About two weeks ago, the National Institute of Health announced part of the government’s commitment to autism research through the ACE projects, or Autism Centers for Excellence. Highly competitive and intensely scrutinized, these 5 year projects all investigates areas of autism aimed at helping people with ASD and their families. This week’s podcast summaries them, discusses how they interact and complement each other, and explains how they are going to affect the lives of people with autism.
This week’s podcast summarizes recent evidence on why there is good and bad in treating autism with medication, but there is also lots of ugly. While new medications are being developed and researchers are looking into new ways of measuring change across time time, medications are not effective in treating the core symptoms of autism and they have pretty harsh side effects which, you guessed it, are dealt with by prescribing more medications. There are a lot of reasons to be hopeful about the future of medication use in autism, but lots of reasons to feel frustrated too.
Here are some of the articles that were cited:
This podcast was going to be dedicated to new early detection research which shows what the USPSTF has been looking for – the link between early detection, early intervention, and improved outcomes in a community setting. Those findings are still included this week, but there is a slight diversion in theme. The podcast will also include an explanation of the immune/microbiome study published in Nature and misrepresented by Korea Daily. The study is important, however, the media sensationalized the findings and did the research no favors by labeling it a “major cause”. Learn what the study did and what it actually discovered in this week’s podcast.
Here are the references of the studies mentioned in the podcast:
This week’s ASF Podcast is a special interview with Dr. Gil Sharon from CalTech, who studies the microbiome in animal models and potential link to ASD. The microbiome is the full community of bacteria that live in our bodies and outnumber cells 10-1. They can affect the genome directly and they can respond to environmental factors which means they may be a site for important gene x environment interactions in autism. Some people with ASD, especially those with gastrointestinal problems, show alterations in the microbiome and more and more scientists are starting to incorporate studying this complex system into their research. Most importantly, new research is suggesting potential for probiotic therapies to not only treat GI symptoms, but also core autism symptoms. If you like the podcast, Dr. Sharon has provided a list of resources which can provide more detail:
Interventions in mice –
Hsiao, E.Y., McBride, S.W., Hsien, S., Sharon, G., Hyde, E.R., McCue, T., Codelli, J.A., Chow, J., Reisman, S.E., Petrosino, J.F., et al. (2013). Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell 155, 1451–1463.
Buffington, S.A., Di Prisco, G.V., Auchtung, T.A., Ajami, N.J., Petrosino, J.F., and Costa-Mattioli, M. (2016). Microbial Reconstitution Reverses Maternal Diet-Induced Social and Synaptic Deficits in Offspring. Cell 165, 1762–1775.
Intervention in humans –
Kang, D.-W., Adams, J.B., Gregory, A.C., Borody, T., Chittick, L., Fasano, A., Khoruts, A., Geis, E., Maldonado, J., McDonough-Means, S., et al. (2017). Microbiota Transfer Therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study. Microbiome 5, 10.
Microbiome profiling –
Gondalia, S.V., Palombo, E.A., Knowles, S.R., Cox, S.B., Meyer, D., and Austin, D.W. (2012). Molecular characterisation of gastrointestinal microbiota of children with autism (with and without gastrointestinal dysfunction) and their neurotypical siblings. Autism Res. 5, 419–427.
De Angelis, M., Piccolo, M., Vannini, L., Siragusa, S., De Giacomo, A., Serrazzanetti, D.I., Cristofori, F., Guerzoni, M.E., Gobbetti, M., and Francavilla, R. (2013). Fecal microbiota and metabolome of children with autism and pervasive developmental disorder not otherwise specified. PLoS One 8, e76993.
Son, J.S., Zheng, L.J., Rowehl, L.M., Tian, X., Zhang, Y., Zhu, W., Litcher-Kelly, L., Gadow, K.D., Gathungu, G., Robertson, C.E., et al. (2015). Comparison of Fecal Microbiota in Children with Autism Spectrum Disorders and Neurotypical Siblings in the Simons Simplex Collection. PLoS One 10, e0137725.
Identifying subtypes for autism and narrowing down the heterogeneity of symptoms has been considered the holy grail of autism research. If one person with autism is not like another person with autism, can they at least be put into groups to speed up studies into causes, intervention and services? And how? This podcast explains two different studies that used the same statistical method but different children with autism to identify different groups. One of the things that helped define these groups was verbal ability and IQ. For the first time, comorbid symptoms like medical issues and psychiatric diagnoses are being taken into account. Already, this approach is helping scientists better understand why fever improves symptoms in some people with autism.
Labor Day is a time to appreciate and honor all those people who work to make this world a better place. People with autism do that, but they also want to get paid and be employed just like anyone else. This Labor Day, the podcast summarizes challenges to studying employment in people with ASD, what we know, and what is being done in a collaboration between ASF, Curtin University in Australia, the Karolinska Institute and Stony Brook University in Long Island. This is the INSAR supported policy brief project that will be completed next year, but you will all be receiving a request to fill out a survey about employment in the coming weeks. In addition, what does employment mean for people with autism? A NY Times article recently highlighted the journey from childhood to adulthood and what having a job means.
Thank you to Sonia Agarwal, smart, efficient and eloquent ASF summer intern for putting together a summary of resources and services and rights for adolescents and young adults with autism, focusing on those who are not intellectually disabled. They include resources for transitioning into college and support programs at college, with tips and hints along the way. Sonia has a younger brother with autism and is committed to helping families access the help they need.
Every time you turn around there is another study contradicting the last on antidepressant use and autism risk. An answer on why there are differences across different studies may be found in a new analysis published by University of Washington and SSM Dean Medical Group in Wisconsin this week. They showed that autism severity (not risk) is increased only with both a likely gene disruption AND following antidepressant exposure in pregnancy together. This suggests a double hit model similar to other complex neuropsychiatric disorders like depression. It also suggests that findings from other chemicals, like PBDE’s, may be dependent on gene / environment interactions too. After all, a new systematic review showed PBDE’s during pregnancy are bad for the IQ of the child. This provides insight on ASD risk and subtype given the multitude of possible genetic / environmental combinations out there.
This week’s podcast is a throwback from a few months ago which highlighted research using brain tissue of individuals with ASD. To understand the brains of people with autism, researchers need to look at the brains of people with autism. This means people with autism and their families need to learn more about this option so they can be prepared when the time comes. Listen to the podcast to hear how brain tissue research is helping scientists understand autism better, and making a difference in the lives of people with autism now.
Parents of children with seizures are desperate to find something that will at the very least reduce the frequency of seizures in their kids. Answers came in an unlikely place two months ago with the publication of a randomized clinical trial showing that seizures could be reduced with use of cannabinoids in kids with a condition called Dravet’s Syndrome. Cannabinoids are one of the chemicals found in marijuana, and there are anecdotal reports on the use of marijuana or cannabinoids to treat autism. Unlike THC, CBD (cannabinoids) do not cause euphoria or any psychoactive effects and are used exclusively for medicinal reasons. This podcast summarizes current literature and also explains why it is so hard to study cannabinoids, including federal and state regulations and what needs to happen to open up this field of science