Autism – does inflammation play a role?

Autism – does inflammation play a role?

One of my patient’s moms, a well-researched, actively engaged parent with a high-functioning autistic son, asked my opinion regarding an article recently published via Autism Speaks that outlines the discovery of a functioning lymphatic network in the brain. The data was initially published in Nature online magazine June 1st of this year and confers additional support to a growing body of evidence supporting the role of inflammation in both brain and body dysfunction.

Autism, essentially defined as a neurologic disorder manifesting in disordered communicative abilities and restricted interests, has long been thought to be due to an interplay of both genetics and environment. In my own practice, I have observed a multitude of presentations– from kids with altered parental/peer interaction that initially appeared more anxious or conduct disordered, to children presenting with classic signs – poor eye contact, little or no speech, excessive attention to obscure observations etc., in only one patient have I witnessed an actual regression of previously attained skills.

The difficulty in determining the cause of autism partly resides in the fact that a person’s genes (or DNA) is not the same as their gene expression – meaning that some genes manifest differently in one person compared to another likely due to some other constellation of factors. Autism researchers have struggled with how to effectively study gene expression and have essentially had to perform testing on brain samples from anatomical specimens. Professor Arking and his colleagues at Johns Hopkins analyzed 104 brain samples and subsequently concluded that in the brains of individuals with autism, the microglia (the primary active immune defense in the brain) were constantly activated and their inflammation response genes were turned on — unlike the study controls. 1

The real question then becomes — does reducing the inflammation that occurs secondary to a heightened immune response help improve autistic symptoms?

Another interesting finding is that of reduced autophagocytic activity in the autistic child’s brain, or in other words, the effective removal of damaged or useless brain synapses by the immune system. 2 The autistic child’s immune system appears to be both overactive and dysfunctional in its behavior. Uncovering the disordered gene expression behind these abnormalities is likely the golden ticket, but controlling the inflammation and encouraging effective autophagocytic activity will likely play a significant role in dampening autistic symptoms. In fact, one study is currently looking into minocycline, a broad-spectrum antibiotic with anti-inflammatory effects on the nervous system, as a means to improve autistic behaviors; while another study is looking at medications that can safely encourage garbage clean-up within the brain. In the meantime, perhaps simple holistic measures that reduce general inflammation can prove helpful at most and not harmful at least…

Consider the following:

  1. Foods high in sugar and saturated fat can spur inflammation. “They cause overactivity in the immune system, which can lead to joint pain, fatigue, and damage to the blood vessels,” says Scott Zashin, MD, clinical professor at the University of Texas Southwestern Medical Center in Dallas 3
  2. Fatty fish, like salmon, and nuts (or low dose Omega 3 supplements)
  3. Whole grains without added sugars
  4. Leafy greens (vitamin E), soy (edamame or tofu), and for most people, low-fat dairy (except in cases of true casein (milk protein) allergy) —“Foods with calcium and vitamin D, such as yogurt and skim milk, are good for everyone,” says Karen H. Costenbader, MD, associate professor of medicine and rheumatoid arthritis doctor at Harvard Medical School. In addition to their anti-inflammatory properties, she says, “it is important to get enough calcium and vitamin D for bone strength, and possibly reduction of cancer and other health risks.3
  5. Colorful peppers (contain known anti-inflammatory capsaicin), tomatoes for lycopene and beets for vitamin C and betalains.
  6. Spices with anti-inflammatory properties – ginger or turmeric, as well as flavor-rich garlic and onion
  7. Lastly — olive oil, berries and tart cherries

I know my kids will scoff if I offer up beets, turmeric and tofu, but incorporating the majority of these ingredients into a diverse diet is not an exceptionally difficult thing to do. It is best to pull vitamins from actual foods, but a daily chewable multivitamin, an additional low dose Omega, probiotic, vitamin C and vitamin D are innocuous additions that may help minimize systemic inflammation and are generally safe in kids (discuss dosing with your pediatrician if you are unsure)! Reducing sugar, processed foods and saturated fats is always beneficial as well. I’ll continue to watch the evolution of how to improve the richness of the lives of autistic children and keep you posted on any promising developments.