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> Nature Reviews Neuroscience 6, 9 (January 2005) | doi:10.1038/nrn1598

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>

> Neurological disorders: A new dimension of autism

>

> Jane Qiu

>

> A new dimension of autism

>

> A marked increase in the number of activated microglia (stained brown)

> in the cerebellum from patients with autism (right) compared with

> healthy controls (left). Courtesy of C. A. Pardo, Hopkins University.

>

> Autism is regarded as a developmental disorder of the nervous system —

> an idea that is consistent with the gross abnormalities seen in the

> brains of patients with autism. The clinical manifestation of the

> disease is heterogeneous and the causes remain controversial.

> Reporting in the ls of Neurology, Vargas and colleagues have added

> another layer of complexity by showing that immune cells are more

> active in the brains of patients with autism and cause increased

> inflammation.

>

> Immune dysfunction has been implicated as a potential mechanism for

> the pathogenesis of autism, but previous research has focused on

> immunological measures made outside the brain. In this study, the

> authors analysed pathological changes in brain tissues from 7 healthy

> controls and 11 patients with autism. They found that, compared with

> brain tissues from the healthy controls, tissues from the patients

> with autism showed extensive neuroglial responses in the frontal

> cortex, cingulate gyrus and cerebellum. These responses are

> characterized by activation of microglia and astroglia, which are the

> only immune-competent cells in the nervous system and are important in

> both innate and adaptive immune responses.

>

> As there was no indication of lymphocyte infiltration or deposits of

> immunoglobulin and complement in the brain tissues of patients with

> autism, the immune activity probably reflects the neuroinflammatory

> reaction associated with the central nervous system's innate immune

> system. Consistent with this view, there was an increase in the

> expression of inflammatory cytokines, such as macrophage

> chemoattractant protein 1 (MCP1) and transforming growth factor beta1

> (TGFbeta1), in tissue samples from these regions of the brains of

> patients with autism. Astroglia and, to a lesser degree, microglia,

> seemed to be the main sources of cytokine production.

>

> These are interesting findings, but immune activity in living patients

> cannot be detected in this way. The authors reasoned that if there is

> an ongoing inflammatory reaction in the brains of patients with

> autism, their cerebrospinal fluid (CSF) might also contain those

> cytokines. They investigated the immune system of six living patients

> with autism by measuring the levels of cytokines in their CSF. They

> found that there was a significant increase in the levels of MCP1 and

> other cytokines, such as interleukin-6 and interferon-gamma, in the

> CSF of patients with autism, whereas the expression of TGFbeta1 was

> comparable to that of controls.

>

> Whether these cytokines serve as direct effectors of injury or as

> neuroprotectants to repair damage has still to be determined. However,

> these findings have important implications for understanding the

> pathogenesis of autism and might assist in the diagnosis of this

> condition.

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> References and links

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>

> ORIGINAL RESEARCH PAPER

>

> 1.

>

> Vargas, D. L. /et al/. Neuroglial activation and

> neuroinflammation in the brain of patients with autism. ls

> Neurol. 15 November 2004 (10.1002/ana.20315)

>

>

> FURTHER READING

>

> 1.

>

> Folstein, S. E. & Rosen-Sheidley, B. Genetics of autism: complex

> aetiology for a heterogeneous disorder. Nature Rev. Genet. 2,

> 943–955 (2001)

>

> * Article <http://www.nature.com/doifinder/10.1038/35103559>

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