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‏إظهار الرسائل ذات التسميات maternal antibodies. إظهار كافة الرسائل
‏إظهار الرسائل ذات التسميات maternal antibodies. إظهار كافة الرسائل

Autism Is A Complex Disorder, A Single Causal Mechanism Is Unlikely

There are some who believe, as an article of faith, that autism is 100% genetic.

They cling to this belief even though the fact that one identical twin has an Autism Spectrum Disorder diagnosis does not necessarily mean that the other twin will also have an ASD. For many with the "it's gotta be genetic" mindset no explanation, no study, no evidence will budge them.

For everyone else in the world though Dr. Harvey Singer of Johns Hopkins Hospital in Baltimore who, with his colleagues, has studied the effects of mice that developed autistic like behaviors after being exposed before birth to antibodies from mothers of autistic children, has some wise words to share with us. Dr. Singer is quoted in a Reuters article Mother's antibodies may contribute to autism :

"Autism is a complex disorder and it would be naïve to assume there's a single mechanism that can cause it. It's most likely the cumulative effect of several factors, including genes, metabolism, and the environment. We believe we have identified one of those factors."

I am pleased any time I see such a sensible perspective offered about autism by someone with the knowledge and credibility to have his comments be given serious weight and consideration. Here in Canada our autism research community, and our CIHR, are dominated by a small Montreal based neuroscience elite that still leans heavily towards the outdated "it's gotta be genetic" view of autism that Teresa Binstock cautioned against a decade ago. There is an Autism Research Paradigm Shift taking place ... in the United States ... if not in Canada.

Once again, I must thank our American friends for offering informed, sensible information about the nature of autism disorders, their possible causes and interventions.




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Evidence Maternal Antibodies can Trigger Autism - What starts with V and can Trigger Maternal Antibodies?

As reported in the following excerpt from a EurekaAlert news release, recent mice studies add to previous research indicating that maternal antibodies can trigger autism. Can anyone think of a word starting with the letter V that can trigger antibodies .... and therefore autism?

New studies in pregnant mice using antibodies against fetal brains made by the mothers of autistic children show that immune cells can cross the placenta and trigger neurobehavioral changes similar to autism in the mouse pups.

A report on the research from investigators at the Johns Hopkins Children's Center published online in the Journal of Neuroimmunology expands on a 2008 report from the same team showing that mothers of autistic children tested positive for fetal brain antibodies. Antibodies are proteins the body naturally makes to attack foreign tissues, viruses or bacteria. Because a growing fetus is not "rejected" by the mother's immune system even though some of its DNA is "foreign" (from the father), scientists have long suspected that some combination of maternal and fetal biological protection is at work.

The new research from Hopkins, however, suggests that the protective system is not perfect and that antibodies are not only made but are re-circulated back to the fetus through the placenta, possibly triggering inflammation in the brain and leading to a cascade of neurological changes resulting in neurodevelopmental disorders, such as autism.







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Autism and Maternal Antibodies On The Johns Hopkins News-Letter


In Maternal antibodies may cause autism, published in the March 6, 2008, issue of The John Hopkins Newsletter discusses the recent study led by Hopkins pediatric neurologist Harvey Singer suggesting a possible connection between maternal antibodies and autism. The study focused on the role of the immune system in causing autism.

Singer and his group found that, in some cases of autism, pregnant women's bodies actually raise antibodies against their babies, which sets off a series of events that slowed the normal development of the infants' brains.

The team found that mothers of children with autism had heightened levels of certain antibodies during their pregnancies. "The presence of specific antibodies correlated with the presence of developmental regression in the affected child," Singer said.

"About 40 percent of mothers with autistic offspring had significant differences on Western immunoblots," Singer said, referring to analyses conducted on fetal fluids to measure levels of certain anti-brain antibodies.

This finding suggests that there may be a truly devastating link between maternal antibodies and autism. Singer's team and others are now moving toward a greater understanding of the causes of the illness.

The next step of the research is aimed at trying to discover which proteins are engaged in this immunological backfiring, in hopes of being able to prevent this process.

Autism Likely Caused By Interplay of Immune, Genetic and Environmental factors


Following is the link to an abstract of an article, Antibodies against fetal brain in sera of mothers with autistic children, published in the February issue of the Journal of Neuroimmunology
and the media release translating it into ordinary language for us mortals which implicates the mother's immune system as a possible contributing factor in causing autism.

