Autism and Somatic Disorders

Autism: It’s Not Just in the Head

The devastating derangements of autism also show up in the gut and in the immune system. That unexpected discovery is sparking new treatments that target the body in addition to the brain.

By Jill Neimark, Discover Magazine, March 22, 2007

“There were days I considered shutting the garage door and letting the car run until I was dead,” says Colorado mom Erin Griffin, of the time nine years ago when she learned that both her boys—not just her firstborn—suffered from autism. Brendan, her angular, dark-haired older child, was diagnosed in 1996 at age 4. Kyle, her round-faced, hazel-eyed younger son, was diagnosed in 1998 at age 2½.

But Kyle and Brendan’s story does not have a tragic ending. After interventions that included occupational and speech therapy, as well as dietary change and nutritional supplements, both boys improved significantly. Their tale of slow, steady recovery reflects the changing landscape of autism today. The condition, traditionally seen as genetic and originating in the brain, is starting to be viewed in a broader and very different light, as a possible immune and neuroinflammatory disorder. As a result, autism is beginning to look like a condition that can, in some and perhaps many cases, be successfully treated.

That is astonishing news about a disorder that usually makes headlines because it seems to be growing rapidly more widespread. In the United States, the diagnosis of autism spectrum disorders has increased about tenfold over the past two decades, and a 2003 report by the Centers for Disease Control suggests that as many as one in every 166 children is now on the autism spectrum, while another one in six suffers from a neurodevelopmental delay. This explosion of cases has raised countless questions: Is the increase real, is it the result of increased awareness and expanding diagnostic categories, is it due to environmental changes, or all of the above? There may be no single answer. But the public concern about autism has caught the ear of federal lawmakers. The Combating Autism Act, approved last December, authorized nearly $1 billion over the next four years for autism-related research and intervention.

Meanwhile, on the sidelines of that confusing discussion, a disparate group—immunologists, naturopaths, neuroscientists, and toxicologists—is turning up clues that are yielding novel strategies to help autistic patients. New studies are examining contributing factors ranging from vaccine reactions to atypical growth in the placenta, abnormal tissue in the gut, inflamed tissue in the brain, food allergies, and disturbed brain wave synchrony. Some clinicians are using genetic test results to recommend unconventional nutritional therapies, and others employ drugs to fight viruses and quell inflammation.

Above all, there is a new emphasis on the interaction between vulnerable genes and environmental triggers, along with a growing sense that low-dose, multiple toxic and infectious exposures may be a major contributing factor to autism and its related disorders. A vivid analogy is that genes load the gun, but environment pulls the trigger. “Like cancer, autism is a very complex disease,” says Craig Newschaffer, chairman of Epidemiology and Biostatistics at the Drexel University School of Public Health, “and it’s exciting to start asking questions about the interaction between genes and environment. There’s really a very rich array of potential exposure variables.”

In one way, the field seems like a free-for-all, staggeringly disordered because it is littered with so many possibilities. But one can distill a few revolutionary insights. First, autism may not be rigidly determined but instead may be related to common gene variants, called polymorphisms, that may be derailed by environmental triggers. Second, affected genes may disturb fundamental pathways in the body and lead to chronic inflammation across the brain, immune system, and digestive system. Third, inflammation is treatable.

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