Continuing the discussion post of Ashley Assadi regarding inflammation and autism
I came a across an interesting lay article that expanded on the topic in a
slightly different direction. This article
was more of a lay article that was published in The New York Times Opinions
Page ( http://www.nytimes.com/2012/08/26/opinion/sunday/immune-disorders-and-autism.html?_r=4&pagewanted=all&
) The article titled “An Immune Disorder at the Root of Autism” begins by pointing out that just inflammation
it’s self is not the culprit but an unregulated or unbalanced inflammation response.
I liked that this point was included because this topic has been supported by
previous articles reviewed in our course. The article goes on to give several
examples of studies that have shown significant correlations between infections
during pregnancy with an increased risk of autism in the birthed child. The
article also gives examples of studies that have shown a significant increase
in the prevalence of inflammatory diseases in the past 60 years. It is thought
that these increased numbers are due to environmental factors and the increasing
trend of urban and city living. The article claims that “Scientists have
repeatedly observed that people living in environments that resemble our
evolutionary past, full of microbes and parasites, don’t suffer from
inflammatory diseases as frequently as we do.” Although the article has
some good information and interesting points these studies described do not
have citations and is a little vague at times. There “take-away” message was that
if inflammation is controlled during pregnancy “it won’t interfere with
fetal brain development.” The article goes on to recommend taking
anti-inflammatory remedies during pregnancy. I felt that their claims were not very strong
and not scientifically supported. Many of the processes and pathways involved
in inflammation are still not fully understood and I believe additional studies
are needed before we are ready to recommend treatments for autism prevention. However
over all this was an interesting article that had some very good points that highlighted
the issue of immune dysregulation and unregulated inflammation associations with
autism.
Are there any other types of infections that have been studied that could lead to an increased chance of autism? They only talked about only a few types of infections. Also, what does an increase of about 40 percent actually mean? According to this website http://www.everydayhealth.com/autism/whos-at-risk.aspx there is a 5 % chance of the development of autism in the baby of a normal healthy woman. A 40 percent increase of the original 5% risk means that we would only have a 7 % chance of having an autistic baby even after bacterial infection.
ReplyDeleteWhat about people with inflammatory disorders, these people have abnormal inflammation continuously. So, my question is, is it the inflammation associated with the infection that is causing the disease, or is it the infection itself?
I think it's really interesting to consider April's questions. I wonder if any more research will be done to try and see the mechanism of how infection and inflammation affects the brain of the fetus. I know autism is tricky to diagnose, so it may pose a problem to research. I just think it would be interesting to know exactly how inflammation and infection contributes. I also wondered if chronic inflammation disorders in mothers could also contribute to development of autism in the child, like April asked. They have arguably more inflammation than a mother who had an infection and recovered, so I wonder if that contributes?
ReplyDeleteAlso, the article said that autistic children have inflammatory dysregulation, so I wonder if autistic children tend to get the inflammatory/ autoimmune disorders we talk about in class more easily? It seems to me like maybe the increased inflammation could lead to some of the chronic disorders we've talked about.
Overall, I think the article is interesting. However, we still don't know a lot about autism, and I think there's tons of factors that contribute at once. So, even if we do more research on perinatal infection, it still may not play as big a part as other factors. My sister had the flu while she was pregnant during the first trimester, but had a normal baby. Also, my friend's mom had a really easy pregnancy, never got sick, and has a severely autistic daughter. So it kind of shows that there's lot to consider with autism.
With ideas like this, it's always possible to draw some link, the real question is how strong the links are and what are the benefits verses risks of an anti-inflammatory regiment during pregnancy to the fetus as well as the mother. This first thing that came to my mind while reading this post was the concept of pregnant woman ingesting folic acid. For a small portion of our population, not having enough folic acid during development can cause neural tube problems. Since this discovery, also every pregnant woman in the USA is recommended to take folic acid. On the other hand, more recent studies have suggested that too much folic acid during development could be linked with asthma and IBD (two very common and treatable conditions). So, to link this back to taking anti-inflammatories during pregnancy to possibly lower the risk of autism may result in higher prevalence of other conditions and may not necessarily eliminate the risk of autism. I agree with Dan, there needs to be more research done to determine the path of effect before we start handing out anti-inflammatories to pregnant women or children.
ReplyDeleteThe work out of Johns Hopkins suggests that the second trimester is the time that the MHC class II-positive microglia potentially cause a problem in the central nervous system (CNS). This would make sense as this is a critical time in fetal neurodevelopment. Most neurons are produced between 12 and 18 weeks gestation, and any disruption to this process can change both the number and the size of the cells in the brain. In addition, once the neurons are formed in the germinal layer they migrate to the gray matter where they further differentiate. This process peaks between 3-5 months gestation. Perhaps it is a disruption in this development that contributes to autism.
ReplyDeleteBlackburn, S. T. (2007). Maternal, fetal, & neonatal physiology. A clinical perspective. (3rd ed). St. Louis: Saunders.
I use to babysit a boy with Autism. Once his mom put him on a Gluten Free diet his behavior began to improve after a few months. I've read a little into it and there is a theory that autistic children have a hypersensitivity to the peptides that affect their brain chemistry, but I didn't know about the inflammation part of it. That is good information to have.
ReplyDeleteThere haven't been any studies done as far as I know to prove the theory or even that the diet works besides parents noticing a difference. I did find one article that talked about this diet. The link is: http://www.webmd.com/brain/autism/gluten-free-casein-free-diets-for-autism