A recent study survey by the Center for Disease Control and Prevention's
National Health conducted in 2014 on over 11,000 children ages 3 to 17
years old estimates than 2.24% of children (1 in 45) have Autism in the
United States. This is a significant increase compared to the prevalence
of 1.25% (1 in 80) based on previous data.
Autism spectrum disorder (ASD) is the fastest growing developmental disability
in the United States with a prevalence that has almost double within 10 years.
There are 3.5 million American and their family living with the diagnosis
regardless of ethnicity or socio-economic backgrounds.
In light of this recent study and its staggering statistics, it is crucial
to better understand the causes leading to Autism. For a better understanding,
consult our website (www.preventautism.com).
Autism has multifactorial causes. Besides the well-defined genetic component
playing a key role in Autism as seen by the concordance of rate between
monozygotic twins (40-90%) versus dizygotic twins (0-10%),
an alteration of the maternal immune system regardless of the causes leading to inflammation (such as maternal autoimmune
diseases, maternal inflammatory response due to syndromes such as PCOS
and endometriosis, maternal production of anti-paternal HLA antibodies)
dramatically impacts the fetal environment
in utero and seems to be a major event triggering the neuro-developmental abnormalities
in the fetal brain during pregnancy (1).
Genetic predispositions such as MTHFR mutation (alteration of folate and
methylation pathways) or a deficient glutathione metabolism are largely
found in patients with
autoimmune disease (2),
endometriosis (3) or
suffering from recurrent pregnancy losses (4). In addition, these genetic predispositions couldact in synergy with the patients autoimmune or inflammatory disorders to
promote autism development.
Because these conditions that increase the vulnerability to Autism are
commonly found in our patient population at
Braverman Reproductive Immunology, we take particular interest in unraveling any causes potentially disturbing
the fetal environment in the maternal womb by a thorough maternal genetic
screening and a close monitoring of immune factors .Treating our patients
with adequate therapies before but also during pregnancy may reduce fetal
susceptibility for ASD.
We are currently developing new testing with
Baylor College of Medicine (Houston) to create the most complete preimplantation diagnostic probes that may
help identify embryos that have the known genetic predispositions to autism.
This will provide us with a better assessment of autism susceptibility
in an embryo (in IVF cycles). Hopefully this genetic testing that can
eliminate transfer of susceptible embryos, along with immune therapies
to reduce the maternal inflammatory response, may help to reduce the reoccurrence
of ASD in families that have an affected child.
- McAllister AK, Van de Water J. Breaking boundaries in neural-immune interactions.
Neuron, 2009 Oct 15; 64(1): 9-12.
- Shah D, Mahajan N, Sah S, Nath SK, Paudyal B. Oxidative stress and its
biomarkers in systemic lupus erythematosus. J Biomed Sci. 2014 Mar 17; 21:23.
- Dubinskaia ED, Gasparov AS, Fedorova TA, Lapteva NV. [Role of the genetic
factors, detoxication systems and oxidative stress in the pathogenesis
of endometriosis and infertility (review)]. Vestn Ross Akad Med Nauk.
- Yiyenoğlu ÖB, Uğur MG, Özcan HÇ, Can G, Öztürk
E, Balat Ö, Erel Ö. Assessment of oxidative stress markers in
recurrent pregnancy loss: a prospective study. Arch Gynecol Obstet. 2014