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Find the silence
   which contains thought.
       --Hakuin       

    

The Brain, Inflammation
and Autism Spectrum Disorders

I see autoimmune conditions every day in my practice with each and every patient.  They can range from something severe like Lupus or Rheumatoid Arthritis to virtually any chronic inflammatory process that goes on to disrupt or target another system in the body.  One of the increasingly common autoimmune diagnoses these days is autism.  As of 2008, according to the Centers for Disease Control and Prevention, 1 child in 88 is diagnosed with an Autism Spectrum Disorder (ASD), a 23% increase since 2006. (1)   This article will explore the most current research into the etiology of ASD, the possible mechanisms contributing to the spectrum of symptoms, and goals for treatment.

Autoimmunity & ASD

Our immune system works 24 hours a day, 7 days a week, determining what will aid our health and what will hurt us.  As part of this process, it produces antibodies to neutralize and clear those pathogens designed to harm us.  More often than not, these antibodies do their job well and are cleared by the immune system.  Other times, they don’t get cleared and go on to interfere with other systems in the body setting the stage for an autoimmune process to occur.  ASD are a spectrum of congenital neuro-developmental diseases often diagnosed by 3 years of age, affecting more boys than girls by a 4:1 ratio (2) and are characterized by a combination of “abnormal social interaction and communication, and repetitive, restricted, and stereotyped patterns of behavior, interests, and activities.” There may also be delays in language development. (3) The most current research indicates that it may stem from a genetic neuro-immune dysfunction that allows maternal, environmental or possible dietary pathogens to trigger anti-neuronal auto-antibodies to attack the fetal or infant brain.

Maternal health 

While pregnant, the mother’s own antibodies can either have a protective or pathogenic effect on the developing fetus depending on the state of her health.  According to a 2012 University of California, Davis study, “If the mother has an underlying autoimmune disease or has reactivity to fetal antigens, autoantibodies produced before or during pregnancy can target tissues in the developing fetus. One such tissue is the fetal brain.” (4) 

One of the most common pathogens that can trigger an auto-immune process is mercury toxicity commonly from dental amalgams.  Mercury, a known neurotoxin, is so hard for the immune system to clear that its constant efforts result in an on-going low-grade inflammatory process that can disrupt other systems in the body—your nervous system being one of them, presenting as, but not limited to, headaches and migraines, insomnia, dizziness, twitches, tics, and convulsions.  Or, most troubling, it can be asymptomatic or show up in unpredictable ways. Regardless, mercury fillings’ mere presence in the mother’s mouth opens her up to the possibility of transferring the mercury into fetal circulation (5) triggering the development of autism. (6)

Mercury is, by no means, the only concern to the mother’s health.  While much of the remaining article covers post-natal infant health, the pathogens that may affect the infant’s neurological development should not be ruled out to also affect maternal health while pregnant.

Post-natal Health

Once the infant is born, there are a number of external pathogens that have been shown to trigger anti-neuronal antibodies to attack and compromise the growth and development of the newborn’s brain showing up potentially as an ASD.  One study linked mycobacterium avium paratuberculosis, a common bacterium found in water and food, with autism. (7)  Another found measles viral antibodies in the cerebral spinal fluid of autistic children, suggesting that “viruses may initiate the process but the subsequent activation of cytokines [inflammatory markers] is the damaging factor associated with autism.” (8) Once again, we see the downstream disruptive effects of a confused immune system—auto-immunity.

Viruses, bacteria… these are pathogens we have no control over.  Our ability to combat them depends largely on the strength of our immune system.  What is within our control is the food we eat.  A significant part of my work with patients of all ages is around proper food choices.  I help patients identify what foods are causing them health problems and what foods are not. While I have yet to find even one patient for whom dairy is not completely destructive to their health, wheat and its main protein, gluten, has been receiving a great deal of recent attention for it’s possible ill effects on our health. Both casein, the principle protein in dairy, and gluten are linked to autism.  One Italian study found high levels of antibodies to casein and other dairy proteins in children with autism and after an 8-week dairy-free program noticed a “marked improvement in the behavioral symptoms.” (9)  Casein and gluten are opioid-like proteins that can “pass through an abnormally permeable intestinal membrane and enter the central nervous system (CNS) to exert an effect on neurotransmission, as well as producing other physiologically-based symptoms.” (10) Under healthy circumstances, by the time food gets to our small intestine it is sufficiently broken down to allow for easy absorption of nutrients.  But due to poor food choices or something as seemingly benign as a sinus infection, your gut could become so inflamed that it allows larger than normal particles to be absorbed triggering any number of inflammatory processes.  This is called Leaky Gut.  Dairy in any form, for any individual, can cause this.  Gluten, for some, can do the same.  For kids with autism, these proteins can have a destructive effect on their neuro-development.

Digestive distress seems to be a very common comorbid concern for children with autism.  A Columbia University study actually found a little-known bacteria, Sutterella, present in their digestive tracts but absent in children without autism, saying that such digestive disturbances “can complicate clinical management and contribute to behavioral problems.” (11)

Then there is the controversial issue of vaccines.  PBS’ Frontline did a 2-hour piece called “The Vaccine War” that pitted the entire western medical establishment against a few impassioned moms, led by Jenna McCarthy whose son has autism.  Research and, worse, the media today can point you to either side of the argument depending on what you choose to believe—vaccines either cause autism or have nothing to do with it.  Medicine is never that cut and dry.  So let’s dig a little deeper.  Mercury in the form of thimerosal, in the Measles-Mumps-Rubella shot, in particular, has been linked to autism. Research shows that autistic children have far higher levels of antibodies to the MMR shot than children without autism. (12) But nowadays, the only vaccine that still uses thimerosal is the flu vaccine. Nevertheless, once again, we see antibodies.  While it may not necessarily be the virus, the dairy or wheat protein, the unique gut bacteria, the mercury, or, as a 2011 study showed, neurotoxic aluminum in vaccines (13) themselves that cause the ASD, it could very well be how the immune system of the child with autism responds to pathogens that makes the difference.  If that response is to target and attack the brain, then you have set the stage for the possible development of an Autism Spectrum Disorder.

