I’ll be answering questions and discussing the NYT article on immune involvement in autism tomorrow, 8/29, 3pm EDT: https://www.facebook.com/autismspeaks?ref=stream&sk=app_226961267321617
So it turned out than an hour was no where near long enough to answer all the questions. Therefore, I’ll attempt to comment on those remaining questions for which I am able to provide useful info.
[for answers to questions that were already dealt with on line, see the Autism Speaks-coveritlive site.]
“NoName” asked if there are any connections between autism and schizophrenia? Yes, there are. some symptoms overlap – anxiety, social deficits, sensory motor gating, lack of facial affect. Kanner’s original description of autism placed it as a subset of schizophrenia. Maternal infection is risk for both disorders in the offspring. A number of candidate genes apply to both. A recent paper indicated that autism prevalence is higher than expected in schizophrenic subjects (or was it the other way round?). Both disorders have immune dysregulation in the blood and in the brain, and both have GI problems and cerebellar neuropathology.
Patrice Gilbert – please contact Beth Maloney to get the name of a Pandas expert near you. You can find Beth at her Facebook site.
Melissa – Pediatricians can make the initial diagnosis of ASD but it is advisable to also see a specialist, and that can help find a good treatment place also.
Amanda asked about Elaine Hsiao’s experiments on IL-6 and the placenta. Here is a link to that paper.
Melinda suggests that there should be a national forum on neuroimmune dysregulation. There is a neuroimmune meeting coming up in Boston Nov 5-7, and a Pandas mtg in Irvine Calif Sept 24-5. There is also the annual autism mtg called IMFAR, which would be a logical place to hold a wide discussion on this, but those organizers rarely include anything on immune-related issues in plenary sessions. Some years ago, we held this type of small mtg at Caltech sponsored by Cure Autism Now (now joined with Autism Speaks), and that was very successful. Autism Speaks also hosted an excellent mtg on GI issues in ASD last year, and a report coming out of that should be published soon.
Patrice further asks if IL-6 can be blocked in the mom to prevent autism in the offspring. In our mouse model, Steve Smith did block IL-6 and did prevent the ASD behaviors from developing in the offspring. However, that mom was immune activated by using a viral mimic (a chemical that the immune system sees as a virus) not the virus itself. If he blocked IL-6 and injected the flu virus the mom gets supersick and aborts. This is because IL-6 is needed to fight the infection. Thus, this approach would not work in a pregnant woman. Moreover, clinical tests will not be done of this type because even if a woman gets the flu during pregnancy, the odds that her offspring will develop autism are small. The odds are greater than if she did not get the flu, but still the odds are small. So tests on pregnant women will not be done.
Christina asks, “I was really interested in a response to Kay’s question. What kind of inflammation markers are we looking for? I still need to help my son, and he has a doctor’s appointment next week. What tests should I be asking them to run? Has anyone used immunosupressant drugs to see if that gives relief? Would regular use of NSAIDS help autism symptoms? Or is it only during pregnancy that it matters.” The blood tests for abnormal immune status are found in papers by Judy van de Water at UC Davis. If your doctor is willing, she/he can look them up on line. A number of immune suppressant drugs have been and are being tested in autism. You can find these on the ClincalTrials.gov site. This site also lists the location of each trial. You can also see more about this on my post here of July 20. There is also the new worm trial being started that was mentioned in the NYT article. You can read more about the background for that treatment on other posts on my blog here.
Lori asks if smoking has been linked to having an ASD child. I should know the answer to that but I don’t. I’ll have to look it up. Or, a reader of this post may know the answer and pass it along? A good summary about avoiding environmental hazards is by Alycia Halladay at Autism Speaks: ttp://www.autismspeaks.org/blog/2012/04/06/avoiding-environmental-hazards-during-pregnancy
Infectious Behavior 
Thank you for your generous gift of time and insight on the Autism Speaks forum. I had another question I wanted to ask but ran out of time. I was wondering what your thoughts are regarding the use of medications such as Haldol and Risperdal and Clozaril for children with “psychiatric” issues– considering that these specific medications actually address inflammation– whether it be by blocking glutamate or inhibiting IL-6. Does it seem logical that if a child is responsive to such medications for their “psychiatric” illness, then that said illness might actually be a result of an inflammatory process that might be treated by addressing the underlying infection?
HI Shannon, You raise an excellent question! The immune effects of the anti-psychotic medications are totally ignored by the general medical community, and also generally by psychiatrists. It would be of interest to do more research on this in mouse models where one could begin to ask whether a drug’s effects are more important on the brain or on the immune system, or both. Cheers, PHP
My High Functioning Autistic 16 yr old son has been dx with Stevens Johnson Syndrome 4 times in the past 2 years, each time the only apparent trigger is mycoplasma. No medication involvement, no herpes, Buchets was ruled out. Otherwise healthy, does not get sick often, and no hx of GI difficulty. The Univ. of Utah/Primary Children’s Medical Center physicians (Pediatricians, Rheumatologists, Dermatologists, Infectious Diseases, Cardio, and Optho) have been unable to find any other repetitive SJS case with mycoplasma and need a plan to prevent/intervene. The last time it affected his eyes & lungs & he is no longer responding to the IVIG as quickly. I had gestational Diabetes, late maternal age, and high fam hx of Type II Diabetes but we have no other hx of immune disorders. The physicians did not do their search including the Autism factor. Where would you suggest we go to look? They plan on writing him up – could his case be useful in anything you know is being studied? He has told me that if he has to be that sick then at least he “could be in a book:”.
Janet, luckily, you have already consulted folks who know far, far more than I do about JSJ. I’m afraid that I also don’t know about any connections with autism. I love your son’s comment about being in a book. Sorry to be of no help, PHP
Thanks for taking your time to reply, it means a lot. If you are indeed at Cal Tech, say hi to Pasadena for me – I am a Padadena girl who grew up just a few blocks away and my neices are at Poly. Oh – the latest Joeyism (moved from small jr high to 1800 student high school that started this week): when asked how his day went “Mom, back off. I can’t find my classes and I’m stressed out. You know this is the first time I have gone to a school with more than a 100 doors”. Just thought you might enjoy the chuckle. He is wonderful. Thank you for what you are doing.
That’s funny; my own son just started middle school, with 100 doors also. Cheers, PHP