Autism, an extreme challenge to integrative medicine. Part:
1: The knowledge base.
Kidd PM.
Autism, archetype of the autistic spectrum disorders (ASD), is a
neurodevelopmental disorder characterized by socially aloof behavior and
impairment of language and social interaction. Its prevalence has surged in
recent years. Advanced functional brain imaging has confirmed pervasive
neurologic involvement. Parent involvement in autism management has accelerated
understanding and treatment. Often accompanied by epilepsy, cognitive deficits,
or other neurologic impairment, autism manifests in the first three years of
life and persists into adulthood. Its etiopathology is poorly defined but likely
multifactorial with heritability playing a major role. Prenatal toxic exposures
(teratogens) are consistent with autism spectrum symptomatology. Frequent
vaccinations with live virus and toxic mercurial content (thimerosal) are a
plausible etiologic factor. Autistic children frequently have abnormalities of
sulfoxidation and sulfation that compromise liver detoxification, which may
contribute to the high body burden of xenobiotics frequently found. Frequent
copper-zinc imbalance implies metallothionein impairment that could compound the
negative impact of sulfur metabolism impairments on detoxification and on
intestinal lining integrity. Intestinal hyperpermeability manifests in autistic
children as dysbiosis, food intolerances, and exorphin (opioid) intoxication,
most frequently from casein and gluten. Immune system abnormalities encompass
derangement of antibody production, skewing of T cell subsets, aberrant cytokine
profiles, and other impairments consistent with chronic inflammation and
autoimmunity. Coagulation abnormalities have been reported. Part 2 of this
review will attempt to consolidate progress in integrative management of autism,
aimed at improving independence and lifespan for people with the disorder.
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