MMR or autism and gastrointestinal or inflammatory
symptoms – literature search
Search History
* #3 #1 and #2
(116 records) - included some cancer and other non-related articles
#2 MMR or
autis* (8029 records)
#1
gastrointestinal or inflammatory or crohn's (307997 records)
|
Neuropsychobiology 2002 Jan;45(1):1-6 |
Books
Activation of the inflammatory response
system in autism.
Croonenberghs J, Bosmans E, Deboutte D, Kenis G, Maes M.
University Center of Child and Adolescent Psychiatry, Antwerp, Belgium.
Background/Aim: There is
now some evidence that autism may be accompanied by abnormalities in the
inflammatory response system (IRS). Products of the IRS, such as
proinflammatory cytokines, may induce some of the behavioral symptoms of
autism, such as social withdrawal, resistance to novelty and sleep
disturbances. The main aim of the present study was to examine whether autism
is accompanied by an activation of the IRS. Methods: We measured the production
of interleukin (IL)-6, IL-10, the IL-1 receptor antagonist (IL-1RA), interferon
(IFN)-gamma and tumor necrosis factor (TNF)-alpha by whole blood and the serum
concentrations of IL-6, the IL-2 receptor (IL-2R) and IL-1RA. Results: This
study showed a significantly increased production of IFN-gamma and IL-1RA and a
trend toward a significantly increased production of IL-6 and TNF-alpha by
whole blood of autistic children. There were no significant differences in the
serum concentrations of IL-6, IL-2R and IL-1RA between autistic and normal
children. Conclusions: These
results suggest that autism may be accompanied by an activation of the
monocytic (increased IL-1RA) and Th-1-like (increased IFN-gamma) arm of the
IRS. It is hypothesized that increased production of proinflammatory cytokines
could play a role in the pathophysiology of autism. Copyright 2002 S.
Karger AG, Basel
PMID: 11803234 [PubMed - in process]
|
Med Sci Monit 2002 Sep-Oct;8(1):BR22-6 |
Use of secretin in the treatment of childhood
autism.
Kaminska B, Czaja M, Kozielska E, Mazur E, Korzon M.
Department and Clinic of Pediatrics, Gastroenterology and Pediatric Oncology,
Medical University, Gdansk, Poland.
The paper presents current views concerning childhood autism. The authors
present the concepts of etiology of this disorder, emphasizing the role of
negative psychical stimuli in early childhood and the role of mother's contact
with the child. Organic factors, including genetic background, developmental
abnormalities of the nervous system, teratogenic factors and perinatal traumas
are also taken into consideration. The role of metabolic factors and
enterohormones, particularly those belonging to the secretin group and their
effect on the function of the gastrointestinal tract and central nervous system
is emphasized. We discuss signs which may be indicative of first symptoms of
autism in different age groups. A typical symptom of autism is no development
of speech, observed from infancy, taking the form of complete mutism at later
stages. It has been emphasized that most pathologic symptoms result from
altered perception of external stimuli, which arouse fear and anxiety. Autistic patients may suffer
from gastrointestinal tract disturbances such as abdominal pains and diarrhea.
Methods used hitherto in the therapy of childhood autism, mainly by
psychologists and psychiatrists, as well as some attempts of pharmacological
treatment, are presented. The structure and function of secretin, as well as
its effects on the motor and secretory function of the stomach and the exocrine
function of the pancreas are discussed. The role of secretin in diagnostic
tests, among others in the diagnosis of gastrinoma, is emphasized. We also
present the history of the application of secretin in the therapy of childhood
autism.
PMID: 11782669 [PubMed - in process]
|
Inflamm Bowel Dis 2001 Nov;7(4):349-50 |
MMR and IBD: the only thing we have to fear
is...fear itself.
Kugathasan S.
Pediatric IBD Center, Medical College of Wisconsin, Milwaukee, USA.
PMID: 11720330 [PubMed - in process]
|
J Autism Dev Disord 2001 Jun;31(3):361-2 |
What to measure in autism drug trials.
Roseman B, Schneider E, Crimmins D, Bostwick H, Visintainer P, Jaskow PA,
Accardo P.
Publication Types:
·
Clinical Trial
·
Letter
PMID: 11518490 [PubMed - indexed for MEDLINE]
|
Pediatrics 2001 Oct;108(4):E58 |
No evidence for a new variant of
measles-mumps-rubella-induced autism.
