The Role of Immune-Inflammatory Factors in the Pathophysiology of Obsessive–Compulsive Disorder

The immune-inflammatory system plays a pivotal role in the pathophysiology of obsessive–compulsive disorder (OCD). The immune mechanisms of OCD may exhibit some consistency with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infectionsPediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), suggesting a potential causal relationship between autoimmune reactions, disrupted inflammatory pathways, and the manifestation of obsessive–compulsive symptoms. Furthermore, the immune-inflammatory system may exert diverse effects on the neurochemical processes of the gut-brain axisGut-brain axis, hypothalamic–pituitary–adrenal axisHypothalamic-pituitary-adrenal axis (HPA axis), and cortico-striato-thalamo-cortical circuitry (CSTC circuitry), significantly influencing the development of OCD. Anti-inflammatory drugs and other immune-modulating agents could emerge as prospective treatmentsTreatment for OCD. This review underscores the significance of considering the immune-inflammatory pathway as a key mechanism in understanding the etiology of OCD, while also emphasizing a comprehensive approach to the multifaceted nature of obsessive–compulsive symptoms.