Lead investigator Harvey Singer, M.D., director of pediatric neurology at John Hopkins Children's Center, stresses that autism is a complex condition caused by an interplay of immune, genetics and environmental factors. Further studies are needed to confirm that particular antibodies do indeed cross the placenta and cause damage to the fetal brain.

Autism's Origins: Mother's Antibody Production May Affect Fetal Brain BALTIMORE, Feb. 25


(AScribe Newswire) -- The mothers of some autistic children may have made antibodies against their fetuses' brain tissue during pregnancy that crossed the placenta and caused changes that led to autism, suggests research led by Johns Hopkins Children's Center investigators and published in the February issue of the Journal of Neuroimmunology.

The causes of autism, a disorder manifesting itself with a range of brain problems and marked by impaired social interactions, communication disorders and repetitive behaviors, remain unknown for an estimated 90 percent of children diagnosed with it. Genetic, metabolic and environmental factors have been implicated in various studies of autism, a disorder affecting 1 in 150 U.S. children, according to estimates by the Centers for Disease Control and Prevention.

"Now our research suggests that the mother's immune system may be yet another factor or a trigger in those already predisposed," says lead investigator Harvey Singer, M.D., director of pediatric neurology at Hopkins Children's.

Researchers caution that the findings needn't be cause for alarm, but should be viewed instead as a step forward in untangling the complex nature of autism.

Mostly anecdotal past evidence of immune system involvement has emerged from unusual antibody levels in some autistic children and from postmortem brain tissue studies showing immune abnormalities in areas of the brain. Antibodies are proteins the body makes in response to viruses and bacteria or sometimes mistakenly against its own tissues. Yet, the majority of children with autism have no clinical evidence of autoimmune diseases, which prompted researchers to wonder whether the antibodies transferred from mother to child during pregnancy could interfere with the fetal brain directly.

To test their hypothesis, the research team used a technique called immunoblotting (or Western blot technology), in which antibodies derived from blood samples are exposed to adult and fetal brain tissue to check whether the antibodies recognize and react against specific brain proteins.

Comparing the antibody-brain interaction in samples obtained from 100 mothers of autistic children and 100 mothers of children without autism, researchers found either stronger reactivity or more areas of reactivity between antibodies and brain proteins in about 40 percent of the samples obtained from the mothers of autistic children. Further, the presence of maternal antibodies was associated with so-called developmental regression in children, increasingly immature behaviors that are a hallmark of autism.

While the findings suggest an association between autism and the presence of fetal brain antibodies, the investigators say further studies are needed to confirm that particular antibodies do indeed cross the placenta and cause damage to the fetal brain.

"The mere fact that a pregnant woman has antibodies against the fetal brain doesn't mean she will have an autistic child," Singer says. "Autism is a complex condition and one that is likely caused by the interplay of immune, genetic and environmental factors."

Researchers are also studying the effect of maternal antibodies in pregnant mice. Preliminary results show that the offspring of mice injected with brain antibodies exhibit developmental and social behaviors consistent with autism.

Senior author on the study: Andrew W. Zimmerman, M.D., of the Center for Autism and Related Disorders at the Kennedy Krieger Institute.

Co-authors: Christina Morris and Colin Gause, both of Hopkins; Pam Gillin of the Kennedy Krieger Institute; and Stephen Crawford, Ph.D., Johns Hopkins Bloomberg School of Public Health. The study was funded by the Alliance for Autism Research.

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CONTACT: Ekaterina Pesheva, Johns Hopkins Children's Center, 410-516-4996, pager 410-283-1966, epeshev1@jhmi.edu

More On Autism and Maternal IgG Antibodies From the UC Davis MIND Institute

The UC Davis Mind Institute has issued a press release elaborating on its new study on maternal IgG antibodies and autism which found that "antibodies in the blood of mothers of children with autism bind to fetal brain cells, potentially interrupting healthy brain development" and that "the reaction was most common in mothers of children with the regressive form of autism"

Some cases of autism may be traced to the immune system of mothers during pregnancy


UC-Davis discovery could lead to prenatal identification and prevention

(SACRAMENTO, Calif.) – New research from the UC Davis M.I.N.D. Institute and Center for Children’s Environmental Health has found that antibodies in the blood of mothers of children with autism bind to fetal brain cells, potentially interrupting healthy brain development. The study authors also found that the reaction was most common in mothers of children with the regressive form of autism, which occurs when a period of typical development is followed by loss of social and/or language skills. The findings, to be published in the March 2008 issue of Neurotoxicology, raise the possibility that the transfer of maternal antibodies during pregnancy is a risk factor for autism and, at some point, that a prenatal test and treatment could prevent the disorder for some children.

