Re: [NVIC] Study Suggests Autism is Autoimmune

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> >From UniSci.com

>

> http://unisci.com/stories/20022/0430023.htm

> Bowel Finding Suggests Autism Is Autoimmune Disorder

>

> Researchers from England have shown that unexpected bowel abnormalities in

> children with regressive autism may have a basis in autoimmunity.

> The authors used a panel of monoclonal antibodies to study small bowel

> biopsies from children with autism in comparison to unaffected children with

> other diseases.

>

> The abnormalities were distinct from previously reported conditions,

> pointing to the gut epithelium as a target of a specific immune response.

>

> This finding suggests that autism may be an autoimmune disorder.

>

> The work was performed by researchers at the Centre for Paediatric

> Gastroenterology, with the Inflammatory Bowel Disease Study Group, Royal

> Free & University College Medical School, London, UK; The IBD Research Unit,

> St. Mark's Hospital, Harrow, London, UK; Department of Medicine, Royal Free

> and University College Medical School, London, UK; Department of

> Histopathology, Royal Free and University College Medical School, London,

> UK.

>

> It remains unclear whether autism is a single disease or a condition

> occurring as an end result of various abnormalities. Fundamental uncertainty

> remains about the relative input of genetic predisposition and environmental

> exposures.

>

> Central to this uncertainty is the conflicting evidence concerning the

> incidence of autism. While there are several reports of rapid increase in

> incidence in Western countries -- suggesting an important environmental

> component -- others suggest that the increase is more apparent than real,

> and dependent on increased recognition, thus favoring a primarily genetic

> predisposition.

>

> Most research has focused on the genetics of autism, and several genes have

> been implicated in classic autism.

>

> This study is based on children with a form of autism characterized by

> regression in the second year of life, after apparently normal early

> development.

>

> Most reports of immunological abnormalities in autistic children have been

> from this subgroup of affected children, and the authors cite the increasing

> body of evidence for abnormal immune regulation and autoimmunity in autism.

>

> The initial observation of unexpected bowel pathology in autistic children

> came from the same group, and centered on pathology in the colon (Lancet

> 1998; 351: 637-641, American Journal of Gastroenterology 2000; 95:

> 2285-2295).

>

> Use of immunohistochemical techniques had suggested a novel form of colitis,

> in which the epithelium of the colon was particularly affected (Journal of

> Pediatrics 2001; 138: 366-372), and, thus, possibly suggestive of

> autoimmunity.

>

> In the current study, the authors report a highly unusual form of small

> bowel abnormality, subtle on routine staining, but with distinct and

> apparent autoimmune features.

>

> Again the epithelium appears to be the focus of this immune response, with

> evidence of direct binding of self antibody to the surface of the epithelial

> cells (enterocytes), increased epithelial division and infiltration of T

> lymphocytes.

>

> The authors used an extensive panel of monoclonal antibodies, and made

> comparisons to children with celiac disease, cerebral palsy and mental

> retardation, and apparently normal controls, none of whom showed this

> pattern of abnormalities.

>

> The findings thus support an autoimmune basis for the unexpected bowel

> abnormalities in children with autism.

>

> Many questions remain, in particular, the relevance of these findings to the

> general autistic population, as these children had more obvious bowel

> symptoms than commonly seen.

>

> The authors avoid a direct suggestion that these bowel findings may be

> causal in autistic regression, but they cite reports that cognitive function

> is enhanced in some children with regressive autism when gut-based therapy

> is introduced.

>

> They also raise the possibility that the bowel changes may be a

> manifestation of a primarily genetic condition affecting several systems in

> which disturbance of brain function is simply more apparent.

>

> Further work thus clearly needs to be done to determine the role of the

> " gut-brain axis " in autism. However, confirmation that autoimmune responses

> really do contribute to cognitive regression in autistic children will raise

> the probability of a fundamental change in the treatment of autistic

> regression, based on modulating the immune response in children with early

> autistic symptoms.

>

> An accompanying editorial further discusses this work and its implications

> ( " Autoimmunity in Autism, " by J Licinio, I Alvarado, and Ma-Li Wong,

> Molecular Psychiatry 2002 Volume 7, number 4, page 329.)

>

> Molecular Psychiatry is published by the Nature Publishing Group. Its editor

> is Julio Licinio, M.D.

>

> (Reference: " Small intestinal enteropathy with epithelial IgG and complement

> deposition in children with regressive autism; " F Torrente, P Ashwood, R

> Day, N Machado, RI Furlano, A , SE Davies, AJ Wakefield, MA ,

> JA - and SH Murch, Molecular Psychiatry 2002 Volume 7, number 4,

> pages 375-382.)

>

> [Contact: Dr. Simon Murch, Julio Licinio]

>

> 30-Apr-2002

>

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