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DelGiudice-Asch, Gina; Simon, Lorraine; Schmeidler, James; Cunningham‐Rundles, Charlotte; Hollander, Eric

doi:10.1023/a:1023096728131

Cited by 59 publications

(14 citation statements)

References 20 publications

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“…In contrast, other smaller case series (Level 4) (72) and case series (Level 4) using non-standardized protocols (73) were not able to confirm such improvements (overall GOR of C for the treatment of ASD symptoms). Although IVIG is not uncommonly used in drug-resistant epilepsy, the evidence for its efficacy remains documented in case series (Level 4) (74–77) (overall GOR of C for the treatment of seizures in general).…”

Section: Traditional Treatmentsmentioning

confidence: 78%

A review of traditional and novel treatments for seizures in autism spectrum disorder: findings from a systematic review and expert panel

Frye

Rossignol²,

Casanova

et al. 2013

Front. Public Health

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Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs) have undergone carefully controlled trials in ASD, but these trials examined outcomes other than seizures. Several lines of evidence point to valproate, lamotrigine, and levetiracetam as the most effective and tolerable AEDs for individuals with ASD. Limited evidence supports the use of traditional non-AED treatments, such as the ketogenic and modified Atkins diet, multiple subpial transections, immunomodulation, and neurofeedback treatments. Although specific treatments may be more appropriate for specific genetic and metabolic syndromes associated with ASD and seizures, there are few studies which have documented the effectiveness of treatments for seizures for specific syndromes. Limited evidence supports l-carnitine, multivitamins, and N-acetyl-l-cysteine in mitochondrial disease and dysfunction, folinic acid in cerebral folate abnormalities and early treatment with vigabatrin in tuberous sclerosis complex. Finally, there is limited evidence for a number of novel treatments, particularly magnesium with pyridoxine, omega-3 fatty acids, the gluten-free casein-free diet, and low-frequency repetitive transcranial magnetic simulation. Zinc and l-carnosine are potential novel treatments supported by basic research but not clinical studies. This review demonstrates the wide variety of treatments used to treat seizures in individuals with ASD as well as the striking lack of clinical trials performed to support the use of these treatments. Additional studies concerning these treatments for controlling seizures in individuals with ASD are warranted.

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Section: Traditional Treatmentsmentioning

confidence: 78%

A review of traditional and novel treatments for seizures in autism spectrum disorder: findings from a systematic review and expert panel

Frye

Rossignol²,

Casanova

et al. 2013

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Use of IVIG for treatment of autism or its 'presumed' autoimmune co-morbid conditions, such as pediatric autoimmune neuropsychiatric disorders associated with streptococci (PANDAS), has been controversial, and clinical trials yielded conflicting results [39-41]. The controversy surrounding the effects of IVIG on ASD children is partly attributed to marked heterogeneity of ASD subjects and relatively small numbers of study subjects.…”

Section: Discussion and Evaluationmentioning

confidence: 99%

Immunological characterization and transcription profiling of peripheral blood (PB) monocytes in children with autism spectrum disorders (ASD) and specific polysaccharide antibody deficiency (SPAD): case study