Fombonne E, Chakrabarti S.
Institute of Psychiatry, Department of Child and Adolescent Psychiatry, King's
College London, London, United Kingdom.
OBJECTIVE: A link has been postulated between measles-mumps-rubella (MMR)
vaccine and a form of autism that is a combination of developmental regression
and gastrointestinal symptoms that occur shortly after immunization. This
hypothesis has involved 3 separate claims: 1) that there is new phenotype of
autism involving regression and gastrointestinal symptoms, 2) that this new
variant is responsible for the alleged rise of autism rates, and 3) that this
phenotype is associated with biological findings suggestive of the persistence
of measles infection. We tested the first of these claims. If this new
"autistic enterocolitis" syndrome had some validity, then 1 or
several of the following 6 predictions should be supported by empirical data:
1) childhood disintegrative disorder has become more frequent, 2) the mean age
of first parental concern for autistic children who are exposed to MMR is
closer to the mean immunization age than in children who are not exposed to
MMR, 3) regression in the development of children with autism has become more
common in MMR-vaccinated children, 4) the age of onset for autistic children
with regression clusters around the MMR immunization date and is different from
that of autistic children without regression, 5) children with regressive
autism have distinct symptom and severity profiles, and 6) regressive autism is
associated with gastrointestinal symptoms and/or inflammatory bowel disorder.
METHODS: Three samples were used. Epidemiologic data on 96 children (95
immunized with MMR at a median age of 13.5 months) who were born between 1992
and 1995 and had a pervasive developmental disorder diagnosis as reported in a
recent UK survey (post-MMR sample) were compared with data from 2 previous
clinical samples (1 pre-MMR [n = 98] and 1 post-MMR [n = 68]) of autistic
patients. All patients were assessed with the standardized Autism Diagnostic
Interview (ADI), allowing rigorous comparison of age at first parental concerns
and rates of regression across samples. Reliability was excellent on ADI
scores, age of parental concern, and developmental regression. Furthermore,
data on bowel symptoms and disorders were available in the epidemiologic survey
from both pediatric and parental sources, and immunization dates were obtained
from computerized records. RESULTS: The prevalence of childhood disintegrative disorder was 0.6/10 000 (95%
confidence interval: 0.02-3.6/10 000); this very low rate is consistent with
previous estimates and is not suggestive of an increased frequency of this form
of pervasive developmental disorder in samples of children who are immunized
with MMR. There was no difference in the mean age at first parental
concern between the 2 samples exposed to MMR (19.3 and 19.2 months) and the
pre-MMR sample (19.5 months). Thus, MMR immunization was not associated with a
shift toward an earlier age for first parental concerns. Similarly, the rate of
developmental regression reported in the post-MMR sample (15.6%) was not
different from that in the pre-MMR sample (18.4%); therefore, there was no
suggestion that regression in the developmental course of autism had increased
in frequency since MMR was introduced. In the epidemiologic sample, the subset
of autistic children with regression had no other developmental or clinical
characteristics, which would have argued for a specific, etiologically distinct
phenotype. Parents of autistic children with developmental regression detected
the first symptoms at a very similar age (19.8 months) to those of autistic
children without regression (19.3 months). Moreover, the mean intervals from
MMR immunization to parental recognition of autistic symptoms were comparable
in autistic children with or without regression (248 vs 272 days; not
significant). In the epidemiologic sample, gastrointestinal symptoms were
reported in 18.8% of children. Constipation was the most common symptom (9.4%), and no inflammatory
bowel disorder was reported. Furthermore, there was no association
between developmental regression and gastrointestinal symptoms (odds ratio:
0.63; 95% confidence interval: 0.06-3.2; not significant), and only 2.1% of the
sample experienced both problems, a rate that did not exceed chance
expectations. CONCLUSIONS: No
evidence was found to support a distinct syndrome of MMR-induced autism or of
"autistic enterocolitis." These results add to the recent
accumulation of large-scale epidemiologic studies that all failed to support an
association between MMR and autism at population level. When combined, the
current findings do not argue for changes in current immunization programs and
recommendations.
Some
questions: 1) Since these children were born and received MMR prior to anyone
connecting MMR to autism, how did that effect the results? 2) Why are the
cases included in this study treated like the only cases and then this
"sample" used to disprove the notion that there has been an
increase? 3) Why are the assumptions (1-6) being used to disprove
the theory, rather than tested first (separately) to see if they are valid?
