Immune Disorders and Autism - NYT

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http://www.nytimes.com/2012/08/26/opinion/sunday/immune-disorders-and-autism.htm\

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An Immune Disorder at the Root of Autism

By MOISES VELASQUEZ-MANOFF

IN recent years, scientists have made extraordinary advances in

understanding the causes of autism, now estimated to afflict 1 in 88

children. But remarkably little of this understanding has percolated

into popular awareness, which often remains fixated on vaccines.

So here's the short of it: At least a subset of autism --- perhaps

one-third, and very likely more --- looks like a type of inflammatory

disease. And it begins in the womb.

It starts with what scientists call immune dysregulation. Ideally, your

immune system should operate like an enlightened action hero, meting out

inflammation precisely, accurately and with deadly force when necessary,

but then quickly returning to a Zen-like calm. Doing so requires an

optimal balance of pro- and anti-inflammatory muscle.

In autistic individuals, the immune system fails at this balancing act.

Inflammatory signals dominate. Anti-inflammatory ones are inadequate. A

state of chronic activation prevails. And the more skewed toward

inflammation, the more acute the autistic symptoms.

Nowhere are the consequences of this dysregulation more evident than in

the autistic brain. Spidery cells that help maintain neurons --- called

astroglia and microglia --- are enlarged from chronic activation.

Pro-inflammatory signaling molecules abound. Genes involved in

inflammation are switched on.

These findings are important for many reasons, but perhaps the most

noteworthy is that they provide evidence of an abnormal, continuing

biological process. That means that there is finally a therapeutic

target for a disorder defined by behavioral criteria like social

impairments, difficulty communicating and repetitive behaviors.

But how to address it, and where to begin?....