http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11929383&dopt=Abstract
The concept of entero-colonic encephalopathy, autism and
opioid receptor ligands.
Wakefield AJ, Puleston JM, Montgomery SM, Anthony A, O'Leary JJ, Murch SH.
Inflammatory Bowel Disease Study Group, Royal Free and University College
Medical School, London, UK, Centre for Gastroenterology, Royal Free and
University College Medical School, London, UK, Centre for Paediatric
Gastroenterology, Royal Free and University College Medical School, London, UK,
Department of Pathology, Coombe Women's Hospital and Trinity College, Dublin,
Ireland.
There is growing awareness that primary gastrointestinal pathology may play an
important role in the inception and clinical expression of some childhood
developmental disorders, including autism. In addition to frequent
gastrointestinal symptoms, children with autism often manifest complex
biochemical and immunological abnormalities. The gut-brain axis is central to
certain encephalopathies of extra-cranial origin, hepatic encephalopathy being
the best characterized. Commonalities in the clinical characteristics of hepatic
encephalopathy and a form of autism associated with developmental regression in
an apparently previously normal child, accompanied by immune-mediated
gastrointestinal pathology, have led to the proposal that there may be analogous
mechanisms of toxic encephalopathy in patients with liver failure and some
children with autism. Aberrations in opioid biochemistry are common to these two
conditions, and there is evidence that opioid peptides may mediate certain
aspects of the respective syndromes. The generation of plausible and testable
hypotheses in this area may help to identify new treatment options in
encephalopathies of extra-cranial origin. Therapeutic targets for this autistic
phenotype may include: modification of diet and entero-colonic microbial milieu
in order to reduce toxin substrates, improve nutritional status and modify
mucosal immunity; anti-inflammatory/immunomodulatory therapy; and specific
treatment of dysmotility, focusing, for example, on the pharmacology of local
opioid activity in the gut.
PMID: 11929383 [PubMed - as supplied by publisher]
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