprostanes and of LPS that could be potentially implicated in the process of neuroinflammation. Background Paediatric acute-onset neuropsychiatric syndrome (PANS) is defined as a wide spectrum of disorders characterised by sudden onset of obsessive-compulsive disorder (OCD) or severely restricted food intake in children [1] [2] [3] . A particular subtype of PANS is considered