Facts of Autism found in Peer Reviewed Journals
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Inflammation: The level of inflammation found in Autistic children is unprecedented. Hs-CRP is a common blood test used to measure inflammation. For reference, normal levels of Hs-CRP are less than 1.0. In patients at increased risk for heart disease the Hs-CRP levels are greater than 3. In patients with Auto Immune Diseases such as Lupus or Crohn’s Disease, Hs-CRP levels are commonly in the 20-80 range. In children with Autism the levels of Hs-CRP are over 500. The levels of Hs-CRP seem to correlate with symptoms. In extreme cases of Autism, levels of Hs-CRP over 1000 are reported.
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Cerebral Blood Flow: The blood flow to the frontal lobes of the brain is decreased (42.7%), basal nucleus decreased (24.9%), temporal lobe decreased (22.8%). Cerebral blood flow in Autistic adults that were diagnosed with Autism as a child are even worse.
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Abnormal Intestinal Permeability: Even without clinical GI symptoms, altered intestinal permeability was detected in 9 of 21 (43%) of Autistic patients in one study.​ Increased intestinal permeability is a condition where the lining of the intestine becomes damaged, allowing undigested food particles, toxic waste, and bacteria to leak into the bloodstream. This increased intestinal permeability will trigger an immune response and clumping of red blood cells as depicted in pictures below.
Connecting the Dots
Cerebral blood flow abnormalities, extremely high levels of inflammation, and increased intestinal permeability are hallmark abnormalities found in persons with Autism, and virtually unknown by treating physicians.
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Cerebral blood flow is markedly decreased in Autism. It seems logical that decreased blood flow to the brain, especially in young children is going to affect behavior and brain development. An assumption can be made. Increased intestinal permeability leads to an immune reaction, leading to clumpy blood, and decreased blood flow to the brain.
Ideally, obstetricians would screen newborns for autism using Hs-CRP blood test. There are portable devices used to measure
Hs-CRP requiring only a single drop of blood from a heel or finger prick. Then pediatricians could continue measuring Hs-CRP every six months while the child is non-verbal or when developmental milestones are delayed. Early diagnosis and treatment of autism can help prevent permanent brain damage.
​Inflammation in the blood causes the Red Blood Cells to clump together in a characteristic “stacking of coins” pattern, called Rouleaux Formations. This clumping of blood is also called Red Blood Cell aggregation. Rouleaux Formations are see by microscopic evaluation, this test performed by Hematologists and Pathologists is called a peripheral smear. I find no reference in the literature of the microscopic evaluation of blood of Autistic children. It can only be assumed that Red Blood Cell aggregation exists because of the profound inflammation found in Autism, but has yet to be documented. There is a high likelihood this clumping of blood is the cause for decreased cerebral blood flow Red Cell in Autism, because Red Cell Aggregation has been shown to decreases tissue perfusion in previous research. However, this question still needs to be definitively answered by further research, specifically in Autistic children.
Inflamed clumpy blood
Normal blood smear
Autism
Important Pieces of the Puzzle are Ignored
The incidence of Autism is now 1 in 31 children born in the United States. The future of America depends on the health and wellbeing of future generations. How medicine and society as a whole has ignored and mismanaged this epidemic is unimaginable. Published research related to the pathology of autism has been ignored in favor of the political debate over whether vaccines are the main cause for autism. The politics must stop. Physicians can use existing science to immediately start screening children for autism and begin treatments to prevent delays in developmental milestones. Currently there are no objective screening tests or treatments to reverse the developmental delays of autism. Studies show children with autism have severely decreased cerebral blood flow, increased gut permeability, and extraordinarily high levels of systemic inflammation. We will attempt to connect these scientific dots to build a foundation for immediate objective screening via blood testing, common sense treatments, and future research.
Autism and elevated High Sensitivity C- Reactive Protein (hs-CRP)
Studies have shown that individuals with Autism Spectrum Disorders (ASD) have an elevated High Sensitivity
C-reactive protein (hs-CRP). hs-CRP is a protein produced by the liver in response to inflammation, even sensitive to low levels of inflammation. This research suggests that inflammation may play a role in the development of ASD, as evidences by higher levels of hs-CRP as well as interleukin-6 (IL-6) in children with ASD compared to typically developing children. Some studies have even noted an increase in ASD of children born to mothers with an elevated maternal C-reactive protein (mCRP), although this may need further studies. Of note, a pooled meta-analysis of over 76,000 records and 43 studies found that children with ASD have significantly higher levels of hs-CRP and GABA (a neurotransmitter, or chemical messenger in the brain), and a variation in the colon bacterial flora when compared to other children. These findings suggest that these may have a potential use as a diagnostic tool or could be used for a therapeutic target in treatment of ASD. Further studies are needed, but as yet it does not seem to be widely pursued in standard of care medicine.
Pieces of the Puzzle
Exploring the Gut-Brain Connection
​Autism is routinely diagnosed with subjective questioning, and ignores an objective diagnosis using the blood test C-Reactive Protein blood test. The mean concentration of high sensitivity (hs)-CRP in children with ASD (540.1 ± 1125.5 ng/ml) was significantly (P < 0.0001) higher than control group (1.3 ± 1.0 ng/ml).
Research related to autism and CRP is already at the level of met analysis. “C reactive protein elevation among children or among mothers’ of children with autism during pregnancy, a review and meta-analysis”, as noted in the studies above. Determined the occurrence of gut mucosal damage using the intestinal permeability test in 21 autistic children who had no clinical and laboratory findings consistent with known intestinal disorders. An altered intestinal permeability was found in 9 of the 21 (43%) autistic patients, but in none of the 40 controls. “Hydrogen as a novel hypothesized emerging treatment for oxidative stress in autism.” Risperidone (Risperdal) and Aripiprazole (Abilify) are the only drugs approved by the FDA for children with autism spectrum disorder. Risperidone can be prescribed for children between 5 and 16 years old to help with irritability and aggression. Aripiprazole can be prescribed for children between 6 and 17 years old. There are just two FDA approved antipsychotic medications, useful in the treatment of some of the symptoms of Autistic children.
Making the Diagnosis of Autism
The Modified Checklist of Autism in Toddlers (M-CHAT) is a behavioral test given to screen for Autism. It seems prudent to add a more definitive blood test such as the
Hs-CRP to a subjective behavioral test when confirming the diagnosis of Autism. Autism needs to be diagnosed early as possible, now in hopes of restoring blood flow to the brain to aid in development. The trick is to make an accurate diagnosis as soon as possibly, and at the same time avoid giving a false positive diagnosis of Autism to a family whose child is not affected by Autism. Other readily available and inexpensive biomarkers for inflammation such as Sed Rate and Lipoprotein Phospholipase A2 (LpPlA2) should also be investigated as possible tools for making the diagnosis of Autism.