Cunningham Panel™ – Results
The Cunningham Panel™ is a blood test which assists physicians in determining whether a patient’s neuropsychiatric symptoms may be due to an autoimmune dysfunction. The panel includes 5 tests which are described in the video below.
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Hello, my name is Amy Cross and I am a nurse with Moleculera Labs. We put this short video together to help answer some important questions about the Cunningham Panel™. This video takes about 5 minutes to review. I hope it will be helpful to you. Moleculera Labs is an accredited clinical laboratory that performs a blood test called the Cunningham Panel™ which is an aid for doctors to help determine if a patient has an autoimmune-based neuropsychiatric disorder. An autoimmune disorder occurs when the body’s immune system loses its ability to tell the difference between “itself” and “foreign invaders” such as bacteria and viruses. When someone becomes ill from an infection, the immune system produces “antibodies” which circulate through the body searching for and removing the foreign invaders, returning the person to good health. In disorders such as PANDAS, PANS and other autoimmune encephalopathies, this process goes awry as the antibodies become autoantibodies and begin to attack healthy tissue in the brain which in some way resembles the germ it is supposed to be eliminating. A patient’s immune system “turns against itself” which is why these disorders are referred to as autoimmune.
The Cunningham Panel™ is a metabolic “point in time” blood test that shows what is going on in the body at the time the blood is drawn. A person’s Cunningham Panel™ results can, and do change, over time. Please don’t compare your, or your child’s, Cunningham Panel™ report to anyone else’s report. There are many variables to be considered which is why we follow up with prescribing clinicians to assist them with questions on the Cunningham Panel™ results. A person’s clinical symptoms and their health history must be taken into consideration.
Here is a copy of the panel results. There are 5 individual tests performed in this panel.
The Dopamine D1 and D2 receptors are used to determine if autoimmune antibodies are present at high enough levels to interfere with this receptor. The dopamine D1 and D2 receptors are widely distributed in the brain and central nervous system. They mediate the effect of the neurotransmitter, dopamine on cognition, emotion, motor activity and other functions. Although not in all cases, in our experience, antibody elevations to Dopamine D1 may be associated with psychiatric symptoms such as depression, anxiety, mood swings, irritability, rage, delusional thinking and possibly psychosis. Although not in all cases, in our experience, antibody elevations to Dopamine D2 may be associated with choreiform movements, sometimes a diagnosis of ADHD, or impulsivity and self-injurious behaviors.
The Lysoganglioside GM1 is a molecule we use to determine if autoimmune antibodies are present at high enough levels to interfere with its function. Lysogangliosides are abundant in motor neurons in the body and in the brain, and help protect nerve cells. Although not in all cases, in our experience, antibody elevations against lysoganglioside GM1 may be associated with motor or vocal tics. Clinicians have reported that when lysoganglioside is the only elevation on a panel, tics are more likely to be present and abundant.
The Tubulin protein is used to determine if autoimmune antibodies are present at high enough levels to interfere with its function. Tubulin is a protein that is contained on the inside of cells. It acts like internal scaffolding giving cells their shape, and is highly abundant in brain tissue. Although not in all cases, in our experience, antibody elevations against tubulin may be associated with symptoms of OCD and “brain fog” such as difficulty attending and following serial commands, confusion, irritability, memory impairment and low energy. OCD symptoms may include frightening or disturbing thoughts, rituals/repetitive movements, and fears of food contamination, vomiting or choking.
The CaM Kinase (calcium/calmodulin-dependent protein kinase II) is used to determine if autoimmune antibodies are present at high enough levels to stimulate this enzyme. One of the functions of the CaMKII enzyme is to upregulate the production of the neurotransmitters dopamine, epinephrine and norepinephrine. Although not in all cases, in our experience, antibody elevations that stimulate the CaMKII enzyme may be associated with sensory disturbances, problems with sleep, mood control, anxiety and “fight or flight” behavior. In our experience we have observed that the CaM KII is likely to be high/elevated during the early stages of an illness and may be the only elevation seen in the beginning. In our experience, over time the CaMKII seems to gradually shift toward the normal level with the possibility that antibody titers against one or more of the other tests begin to rise.
It is important to know that the elevations on the Cunningham Panel™ are not a good indicator of the severity of a person’s symptoms. Very modest elevations may be seen in patients who have severe symptoms, and high elevations may be seen in patients who have symptoms, but appear to be managing fairly well. Our studies do show that as patients recover, their Cunningham Panel™ results return to normal or nearly normal levels and, that during flares or relapses, results tend to again become elevated.
Here are some things that the Cunningham Panel™ does not do. It does not identify any specific cause of symptoms such as a bacteria, virus or fungus. When autoantibody titers are borderline or normal, it does not indicate that a patients symptoms are not autoimmune in nature. As we continue research in this field, there is the possibility that we may identify other receptors that are not yet included in our panel.
While this video is intended to help you understand the biology of the Cunningham Panel™, please do not conclude that if any test is positive that you or your child have these disorders or symptoms. It is very important that your doctor interpret these results as it will be examined in the context of many other factors. The Cunningham Panel™ is intended as an aid to your physician in determining a correct diagnosis. In our experience, patients who are correctly diagnosed and receive proper treatment do improve. If your physician is not a routine Cunningham Panel™ prescriber, please encourage him or her to call us for interpretation guidance.
We thank you for your interest in learning more about the biology behind the Cunningham Panel™. I hope that you found this video to be helpful and informative.