“While a growing body of research is dedicated to finding distinctions in the immune systems of children with autism, this is one of the first studies to identify immunological factors in mothers that could be linked to autism in the very earliest stages of life,” said Judy Van de Water, senior author of the study and professor of rheumatology, allergy and clinical immunology. “Our results should lead to more research on the prenatal environment and the onset of autism. We are also optimistic that in the future a prenatal test and therapeutic intervention preventing IgG exposure during pregnancy could protect some children from ever getting autism.”

Van de Water and her team began their research with blood samples from 123 mothers – 61 whose children have autism and 62 whose children are typically developing. They isolated IgG antibodies from the samples then exposed the antibody to fetal brain tissue by western blot analysis, which detects antibody reactivity to proteins. The outcome revealed a highly specific reactivity pattern to two fetal brain proteins in seven of the 61 samples from the autism group, six of which were from mothers of children who had regressive autism. None of the IgG samples from mothers in the control group produced this same result.

“We’re not entirely sure why the IgG response against fetal brain proteins was so specific for later onset autism,” said Van de Water. “It’s possible that early exposure to maternal antibodies sets in motion a biological path to autism with the behavioral outcomes not apparent until much later. It’s also possible that an environmental exposure sometime after birth could be required to set this process in motion. We are hopeful that this study will help build our understanding of the foundations of the regressive form of the disorder.”

Characteristic features of autism – social deficits, language impairments and limited, repetitive behaviors – are often clear early in an affected child’s life. Other children seem to progress normally until 12-to-24 months of age, when developmental milestones disappear. These distinct pathways have led clinicians to identify autism as one of two types – early onset or regressive – potentially with distinct causes and disease processes.

IgG antibodies are responsible for long-term immune system responses to infection, but they can also contribute to autoimmune diseases such as arthritis, multiple sclerosis and lupus. IgG also crosses the placenta in order to provide key immune system protectants to a growing fetus and newborn child, which is a key reason why Van de Water decided to investigate the role of IgG as a potential factor in autism.

Van de Water next wants to know if IgG in women during the time of their pregnancies produces the same response to fetal brain proteins. Women in the current study were two-to-five years beyond childbirth. She will now conduct the same study with women who are pregnant and already have a child with autism, because such women are much more likely to have another child with the disorder.

“If women in this next phase of the study give birth to a child eventually diagnosed with autism, blood analyses from all stages of her pregnancy will give us a clear picture of the immune system factors that were in play during gestation and could have altered her child’s neurodevelopment,” Van de Water said.

Other key next steps are to identify the specific proteins targeted by autism-specific maternal antibodies and their role in neurodevelopment and to determine whether or not exposure to maternal IgG during pregnancy leads to behavioral or social distinctions in offspring. Animal model studies are now under way to help answer these questions.

“Our outcome leads autism science in many new and exciting directions,” said Daniel Braunschweig, pre-doctoral fellow of immunology in the Van de Water lab, lead author of the current study and recent recipient of an Autism Speaks mentor fellowship to further pursue this research. “We now know we should be looking for the clues to the onset and pathology of autism much earlier than was initially assumed. Future studies should consider the immune system interactions between mother and child as a focal point in creating greater understanding of, and eventually finding effective preventions for, this complex neurodevelopmental disorder.”

“This finding is important because it provides important clues about the potential maternal contributions to autism risk in a subset of children who may develop autism,” said Isaac Pessah, director of the UC Davis Center for Children’s Environmental Health and professor of molecular biosciences. “We’re determined to find out what causes autism. Studies conducted in the Van de Water lab are giving us valuable insights as to when and where in the developmental process we should be looking for those causes.”