4) Isn't the fact that Dr. Wakefield has seen and reported on many
parents of autistic children who do report inflammatory bowel symptoms and the
fact that in this study there is not one such case, compelling evidence that
the sample in this study is seriously flawed?
PMID: 11581466 [PubMed - indexed for MEDLINE]
|
CNS
Drugs 2001;15(11):831-7 |
Books
Autism and measles-mumps-rubella vaccination:
controversy laid to rest?
DeStefano F, Chen RT.
National Center on Birth Defects and Developmental Disabilities, Atlanta, Georgia
30341-3724, USA. fdestefano@cdc.gov
It has been suggested that vaccination, particularly with measles-mumps-rubella
(MMR) vaccine, may be related to the development of autism. The main evidence
for a possible association is that the prevalence of autism has been increasing
at the same time that infant vaccination coverage has increased, and that in
some cases there is an apparent temporal association in which autistic
characteristics are first noted shortly after vaccination. Although the prevalence of autism and similar
disorders appears to have increased recently, it is not clear if this is an
actual increase or the result of increased recognition and changes in
diagnostic criteria. The apparent onset of autism in close proximity to
vaccination may be a coincidental temporal association. The clinical evidence
in support of an association derives from a series of 12 patients with
inflammatory bowel conditions and regressive developmental disorders, mostly
autism. The possibility that measles vaccine may cause autism through a
persistent bowel infection has generated much interest, since it provides a
possible biological mechanism. Epidemiological
studies, however, have not found an association between MMR vaccination and
autism. The epidemiological findings are consistent with current
understanding of the pathogenesis of autism, which has a strong genetic
component and in which the neurological defects probably occur early in
embryonic development. It seems unlikely that a vaccination that is given after
birth could cause autism. A minority of cases of autism may have onset after 1
year of age (regressive autism), but the single epidemiological study that
included such cases did not find an association with MMR vaccination.
Currently, the weight of the available epidemiological and related evidence
does not support a causal association between MMR vaccine, or any other vaccine
or vaccine constituent, and autism.
Some questions: 1) Why is
there only reference to 12 patients in this "review" when by January
of 2001, there was a report of an additional 170
cases? 2) While perhaps there are no epidemiological
"studies" which do so, why is there no reference to the biological
studies which do support the possibility of a connection between MMR and an
autism/gastrointestinal connection and/or autism and gastrointestinal symptoms?
Publication Types:
· Review
· Review,
Tutorial
PMID: 11700148 [PubMed - indexed for MEDLINE
|
Pediatr Infect Dis J 2001 Nov;20(11 Suppl):S40-4 |
Safety of combination vaccines: perception
versus reality.
Halsey NA.
Institute for Vaccine Safety, The Johns Hopkins University, Baltimore, MD, USA.
nhalsey@jhsph.edu
BACKGROUND: Combination vaccines contain multiple antigens to protect against
several diseases simultaneously and have simplified the delivery of childhood
immunizations. Children are healthier today because of the use of combination
vaccines, and the United States is benefiting from record low numbers of
vaccine-preventable diseases. Despite obvious benefits, concerns and
misconceptions exist regarding the safety and efficacy of combination vaccines.
METHODS: A review of the pediatric literature to dispel the common
misperceptions and potential barriers to combining vaccines. RESULTS: Assurance
that combination vaccines approved by the United States Food and Drug
Administration undergo extensive testing will help to alleviate concerns
regarding safety and efficacy of combination vaccines. Food and Drug
Administration standards are rigorous and require that combination vaccines be
as safe and effective as each component of the vaccine administered separately.
Combination vaccines have been available for >50 years, and lessons learned
during this time are continuously applied to the development and use of new
products. CONCLUSIONS: Children will benefit from new combination vaccines
because fewer injections will be required to protect against
vaccine-preventable diseases, allowing for the introduction of new vaccines
into the immunization schedule and prevention of additional diseases.
Publication Types:
·
Review
·
Review, Tutorial
PMID: 11704723 [PubMed - indexed for MEDLINE]
|
Pediatrics 2001 Nov;108(5):E90 |
Effects of intravenous secretin on language
and behavior of children with autism and gastrointestinal symptoms: a
single-blinded, open-label pilot study.
