(III) SHIFTING THE PARADIGM ON AUTISM SPECTRUM DISORDER: Advances in Autism

On October 28, 2007, we had the opportunity of attending the “Advances in Autism Conference” sponsored by Mount Sinai School of Medicine. This conference brought together a distinguished interdisciplinary panel of experts such as Dr. Eric Hollander, Dr. Eric Fombonne, Dr. Frances Champagne, Dr. Sue Carter, Dr. Temple Grandin, Dr. Evdokis Anagnostou, Dr. Latha Soorya, Dr. Jeremy Silverman, and Dr. Joseph Buxbaum, among other experts. In addition, the conference had as speakers Andrew Bauman, President and CEO of NY Families for Autistic Children; Max Chmura, Executive Deputy Commissioner of OMRDD; Dr. Sophia Colamarino, Director of Clinical Research, Autism Speaks; Dr. Stephen Shore from Autism Society of America and Dr. Jonas Waizer from FEGS.

The main objective of this conference was to update and enhance knowledge related to the accurate recognition, diagnosis and treatment of autism and Asperger’s Disorder. The speakers reviewed the current psychological, neurological, functional imaging, neurotransmitter, and molecular biology models of autism as well as pharmacological, behavioral, educational, and support group treatments of autism.

The conference was very interesting and informative on the recent epidemiological studies about autism. According to Dr. Fombonne, the observed increase in autism prevalence is more likely due to the development of methodological factors that identify more cases of autism at an earlier age and diagnose individuals with autism who previously might not have been included in this category. For instance, individual who we now identify as autistic would have been diagnosed as having Learning Disabilities, Mental Retardation, or ADHD. Consequently, the apparent rise in autism is correlated with a decrease in these types of diagnosis. According to data released in 2007, 1 in 150 children had a diagnosis of ASD in the USA, and we know that this number is rising, but this trend cannot be interpreted as evidence of increase in the incidence, that is, the number of new cases of autism in the population. Dr. Fombonne understands that the hypothesis of an increased incidence is not ruled out because adequate epidemiological data is needed. Another important point that he made was regarding autism and its links with immunization. Epidemiological studies have concluded that autism did not arise through vaccinations and there is no evidence that correlates autism with MMR vaccines or mercury-induced autism.

Initially, Autism was diagnosed based on educational and behavioral conditions, but etiology remains to be known. According to Buxbaum from the Psychiatry, Genetics and Genomic Sciences and Neuroscience Dept. at Mount Sinai Medical School and Dr, Schaefer, from Munroe-Meyer Institute for Genetics and Rehabilitation, university of Nebraska, families should need to know why the autism occurred and the risk of recurrence. According to Dr. Schaefer, all individuals diagnosed with Autism Spectrum Disorder (ASD) should have a neurogenetic evaluation.

A presentation that struck my attention was on Oxytocin and Vasopressin and their implications for Autism Spectrum Disorder. According to a randomized double-blind study at Mount Sinai Medical School that tested the effects of Oxytocin, repetitive behaviors in autism spectrum disorders may be related to abnormalities in the Oxytocin system, and may be partially ameliorated by synthetic Oxytocin infusion.

In addition, they reviewed the novel treatment with Trichuris Suis Ova (TSO), which involves the use of eggs of the parasite Trichuris and has become a hypothesis to treat autistic individuals. Some studies suggest that exposure to helminthes may be able to prevent or treat human diseases such colitis, autoimmune diabetes, autoimmune encephalitis, Crohn’s disease and autism. Stewart Johnson presented the case of his 16 years old son diagnosed with autism who after exploring all possible treatments (ABA, 20 hours+ per week from age 3 to age 8 and psychotropic medications) became free from autistic symptoms when he was treated with TSO. Dr. Hollander from Mount Sinai Medical School is developing a double blind, placebo controlled study of TSO in autism. I would like to say that we have made enormous progress in the etiology of Autism Spectrum Disorder, and I am excited about the diverse research reviewed in this conference, which hold much promise for a potential cure of autism.

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Oxytocin: A hormone released from the posterior lobe of the pituitary gland that stimulates the contraction of smooth muscle of the uterus during labor and facilitates ejection of milk from the breast. Vasopressin: A hormone secreted by the posterior lobe of the pituitary gland that constricts blood vessels, raises blood pressure, and reduces excretion of urine.