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I am a cognitive neuroscientist currently in a post-doctoral training program in autism spectrum disorder. Autism spectrum disorder (ASD) is a disorder typifie
by SubiculumCode 10y ago
I am a cognitive neuroscientist currently in a post-doctoral training program in autism spectrum disorder.
Autism spectrum disorder (ASD) is a disorder typified presence of repetitive behaviors and restricted interests, and by disruption to social behaviors, and yet is very heterogeneous in how it presents.
A first point I'd like to make is that there is no pharmaceutical treatment currently approved for ASD. The drugs mentioned by the article are primarily used to treat disorders such as ADHD, anxiety, schizophrenia, or gastrointestinal irritation, which are frequently co-morbid with ASD. These co-morbid disorders typically have large impacts on the quality of life of people with ASD, and frequently aggravate ASD symptomatology. However, the costs and benefits of treating co-morbid disorders have to be weighed and tested at the individual level by a responsive and knowledgeable physician and psychiatrist. In terms of treating ASD itself, this has turned out to be really really hard.
There is a saying that goes, "If you've met one person with autism, you've met one person with autism." This saying captures the tremendous heterogeneity (aka spectrum) of the disorder. There is not one cause of autism, there are hundreds or thousands of genetic causes of autism. Hundreds of genes are implicated in autism, and no single genetic mutation accounts for more than half a percent of autism cases. While many of the known genes contribute to the same major pathways (e.g. the seretonin pathway, or involved in processes of snyaptic pruning), they effect different parts of those complex pathways. Some genetic mutations will severely impact the function of the pathway, while others just make it less efficient, or different. Modern drug treatments would like to target a specific chain link in the pathway with a pharmaceutical, but such a drug would likely just help a small sliver of those with autism. Hundreds of different targeted drugs would need to be developed and then target the specific cases of autism it might help. That is a very difficult task indeed.
The FDA drug approval process doesn't make this easy. Many drugs seeking approval fail because they only help a portion of their sample, (not enough to effect the overall mean above placebo), and until researchers are able to subdivide their ASD sample into the appropriate subgroups that respond and don't respond to a treatment a priori, the FDA won't approve those drugs for treatment.
- SubiculumCode 10y agoI feel compelled to add that aside from (or interact with) genetic risk factors for autism, exposure to excessive immune system antibodies during pregnancy appears to be involved in a significant number of autism cases. Moreover, in rodent models ASD like symptoms in pups have been created by exposing the dam to compounds that ramp up the immune response in the pregnant dam. I think there are real possibilities for preventive medicine here. Citation: http://www.sciencedirect.com/science/article/pii/S0006322316327391 http://www.sciencedirect.com/science/article/pii/S0006322316...
- AstralStorm 10y agoThis is weak evidence, further weakened by not being shown in humans. I suppose some variants of autism could be caused by essentially autoimmune reactions. Good luck showing causation. You would need full immune library of thousands of mothers and their children. Further luck in fixing the problem, you cannot just immunosuppress the mother. What is worse, is that symptoms of autism tend to show up quite late in many cases. Few years of age which suggests some sort of an inherited problem though potentially also autoimmune.
- SubiculumCode 10y agoYou think I covered all the evidence in my forum post? Yes there are many question left, but right now there is evidence in non-human primates and rodents with causal experimental models, and in humans differences in brain morphology and intellectual disability are associated with increased levels of maternal cytokines and chemokines during gestation in humans. Of course, it would be unethical to do random assignment in humans to a condition causing a large cytokine response in mothers. As far as treatment that is a difficult question. Active filtration might be a possibility. In any case, there is more of a possibility here for prevention than gene therapy, imo.
- AstralStorm 10y agoUnless you accept eugenics of course or perhaps in vitro fertilization. Somewhat dirty words nowadays. Or if the problem turns out to be metabolic and thus possible to work around. Compared to drugs, it is no treatment at the moment. Damage done by autoimmune disorders early in life can rarely be fixed. Diagnostics are years off at the very least.
- SubiculumCode 10y agoThere are certainly ethical issues associated with detection of autism risk during pregnancy allowing the choice for termination. I'm not sure about your point though. Fixing things after it has happened is generally hard. I am no immunologist, but preventing excessive immune response is a possibility maybe for prevention of the injury (not completely removing the immune response, just retarding it).