Autistic disorder and gastrointestinal disease

Abstract

Autistic disorder is a pervasive developmental disorder manifested in the first 3 years of life by dysfunction in social interaction and communication. Many efforts have been made to explore the biologic basis of this disorder, but the etiology remains unknown. Recent publications describing upper gastrointestinal abnormalities and ileocolitis have focused attention on gastrointestinal function and morphology in these children. High prevalence of histologic abnormalities in the esophagus, stomach, small intestine and colon, and dysfunction of liver conjugation capacity and intestinal permeability were reported. Three surveys conducted in the United States described high prevalence of gastrointestinal symptoms in children with autistic disorder. Treatment of the digestive problems may have positive effects on their behavior.

Metabolic endophenotype and related genotypes are associated with oxidative stress in children with autism

“…Consistent with low glutathione levels and increased oxidative stress, autistic children would be expected to have difficulty resisting infection, resolving inflammation, and detoxifying environmental contaminants. Indeed, autistic children have been reported to suffer from recurrent infections (Konstantareas and Homatidis 1987), neuroinflammation , gastrointestinal inflammation (Horvath and Perman 2002;Jyonouchi et al 2005), and impaired antioxidant and detoxification capacity (Yorbik et al 2002;Zoroglu et al 2004;Chauhan et al 2004) The abnormalities in the methionine transmethylation pathway in the autistic children are unusual. Reduced plasma methionine and SAM most often reflect a decrease in methionine synthase activity; however, a decrease in methionine synthase activity is most often associated with elevated homocysteine levels (Finkelstein 1998).…”

“…Further, the abnormal metabolic profile observed in a significant proportion of autistic children suggests the provocative possibility that some autistic behaviors could be a neurologic manifestation of a genetically-based systemic metabolic derangement. Such a paradigm shift from a neurodevelopmental disorder to a broader systemic disorder would widen the biologic basis of autism to encompass not only the neurologic manifestations but also the gastrointestinal and immunologic pathology that have received increasing attention in recent years (Horvath and Perman 2002;Jyonouchi et al 2005). Supporting this possibility, abnormalities in folate-dependent methionine and glutathione metabolism have been associated with gastrointestinal and immunologic dysfunction in addition to impaired CNS function (Bains and Shaw 1997;Martensson et al 1990;Droge and Breitkreutz 2000).…”

“…The pathophysiology of autism primarily affects three major systems: neurologic, immunologic, and gastrointestinal (Bauman and Kemper 2003;Hornig and Lipkin 2001;Krause et al 2002;Horvath and Perman 2002;White 2003). An interesting but poorly understood etiologic clue is the fact that four boys are affected for every girl.…”

Generalized Autoimmunity of ANCA and ASCA Related to Severity of Disease in Autistic Children with GI Disease

“…18 Although autism may be apparent soon after birth, many autistic children experience at least several months, up to a year or more in some cases, of normal development-followed by regression, defined as loss of function or failure to progress. [19][20][21] Children with autistic spectrum disorders (ASD) frequently have accompanying gastrointestinal (GI) symptoms and pathology, 22,23 which includes inflammation of the GI tract. [24][25][26][27] Many autistic children, particularly those with GI disease, also have a higher propensity for fungal infections.…”

An investigation of comorbid psychological disorders, sleep problems, gastrointestinal symptoms and epilepsy in children and adolescents with Autism Spectrum Disorder

“…Reports from paediatric gastroenterologists have described gastrointestinal (GI) symptoms in 46% to 84% of children with autism (Horvath & Perman, 2002a;Horvath & 7 Comorbidity in children and adolescents with ASD Kuddo and Nelson (2003) commented on the features of autism that complicate interpretation of GI symptoms. Deficits in language can lead to difficulties in parental perception of pain in children with ASD.…”