“We’re very interested in understanding the underlying causes of autism,” said Cindy Lawler, scientific program director at the National Institute of Environmental Health Sciences. “This finding, in combination with other new research findings coming from NIH-funded studies, demonstrates the complexity of this disorder and underscores the importance of understanding how the mother’s immune system can influence early brain development.”

###

The study, “Maternally Derived Antibodies Specific for Fetal Brain Proteins,” was funded by the National Institutes of Environmental Health Sciences, the U.S. Environmental Protection Agency and the M.I.N.D. Institute. A copy can be requested from newsroom@elsevier.com or downloaded at www.sciencedirect.com.

The UC Davis M.I.N.D. (Medical Investigation of Neurodevelopmental Disorders) Institute is a unique collaborative center that brings together clinicians, scientists, parents and educators for research on causes, treatments, preventions and cures for autism, fragile X syndrome, Tourette’s syndrome, attention-deficit/hyperactivity disorder and other neurodevelopmental disorders. For more information, visit www.mindinstitute.org.

The UC Davis Center for Children’s Environmental Health and Disease Prevention is a multi-disciplinary research effort established to examine how toxic chemicals may influence the development of autism in children. Toward that goal, the center is conducting two large-scale research projects: the Childhood Autism Risks from Genetics and the Environment (CHARGE) study and Markers of Autism Risk in Babies—Learning Early Signs (MARBLES) study. For more information, visit www.vetmed.ucdavis.edu/cceh.

Editor’s note: B-roll of blood sample processing for immunological studies of autism in the Van de Water lab is available on request.


Autism and Potential Environmental Causes - Maternal Antibody IgG

Maternal IgG (an antibody) may be a factor in causing autism according to a study conducted by researchers from the UC-Davis MIND Institute. The study report, Stereotypies and hyperactivity in rhesus monkeys exposed to IgG from mothers of children with autism, by researchers Loren A. Martin, Paul Ashwood, Daniel Braunschweig, Maricel Cabanlit, Judy Van de Water, and David G. Amarala, is currently an article in press in Brain, Behavior, and Immunity and the abstract is available on line from Science Direct. The report notes an emerging consensus that Autism Spectrum Disorders have multiple etiologies (causes or origins) and indicates that the study tested the proposition that one cause of ASD may be exposure of the fetal brain to maternal autoantibodies during pregnancy. The study essentially involved comparing a group of rhesus monkeys exposed to human IgG collected from mothers of multiple children with ASDs to rhesus monkeys exposed to IgG from mothers of multiple typically developing children and to a further control group of untreated rhesus monkeys.

As described in the Science Direct abstract:

"four rhesus monkeys were exposed prenatally to human IgG collected from mothers of multiple children diagnosed with ASD. Four control rhesus monkeys were exposed to human IgG collected from mothers of multiple typically developing children. Five additional monkeys were untreated controls. Monkeys were observed in a variety of behavioral paradigms involving unique social situations. Behaviors were scored by trained observers and overall activity was monitored with actimeters. Rhesus monkeys gestationally exposed to IgG class antibodies from mothers of children with ASD consistently demonstrated increased whole-body stereotypies across multiple testing paradigms. These monkeys were also hyperactive compared to controls. Treatment with IgG purified from mothers of typically developing children did not induce stereotypical or hyperactive behaviors. These findings support the potential for an autoimmune etiology in a subgroup of patients with neurodevelopmental disorders. This research raises the prospect of prenatal evaluation for neurodevelopmental risk factors and the potential for preventative therapeutics."

A helpful definition of IgG can be found at the Dalhousie University Faculty of Medicine Immunology Bookcase web site. The definition points out that IgG is the most abundant form of antibody in the blood, that it is able to leave the blood stream and enter tissues and that it is the only form of antibody to pass the placental barrier:

IgG is the most abundant form (class) of antibody in the blood (serum concentration is 13 mg/ml !). There are four subclasses of IgG which are all monomeric and they usually have a very high affinity for antigen. Unlike IgM, IgG is able to leave the blood stream and enter tissues.

IgG is also the only class of antibody to pass the placental barrier. Therefore IgG provides the only antibody protection for newborns until their own immune system is able to contribute to antibody production.

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