New Hope for Autism Research

The National Institute of Mental Health (NIMH) quietly released a statement yesterday detailing the launch of three new studies into biological and environmental factors in children with autism. This is big news, delivered without much fanfare.

According to the press release:

“The National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), has launched three major clinical studies on autism at its research program on the NIH campus in Bethesda, Maryland. These studies are the first products of a new, integrated focus on autism generated in response to reported increases in autism prevalence and valid opportunities for progress. Initial studies will define the characteristics of different subtypes of autism spectrum disorders (ASD) (http://www.nimh.nih.gov/healthinformation/autismmenu.cfm) and explore possible new treatments.”

The key concepts here are integrated, subtypes and new treatments. Most current federally-funded autism research has focused on genetics and assessment (diagnosis, epidemiology). What’s exciting and novel about this latest statement is the focus on treatment and biology. One of the studies will look at subtypes of autism and the idea that not all autism is the same. This is an idea that integrative practitioners live by, and know well – individuality is key. The study will look at both BIOLOGICAL and BEHAVIORAL differences – unusual for government-sponsored work. Interestingly, the NIMH statement points out that, “in addition, researchers will study a subset of the children in this study to investigate environmental factors that may trigger symptoms of autism.”

Along these lines, another of the studies funded by the NIMH will evaluate chelation therapy, a controversial yet widely-used treatment for heavy metal toxicity in children with autism. There have been few well designed studies in this area, and I for one am happily surprised to see this study supported and look forward to seeing the data. As the press release states: “Because chelation therapy is not specific for mercury alone, it is important to conduct a systematic, controlled trial to determine whether or not chelation therapy is beneficial or potentially harmful to children with autism,” says Susan Swedo, M.D., who leads the branch on pediatric behavioral research in the NIMH Division of Intramural Research Programs (http://intramural.nimh.nih.gov/), where the autism studies are being conducted. This study will have far-reaching implications, politically and practically.

Finally, the third study will look at the effect of an antibiotic (minocycline) on regressive autism. More commonly used in acne, minocycline has been associated with anti-inflammatory effects and may work in this manner to decrease neuroinflammation. Numerous studies have linked autism with inflammation and immune dysregulation.

There hasn’t been much media coverage of this announcement. I’m sure the NIMH doesn’t want to raise too much of a fuss to avoid a medical establishment backlash. Environmental research in autism is often dismissed by hard core genetic supporters. Of course, it’s not that simple – you know, the whole nurture part of nature/nurture is kind of hard to ignore, especially when rates of autism have skyrocketted in the past 15 years. It’s a step in the right direction, in any case. And with the recent passage of the Combating Autism Act by the U.S. Senate, with hope for approval by the House and the President, we should have more funds for similiar projects.

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Related references:

Environmental Issues

Bernard S, et al: The role of mercury in the pathogenesis of autism. Mol Psychiatr 7: S42-43, 2002.

Bradstreet J et al: A case-control study of mercury burden in children with autistic spectrum disorders. J Am Phys Surg 8: 76-79, 2003.

Koger SM, et al: Environmental toxicants and developmental disabilities. American Psychologist 60: 243-255, 2005.

Fido A, Al-Saad S: Toxic trace elements in the hair of children with autism. Autism 9: 290-298, 2005.

Herbert MR, et al: Autism and environmental genomics. Neurotoxicology 2006, in press.

London E, Etzel R: The environment as an etiologic factor in autism: a new direction for research. Environ Health Perspect 108: S3, 2000.

Palmer RF, et al: Environmental mercury release, special education rates, and autism disorder: an ecological study of Texas. Health Place 12: 203-209, 2005.

Szpir M: Focus: New thinking on neurodevelopment. Environ Health Perspect 114: A100-107, 2006.

Trasande L, et al: Public health and economic consequences of methyl mercury toxicity to the developing brain. Environ Health Perspect 113: 590-596, 2005.

Immunology/Allergy

Ashwood P, Van de Water J: Is autism an autoimmune disease? Autoimmunity Reviews 3: 557-562, 2004.

Ashwood P, et al: The immune response in autism: a new frontier for autism research. J Leukoc Biol 2006 May 12; Epub ahead of print.

Cohly HH, Panja A: Immunological findings in autism. Int Rev Neurobiol 71: 317-341, 2005.

Connolly AM, et al: Brain-derived neurotrophic factor and autoantibodies to neural antigens in sera of children with autistic spectrum disorders, Landau-Kleffner Syndrome, and epilepsy. Biol Psychiatry 59: 354-363, 2006.

Jyonouchi H, et al: Dysregulated innate immune responses in young children with autism spectrum disorders: their relationship to gastrointestinal symptoms and dietary intervention. Neuropsychobiology 51: 77-85, 2005

Molly CA, et al: Elevatedcytokine levels in children with autism spectrum disorder. J Neuroimmunol 172: 198-205, 2005.

Silva SC, et al: Autoantibody repertoires to brain tissue in autism nuclear families. J Neuroimmunol 152: 176-182, 2004.

Vargas DL, et al: Neuroglial activation and neuroinflammation in the brain of patients with autism. Ann Neurol 57: 67-81, 2005.

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