Treatment goals

With all my pediatric patients, my treatments focus on customized Chinese medicinal herbal formulas and proper food choices.  I also coach the parents in acupressure techniques to relieve their child’s acute symptoms.  With ASD, there are three main goals with treatment:

  1. Identify, clear and consistently monitor the presence of any type of infection, down-regulating the child’s auto-immune process;
  2. Identify and eliminate any and all immune stimulants that may promote the very auto-immune process we are working hard to treat. These may include aluminum, the vaccine adjuvant mentioned above, the whey protein in dairy which stimulates antibody production, and beta glucan, a protein on the outer sheath of wheat, bacteria and fungi can also stimulate the immune system;
  3. Steadily support the child’s neurological growth and development.

Over time, the goal would be to see modest and incremental shifts in behavior, focus, attention and communication.  Parents might also notice a greater sense of everyday health—fewer stomach aches, allergies, and colds, better sleep and a calmer nervous system, to name just a few potential signs of progress. 

****

As the incidence rates for ASD have increased, there do seem to be far more resources available for parents to get support.  From online communities to medical and therapy specialists, parents are no longer alone in their search for help.  Yet, despite the complex nature of ASD, sometimes it is best to focus on what’s right in front of you—a child with allergies, a child with indigestion, or a child who catches colds easily.  Starting with those basic complaints, offering the child greater daily health and ease in their body, might enable us to get to the next layer linking their immune challenges to their neurological growth and development and, ultimately, their autism. 

I am happy to help.

 

References

  1. Prevalence of Autism Spectrum Disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008, Surveillance Summaries, March 30, 2012 / 61(SS03); 1-19.  http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6103a1.htm?s_cid=ss6103a1_w
  2. Ibid., Autism and Developmental Disabilities Monitoring Network.
  3. Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, D.C.: American Psychiatric Association. 2000.
  4. Dev Neurobiol. 2012 Oct;72(10):1327-34. doi: 10.1002/dneu.22052. Epub 2012 Sep 4. Maternal and fetal antibrain antibodies in development and disease.  Fox E, Amaral D, Van de Water J. Department of Internal Medicine, University of California, Davis, Davis, California 95616, USA. 
  5. Am J Physiol. 1990 Apr;258(4 Pt 2):R939-45. Maternal-fetal distribution of mercury (203Hg) released from dental amalgam fillings.  Vimy MJ, Takahashi Y, Lorscheider FL. Department of Medicine, Faculty of Medicine, University of Calgary, Alberta, Canada.
  6. Int Rev Neurobiol. 2005;71:317-41. Immunological findings in autism. Cohly HH, Panja A. Department of Biology, Jackson State University, Mississippi 39217, USA.
  7. Med Hypotheses. 2011 Dec;77(6):977-81. doi: 10.1016/j.mehy.2011.08.024. Epub 2011 Sep 7. Mycobacterium paratuberculosis and autism: is this a trigger? Dow CT. UW Eye Research Institute, 445 Henry Mall #307, Madison, WI 53706, United States. ctdow@me.com
  8. Ibid., Cohly HH, Panja A.
  9. Panminerva Med 1995 Sep;37(3):137-41 Food allergy and infantile autism.  Lucarelli S, Frediani T, Zingoni AM, Ferruzzi F, Giardini O, Quintieri F, Barbato M, D'Eufemia P, Cardi E. Department of Paediatrics, University of Rome La Sapienza, Italy.
  10. Expert Opin Ther Targets 2002 Apr;6(2):175-83   Related Articles,  Links. Biochemical aspects in autism spectrum disorders: updating the opioid-excess theory and presenting new opportunities for biomedical intervention.  Whiteley P, Shattock P. Autism Research Unit, School of Sciences (Health), University of Sunderland, Sunderland, SR2 7EE, UK. aru@sunderland.ac.uk
  11. MBio. 2012 Jan 10;3(1). pii: e00261-11. doi: 10.1128/mBio.00261-11. Print 2012. Application of novel PCR-based methods for detection, quantitation, and phylogenetic characterization of Sutterella species in intestinal biopsy samples from children with autism and gastrointestinal disturbances. Williams BL, Hornig M, Parekh T, Lipkin WI. Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York, USA. bw2101@columbia.edu . Comment in MBio. 2012;3(1). pii: e00019-12. doi: 10.1128/mBio.00019-12.
  12. Int Rev Neurobiol. 2005;71:317-41. Immunological findings in autism. Cohly HH, Panja A. Department of Biology, Jackson State University, Mississippi 39217, USA.
  13. J Inorg Biochem. 2011 Nov;105(11):1489-99. doi: 10.1016/j.jinorgbio.2011.08.008.  Epub 2011 Aug 23. Do aluminum vaccine adjuvants contribute to the rising prevalence of autism? Tomljenovic L, Shaw CA. Neural Dynamics Research Group, Department of Ophthalmology and Visual Sciences, University of British Columbia, 828 W. 10th Ave, Vancouver, BC, Canada V5Z 1L8. lucijat77@gmail.com

 


 

 




 

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This site and any articles on this site are not medical advice and are not intended as medical advice and are intended to provide only general, non-specific information related to Chinese Medicine and acupuncture and are not intended to cover all the issues related to the topic discussed. You should consult a licensed health practitioner before using any of the information on this site and any articles.