Autism and other autism spectrum disorders (ASDs) have puzzled health professionals and academics for decades and its aetiology is still unclear today. Nevertheless, there has been a growing interest in the potential of stem cell deployment to provide relief from the symptoms of autism and perhaps, one day, to effect a cure.
Explaining Autism and other Autistic Spectrum Disorder (ASD)
What is autism? Classic autism is one of four neuro-developmental conditions classified together as autistic spectrum disorders (ASDs): the others are Asperger syndrome (AS), childhood disintegrative disorder (CDD) and pervasive developmental disorder not otherwise specified (PDD-NOS).
According to the Autism Center of Excellence (ACE) at the UC San Diego School of Medicine, autism affects one in every 150 children born today. From the outside, the symptoms of autism are not apparent from birth but become revealed within the first 36 months of development, often when a parent reports that there is something atypical about their child’s behavior. A medical professional will then use a combination of physical examinations and clinical assessment tools to make a diagnosis. Autism is characterized by lifelong problems with communication, social interaction and behavior. There is no known cure for autistic spectrum disorders and it is largely thought that their aetiology is due to a number of combining factors rather than one single cause. Autism does appear to have a genetic component and is four times more prevalent in males than females.
Gut Inflammation and Atypical Brain Activity in Autistic Patients
There is no definitive physical or biological test for autism but many researchers have studied autistic patients with the goal of finding common biological factors that they share. A recent study conducted in Saudi Arabia, described in this paper, found significantly elevated levels of both macrophage-derived chemokines (MDCs) and thymus and activation-regulated chemokines (TARCs) in the guts of autistic patients. Although it has been suggested that this abnormality is immunologically mediated, and that autism might therefore be classified and potentially treated alongside other immune disorders, this is by no means supported across the field.
Along another line of enquiry, researchers using functional MRI imaging have detected signs of reduced activity in certain areas of the brain when scanning autistic patients. For example, new techniques to measure the brain function of toddlers have indicated differences in activation of the fusiform face area (FFA) between autistic children and normally developing controls. As its name suggests, the FFA is important in the identification of faces and is a very active part of the brain during typical infant development. Researchers at the ACE found that FFA activation was either absent or weak when scanning the brains of autistic infants and that, compared to typical controls, its activity levels were much more dependent on extrinsic factors (e.g. placing a dot on the subject’s forehead to maintain attention).
Stem Cells and Autism: Hope for a Cure?
With a growing body of evidence linking stem cell therapies with symptomatic relief and tissue regeneration in a wide range of disorders, including cardiac, orthopedic, neurological and autoimmune conditions, it is no surprise that their potential application for treating patients with autistic spectrum disorders is now being enthusiastically studied.
Depending on their potency, stem cells are able to rapidly differentiate into a multitude of different types of cell but it is another characteristic of stem cells that is also drawing the interest of researchers – their calming effect on the immune system. Mesenchymal stem cells (MSCs), which are readily found in and easily extracted from the body, have been found to suppress the action of certain catabolic molecules to prevent healing processes from being sabotaged by the body’s own defense systems. MSCs have even been deployed to turn off the immune system in cases of acute graft versus host disease (GvHD), a post-transplant condition that is often associated with bone marrow transplant and can be fatal.
If it is proven that there is an immunological aspect to autism, then the deployment of MSCs could help to improve the cellular environment which may, in turn, have a positive effect on the symptoms of autism.
Although the benefits of stem cell therapy for autistic patients is unproven, research using stem cells definitely offers the potential for an advance in understanding of this enigmatic condition. Somatic stem cells from autistic patients can be harvested and then induced to become neurological cells for use as a treatment model. These so-called induced pluripotent stem cells (iPSCs) can then be cultivated and studied, enabling researchers not only to detect abnormalities in neurological development (which may, for example, shed light on the differences in activation levels picked up by the fMRI studies detailed earlier) but also to see how the patient’s own neurological tissue might respond to chemical interventions and other biological procedures. In this way, progress towards future drug treatments – even personally-tailored treatments – can be accelerated.
Although there may be a time when the transplantation of neurological tissue into the brains of autistic patients becomes feasible as a potential cure, a considerable amount of research would be required to fill in the gaps in understanding that still exist, followed by extensive clinical trials.
Complications in Finding a Cure for Autism
With much of the correlational evidence linking autism to biological conditions disputed, the groundwork for formulating any successful intervention, utilizing stem cells or otherwise, is unstable. In addition, since the mechanisms underlying the biological processes linked with autism are poorly understood, progress is slow and disjointed.
The behavioral and cognitive aspects of autism also complicate matters when it comes to investigative treatments such as those performed at the Gulf Coast Stem Cell and Regenerative Medicine Center. Although the harvesting and deploying stem cell-rich stromal vascular fraction (SVF) from a patient’s own adipose (fat) tissue is a straightforward, minimally invasive procedure for non-autistic patients, it can be traumatic for those with autism due to their atypical cognition. Therefore, donor cells from a parent, after thorough donor matching and screening, as per FDA transplant guidelines are essential to meet the high bar of safety.
Some autistic patients and their families have travelled outside of the United States to seek allogeneic (not self) stem cell therapy, which usually involves the intravenous injection of umbilical cord stem cells, since these are known to be as potent as one’s own, and they are equally immune-privileged (fir a few months), and no HLA matching is required. However, as with all open procedures, there is a risk of infection and extra care must be taken to evaluate the treatment facilities and medical team to one’s satisfaction.
In addition, whereas there is strong evidence from clinical trials supporting the efficacy of stem cell therapies for a number of conditions (e.g. osteoarthritis), evidence for efficacy and benefit in treating autistic spectrum disorders is weaker, but present. Partial benefit has been noted in anecdotal cases. Further, it must be remembered that parents of autistic children who are faced with the certain outcome without stem cell therapy compared to the possibility of partial improvement with stem cell deployment. Therefore, the best course for the guardians of autistic patients and would be to obtain as much information and professional advice as possible so that they can make an informed decision.
The Gulf Coast Stem Cell and Regenerative Medicine Center, has an active research program managing a wide range of varied disorders, including orthopedic, degenerative, neurological and auto-immune. For more information about the diseases and disorders that we currently address and study, please call (866) 885-4823. There is also a lot more information on our website: www.gulfcoaststemcell.com