Research Roundup is a monthly newsletter from N of One’s UK-based science writer, Paul Whiteley, PhD. Each month we summarize a few research papers on a variety of topics in one simple, easy-to-read paragraph. It’s our hope that by skimming these each month, you will broaden your knowledge topics currently being explored by researchers and perhaps find information helpful in your journey of navigating a complex autism landscape.
An interesting n=1 report...
Case report: Omalizumab for allergic rhinitis might have behavioral implications for (some) autism
A fascinating case report (n=1!) from 2021 recently came to our attention regarding the application of an allergy medicine typically used to treat asthma which also seemed to have some important effects on autistic behaviors too. The report details how a young child diagnosed with autism and an autoimmune disease affecting thyroid functions (Hashimoto's disease), presented at clinic with issues including allergic disease coincident to behavioral features. Following a clue of elevated IgE (a type of antibody) levels, doctors hypothesized that perhaps the drug, Omalizumab (trade name Xolair), an injectable drug that is known to reduce IgE for other conditions like asthma. was used and some quite remarkable things happened to both allergy-related symptoms and behavior. One has to be slightly cautious that this was a single case report and correlation doesn’t necessarily mean causation. But taken in the context that behavior and immune functions seem to show a strong ‘association’ for at least some types of autism, there’s a scheme of work to be followed on how such medicines might hold potential for some diagnosed with ASD.
[Note from J Rodakis: There are SO many n=1 stories of children with ASD having dramatic improvements in response to various treatments. In this case, lowering IgE had a profound impact on this child’s life. How many others out there might also benefit? Are we routinely testing IgE levels for children with ASD? Do doctors know to look? Or are parents being told, “I’m sorry, there’s nothing we can do.” We can do better, but it begins with a realization that in many cases severe ASD is amenable to treatment.]
Pick a health condition and there’s a good chance it’s going to be overrepresented in autism
In keeping with a worrying trend observing that a multitude of somatic, behavioral and psychiatric conditions are overrepresented in autism spectrum disorder (ASD), a large study out of Ohio State University arrives at a similar conclusion. Analyzing health data from insurance records for over 30,000 adults with autism holding compared with 60,000 age- and sex-matched non-autistic controls, researchers analyzed what conditions were being billed for between the groups and by how many people. Their results, represented as percentages and adjusted odds ratios (the likelihood of something happening taking into account other potentially influencing variables), are illuminating. Of all the conditions analyzed, schizophrenia and psychotic disorders showed the greatest group disparity between autism and control data, with epilepsy, attention-deficit hyperactivity disorder (ADHD) and personality disorders following suit. Various other somatic complaints also showed similar trends including metabolic disorders like obesity and diabetes. On the basis of the voluminous literature in this area, such work yet again draws attention to the need for preferential and regular screening for comorbid (even multi-morbid) conditions when a diagnosis of autism is received. That potentially serious psychiatric conditions such as schizophrenia figure so prominently in this data is a particular cause for concern, but also provides greater recognition of the need for periodic preferential screening and treatment where appropriate. And such screening sentiments go doubly so for other important issues such as chronic heart failure as described by other recent independent research…
Physical activity interventions are good for autism and range of other neurodevelopmental diagnosis
A recent review paper out of Hong Kong looking at over 70 studies where a physical activity intervention also reported at least one mental health outcome has added weight to the notion that physical activity interventions can impact on the presentation of autism and other developmental conditions. Cumulatively including data from over 3000 participants, the review concluded that effects covering cognitive functions and overall psychological health were apparent following intervention with children and young people with various neurodevelopmental labels. Certain variables seemed to modify the extent of effects from activity intervention (i.e. frequency, duration, etc) as would probably be expected. Alongside other studies looking at how to make physical activities and sport more inclusive for young people with autism, such studies potentially provide a roadmap to better physical and mental health for many.
[note from J. Rodakis: Anecdotal stories of ASD symptom improvement from exercise have existed for years (n=1+). Good to see it begin to be supported in the scientific literature.]
A kidney-autism axis?
Young children awaiting a kidney transplant seem to be at an elevated risk for neurodevelopmental disorders like autism according to new research from the University of Minnesota. Looking back at 12 years worth of clinical data on ‘pretransplant evaluation’ undertaken on each patient, researchers observed several potentially important signals regarding the potential cognitive and behavioral effects of dialysis and the risks of developmental delays and/or receiving a diagnosis of autism. The kidneys and kidney function are probably not, for most people, traditionally linked to the presentation of autism. There has however been a steady rise in research interest given various strands of study ranging from the identification of known uremic toxins as potentially being related to autism and signals pointing to a possible over-representation of issues like chronic kidney disease (CKD) following a diagnosis of ASD. That ‘genes for autism’’ are also probably not just ‘autism genes’ is another consideration (a similarly important tenet when looking at other associations such as the link between congenital heart disease and autism). Further studies are required.
And finally…
A study to watch: The Gut Bugs in Autism Trial
“This study aims to evaluate the efficacy of oral encapsulated fecal microbiome transfer (FMT aka Microbial Transplant Therapy (MTT) in improving gastrointestinal symptoms and well-being among autistic adolescents and adults.” Researchers from New Zealand recently published a study protocol for the ‘Gut Bugs in Autism Trial’ aiming to look at the possible usefulness of fecal microbiome transfer (FMT) for treating gastrointestinal (GI) issues accompanying a diagnosis of autism. This follows their other work looking at such an intervention in the context of obesity. Poo(p) transplants, although not sounding particularly appetizing, have a long history for treating various GI issues, in some cases, providing a lifesaving intervention. Given the increasing interest in how the gut microbiome - the bacterial soup that calls our gut home - seems to be implicated in at least some autism, interest in methods to modify the gut microbiome and potentially affect the course of autism, has also been increasing. Results are awaited.
Full-text: https://bmjopen.bmj.com/content/14/2/e074625
留言