Lightdale JR, Hayer C, Duer A, Lind-White C, Jenkins S, Siegel B, Elliott
GR, Heyman MB.
Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical
School, Boston, Massachusetts, USA.
BACKGROUND: Autism is a severe developmental disorder with poorly understood
etiology. A recently published case series describes 3 autistic children with
gastrointestinal symptoms who underwent endoscopy and intravenous
administration of secretin and were subsequently noted by their parents to
demonstrate improved language skills over a 5-week period. This report sparked
tremendous public interest, and investigators at several sites moved quickly to
design controlled trials to test the efficacy of secretin as a therapy for
autistic children. However, this is the first effort specifically designed to replicate
the initial reported findings in terms of patient age, presenting symptoms, and
drug administration. OBJECTIVE: To rigorously apply the scientific method by
assessing the reproducibility of the reported effects of intravenous secretin
on the language of young children with autism and gastrointestinal symptoms.
METHODS: We performed a single-blinded, prospective, open-label trial by
conducting formal language testing and blinded behavioral rating both before
and repeatedly after a standardized infusion of secretin. We selected autistic
children who were similar in age and profile to those described in the
published retrospective case review. Inclusion criteria for study participation
included age (3-6 years), confirmed diagnosis of autism, and reported
gastrointestinal symptoms (16 had chronic diarrhea, 2 had gastroesophageal
reflux, and 2 had chronic constipation). Twenty children (18 male) were
admitted to the Pediatric Clinical Research Center at the University of
California, San Francisco after administration of the Preschool Language
Scale-3 (PLS-3). A 3 CU/kg dose of secretin (Secretin-Ferring) was administered
intravenously (upper endoscopy was not performed). Behavioral ratings were
derived using the Autism Observation Scale applied to a 30-minute time sample
of the child's behavior consisting of a videotape of the PLS-3 (structured
setting) and a second free play session with a standard set of developmentally
appropriate toys. Participants then returned for follow-up evaluations, with
readministrations of the PLS-3 at 1, 2, 3, and 5 weeks' postinfusion, and
videotaping of each session for later blinded review by 2 independent observers
using the Autism Observation Scale, uninformed about week of posttreatment. We
also surveyed parents of our study children about their impressions of the
effects of secretin using a 5-point Likert scale for parents to rate changes
seen in their child. RESULTS: With a total study completion rate across all
participants of 96%, repeated measures analyses of variance revealed no
significant increases in children's language skills from baseline across all 5
study time periods after a single infusion of secretin. Similarly, neither
significant decreases in atypical behaviors nor increases in prosocial
behaviors and developmentally appropriate play skills emerged. Furthermore, no
relationship was found between parental reports of change and observable
improvement in the sample. Despite the objective lack of drug effect, 70% of
parents in our study reported moderate to high change in their child's language
and behavior. Furthermore, 85% of parents reported that they felt that their
child would obtain at least some additional benefits from another infusion of
secretin. CONCLUSIONS: The results of our pilot study indicate that intravenous
secretin had no effects in a 5-week period on the language and behavior of 20
children with autism and gastrointestinal symptoms. The open-label, prospective
design of our study with blinded reviews of patients both before and after
secretin administration follows the scientific method by seeking to reproduce
an observed phenomenon using validating and reliable outcome measures. Pilot
studies remain a mandatory step for the design of future randomized, clinical
trials investigating potential treatments for children with autism.
PMID: 11694674 [PubMed - indexed for MEDLINE]
|
Tidsskr Nor Laegeforen 2001 Sep 30;121(23):2679 |
[Vaccination, inflammatory bowel disease and
autism--is there a connection?]
[Article in Norwegian]
Nokleby H.
Publication Types:
·
Editorial
PMID: 11699370 [PubMed - indexed for MEDLINE]
|
Pediatr Ann 2001 Jul;30(7):408-15 |
Measles-mumps-rubella vaccine and autism: the
rise (and fall?) of a hypothesis.
Kastner JL, Gellin BG.
Department of Public Health, Vanderbilt University School of Medicine,
Nashville, Tennessee, USA.
PMID: 11469172 [PubMed - indexed for MEDLINE]
|
J Child Neurol 2001 May;16(5):357-63 |
A study of novel polymorphisms in the
upstream region of vasoactive intestinal peptide receptor type 2 gene in
autism.