Jyonouchi¹,

Geng²,

Streck³

et al. 2012

J Neuroinflammation

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IntroductionThere exists a small subset of children with autism spectrum disorders (ASD) characterized by fluctuating behavioral symptoms and cognitive skills following immune insults. Some of these children also exhibit specific polysaccharide antibody deficiency (SPAD), resulting in frequent infection caused by encapsulated organisms, and they often require supplemental intravenous immunoglobulin (IVIG) (ASD/SPAD). This study assessed whether these ASD/SPAD children have distinct immunological findings in comparison with ASD/non-SPAD or non-ASD/SPAD children.Case descriptionWe describe 8 ASD/SPAD children with worsening behavioral symptoms/cognitive skills that are triggered by immune insults. These ASD/SPAD children exhibited delayed type food allergy (5/8), treatment-resistant seizure disorders (4/8), and chronic gastrointestinal (GI) symptoms (5/8) at high frequencies. Control subjects included ASD children without SPAD (N = 39), normal controls (N = 37), and non-ASD children with SPAD (N = 12).Discussion and EvaluationWe assessed their innate and adaptive immune responses, by measuring the production of pro-inflammatory and counter-regulatory cytokines by peripheral blood mononuclear cells (PBMCs) in responses to agonists of toll like receptors (TLR), stimuli of innate immunity, and T cell stimulants. Transcription profiling of PB monocytes was also assessed. ASD/SPAD PBMCs produced less proinflammatory cytokines with agonists of TLR7/8 (IL-6, IL-23), TLR2/6 (IL-6), TLR4 (IL-12p40), and without stimuli (IL-1ß, IL-6, and TNF-α) than normal controls. In addition, cytokine production of ASD/SPAD PBMCs in response to T cell mitogens (IFN-γ, IL-17, and IL-12p40) and candida antigen (Ag) (IL-10, IL-12p40) were less than normal controls. ASD/non-SPAD PBMDs revealed similar results as normal controls, while non-ASD/SPAD PBMCs revealed lower production of IL-6, IL-10 and IL-23 with a TLR4 agonist. Only common features observed between ASD/SPAD and non-ASD/SPAD children is lower IL-10 production in the absence of stimuli. Transcription profiling of PB monocytes revealed over a 2-fold up (830 and 1250) and down (653 and 1235) regulation of genes in ASD/SPAD children, as compared to normal (N = 26) and ASD/non-SPAD (N = 29) controls, respectively. Enriched gene expression of TGFBR (p < 0.005), Notch (p < 0.01), and EGFR1 (p < 0.02) pathways was found in the ASD/SPAD monocytes as compared to ASD/non-SPAD controls.ConclusionsThe Immunological findings in the ASD/SPAD children who exhibit fluctuating behavioral symptoms and cognitive skills cannot be solely attributed to SPAD. Instead, these findings may be more specific for ASD/SPAD children with the above-described clinical characteristics, indicating a possible role of these immune abnormalities in their neuropsychiatric symptoms.

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“…One patient showed significant improvement, with almost complete amelioration of autistic symptoms. DelGiudice-Asch et al [26] treated five children with autism with IVIG at 400 mg/kg/month for 6 months. Using 10 assessment scales, only the Ritvo-Freeman Real Life Rating Scale, the sensory response, showed a clinically meaningful response.…”

Section: Introductionmentioning

confidence: 99%

“…The committee cited the two above-mentioned negative studies [25, 26]—the first with 10 cases with unconventional dosing, interval, and a small number of IVIG infusions [25], and the second [26] with five cases—without citing the original study of 15 patients with positive results [1]. Therefore, such a conclusion by the committee appears to be unjustified because more studies of large numbers of patients treated with an appropriate dosage of IVIG and for longer durations demonstrated beneficial effects [1, 23, 24].…”

Section: Introductionmentioning

confidence: 99%

Chemokine Expression Patterns in the Systemic and Genital Tract Compartments are Associated with HIV-1 Infection in Women from Benin

et al. 2009

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BackgroundAutism is a complex polygenic neurodevelopmental disorder characterized by deficits in communication and social interactions as well as specific stereotypical behaviors. Both genetic and environmental factors appear to contribute to the pathogenesis of autism. Accumulating data including changes in immune responses, linkage to major histocompatibility complex antigens, and the presence of autoantibodies to neural tissues/antigens suggest that the immune system plays an important role in its pathogenesis.SummaryIn this brief review, we discuss the data regarding changes in both innate and adaptive immunity in autism and the evidence in favor of the role of the immune system, especially of maternal autoantibodies in the pathogenesis of a subset of patients with autism. The rationale for possible therapeutic use of intravenous immunoglobulin is also discussed.

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Untitled

Cited by 59 publications

References 20 publications

A review of traditional and novel treatments for seizures in autism spectrum disorder: findings from a systematic review and expert panel

A review of traditional and novel treatments for seizures in autism spectrum disorder: findings from a systematic review and expert panel

Immunological characterization and transcription profiling of peripheral blood (PB) monocytes in children with autism spectrum disorders (ASD) and specific polysaccharide antibody deficiency (SPAD): case study

Chemokine Expression Patterns in the Systemic and Genital Tract Compartments are Associated with HIV-1 Infection in Women from Benin

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