Autism's whole-body connection
Is autism a brain disorder? Or a disorder that affects the brain?
Once thought to be solely brain-based, autism is now increasingly recognized as a whole-body disorder. Like most other chronic disorders, at a biological basis, individuals with autism often exhibit: oxidative stress, inflammation, mitochondrial dysfunction, immune dysregulation, and more. These factors contribute to what can accurately be described as a dynamic encephalopathy.
A complex interplay of genes and the environment affects the epigenetic expression of our genes. In vulnerable individuals, this manifests in behavior and symptoms characteristic of autism spectrum disorders. It is important to consider that the behavor we see on the outside, is a manifestation of the biology occuring on the inside! This exchange between genes and the environment is always changing, hence a dynamic encephalopathy. We can work to reduce exposure to harmful stimuli, environmental toxins, and stress at a celluar level, and this may alter gene expression in a positive way. Although not every factor in our daily lives can be controlled, we can work to diminish exposure to foods that may be aggravating to individuals with autism. We observe many food sensitivities among this population. One very common one is sensitivity to gluten and dairy.
A 2012 CDC study found that children with developmental disabilities including autism have concurrent medical conditions including increased diarrheal and colitis episodes, and a 60% greater risk of asthma and skin allergies. We also know that individuals with autism have higher familial incidence of autoimmune conditions including: celiac disease, ulcerative colitis, psoriasis, Type 1 diabetes, rheumatoid arthritis, and Hashimoto's thyroiditis. Additionally, there is an association between abnormal immune markers in a pregnant mother's blood and increased incidence rates of autism. This prevalence of respiratory, skin, and environmental allergies, and link to autoimmune conditions suggests that the immune system is intricately involved in autism phenotypes. An abnormally functioning immune system may lead to excitotoxicity if components of the immune system leak into the brain. It is therefore important to identify sources of, and try to diminish immune dysregulation.
Immune dysfunction causes inflammation, which may play a key role in autism. Studies show that individuals with autism have elevated inflammatory immune chemicals (cytokines) in their brain and spinal fluid. Brain specimens from subjects with autism have revealed aberrations in genetic pathways associated with immune signaling and function. It is important to consider inflammation because these inflammatory cytokines are also found elsewhere in the body, such as the blood and GI system. This suggests that children with autism and GI problems may have overactive immune cells/inflammation of their intestinal linings.
Furthermore, several studies have confirmed that individuals with autism may have antibodies that target their own brain tissue, and the presence of increased antibodies to gluten.
Evidence for this gut-immune-brain interplay means we have to consider autism's whole-body connection. At Worthington Pediatrics, we seek to provide an integrative--whole-body-- approach for treating all complex-medical problems, including autism.
The following resources will provide additional information about the dynamic and complex integrations of multiple systems, including the gut and immune system, and how this affects autism.
Concurrent medical conditions and health care use and needs among children with learning and behavioral developmental disabilities