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ASD and ADs



Overview and Implications

Many different studies in the field of epidemiology (the study of the distribution of health events) have focused on researching a potential connection between Autism Spectrum Disorder (ASD) and autoimmune diseases (ADs). But as is the case for many topics in academia, the results of the different studies have been quite inconsistent and therefore called for the necessity of a study to confirm any previously collected data. Therefore, as indicated by an article in the Pediatrics journal, a new research study spearheaded by Hjördís O. Atladóttir focused on investigating more about the complex relationship between ADs and ASD, especially that of infantile autism. Such young detection of autism usually means more severe symptoms. It has been noted that researchers performed explorative analyses in conjunction with confirmatory analyses that utilized data from prior studies.


Atladóttir’s study ended up using, in a manner, all of the children that were born in Denmark from 1993-2004; their data, ranging from inpatient data to outpatient diagnoses, were analyzed via assistance from the Danish National Hospital Registry. A statistical method called the log-linear Poisson regression was conducted to ultimately determine the overall incidence ratio of ASD in children whose parents and/or siblings have been diagnosed with ADs. Approximately 33% of the diagnosed children that were analyzed were deemed to have some variation of infantile ASD.


Two major observations were made by the researchers after the study. First, children who have a maternal family history involving celiac disease or rheumatoid arthritis had an elevated risk of being diagnosed with ASD. Second, children with a family history involving Type 1 diabetes had a much greater likelihood of having infantile ASD. Though researchers are not sure regarding the reasoning for the observed phenomena, they state that changes in an infant’s fetal environment and the exposure of prenatal antibodies during the mother’s pregnancy likely play a large role. Maternal antibodies have been found to be essential in ensuring proper neural development. Additionally, better analyzing the genetic backgrounds of the individuals may indicate some other underlying commonality.


Brief Connection to Another Study

Prenatal antibodies may indeed be quite influential as a study in the Brain, Behavior, and Immunity journal discussed the relationship between antibodies, specifically autoantibodies, of a child’s cerebellum and behaviors often associated with ASD; an autoantibody is synthesized by one’s body in direct response to some part of their tissues. The main premise that is communicated via the journal’s article is that children’s antibodies toward brain proteins are often related to lower levels of cognitive function and adaptive function; more importantly, the antibodies are associated with key behaviors that are often integral to ASD. As of right now, it is not apparent whether autoantibodies play a pathologic role. Some autoantibodies that act on the central nervous system have been connected to premature neuron apoptosis (programmed cell death). Future studies that focus on different proteins may be far more telling of their association with ASD.


Critique

The study in Pediatrics decided to do something remarkable in terms of the sample size that was utilized as a part of the study: the researchers decided to use nationwide registers and, more importantly, integrate a study sample that is ≥ 10 times larger than some of the other previous studies. Partly due to the large sample size present in this study, the researchers have been able to adequately “confirm associations found in previous studies, and [explore] the relationship between family history of other ADs and autism” (Atladóttir et al., 2009).


Article Reviewed

Atladóttir HO, Pedersen MG, Thorsen P, et al. Association of family history of autoimmune diseases and autism spectrum disorders. Pediatrics. 2009;124(2):687‐694. doi:10.1542/peds.2008-2445


References

Goines, Paula et al. “Autoantibodies to cerebellum in children with autism associate with behavior.” Brain, behavior, and immunity vol. 25,3 (2011): 514-23. doi:10.1016/j.bbi.2010.11.017

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