Asano E, Kuivaniemi H, Huq AH, Tromp G, Behen M, Rothermel R, Herron J,
Chugani DC.
Department of Pediatrics, Children's Hospital of Michigan and Wayne State
University School of Medicine, Detroit 48201, USA.
We investigated the vasoactive intestinal peptide receptor type 2 (VIPR2) gene
as a candidate gene for autism. We searched for mutations in the VIPR2 gene in
autistic individuals, and 10 novel polymorphisms were identified. Three
polymorphisms in the upstream region were studied in detail, and there was no
significant difference in the frequencies between the autistic group (n = 14)
and unrelated controls (n = 52). The distribution of the genotypes in two of
the three polymorphisms differed somewhat between autistic subjects with
gastrointestinal problems and those without. Moreover, there was a trend
showing a correlation between the genotypes for the third polymorphism and the
severity of stereotypical behavior as ranked by the Gilliam Autism Rating
Scale. These preliminary results suggest that VIPR2 may have a role in
gastrointestinal symptoms and stereotypical behaviors in autism, although a
larger collection of samples suitable for transmission disequilibrium tests is
necessary to validate the results.
PMID: 11392521 [PubMed - indexed for MEDLINE]
|
J Neural Transm 2001;108(5):593-611 |
Famotidine treatment of children with
autistic spectrum disorders: pilot research using single subject research
design.
Linday LA, Tsiouris JA, Cohen IL, Shindledecker R, DeCresce R.
Department of Pediatrics, St. Luke's-Roosevelt Hospital Center, New York, NY,
USA. lal14@columbia.edu
Using single subject research design, we performed pilot research to evaluate
the safety and efficacy of famotidine for the treatment of children with
autistic spectrum disorders. We studied 9 Caucasian boys, 3.8-8.1 years old,
with a DSM-IV diagnosis of a pervasive developmental disorder, living with
their families, receiving no chronic medications, and without significant
gastrointestinal symptoms. The dose of oral famotidine was 2 mg/kg/day (given
in two divided doses); the maximum total daily dose was 100 mg. Using single-subject
research analysis and medication given in a randomized, double-blind,
placebo-controlled, cross-over design, 4 of 9 children randomized (44%) had
evidence of behavioral improvement. Primary efficacy was based on data kept by
primary caregivers, including a daily diary; daily visual analogue scales of
affection, reciting, or aspects of social interaction; Aberrant Behavior
Checklists (ABC, Aman); and Clinical Global Improvement scales. Children with
marked stereotypy (meaningless, repetitive behaviors) did not respond. Our
subjects did not have prominent gastrointestinal symptoms and endoscopy was not
part of our protocol; thus, we cannot exclude the possibility that our subjects
improved due to the effective treatment of asymptomatic esophagitis. The use of
famotidine for the treatment of children with autistic spectrum disorders
warrants further investigation.
Publication Types:
·
Clinical Trial
·
Randomized Controlled Trial
PMID: 11459079 [PubMed - indexed for MEDLINE]
|
BMJ 2001 Jan 13;322(7278):82-85 |
Comment in:
·
BMJ.
2001 May 5;322(7294):1120.
·
BMJ.
2001 May 5;322(7294):1120.
·
BMJ.
2001 May 5;322(7294):1120-1.
·
BMJ.
2001 May 5;322(7294):1121.
·
BMJ.
2001 May 5;322(7294):1121.
Second dose of measles, mumps, and rubella
vaccine: questionnaire survey of health professionals.
Petrovic M, Roberts R, Ramsay M.
Department of Public Health, North Wales Health Authority, Preswylfa, Mold,
Flintshire CH7 1PZ, UK. marko.petrovic@mwales-ha.wales.nhs.uk
OBJECTIVE: To determine the knowledge, attitudes, and practices among health
professionals regarding the measles, mumps, and rubella (MMR) vaccine,
particularly the second dose. DESIGN: Self administered postal questionnaire
survey. SETTING: North Wales Health Authority, 1998. Participants: 148 health
visitors, 239 practice nurses, and 206 general practitioners. MAIN OUTCOME
MEASURES: Respondents' views on MMR vaccination, including their views on the
likelihood of an association with autism and Crohn's disease and on who is the
best person to give advice to parents, whether they agree with the policy of a
second dose of the vaccine, and how confident they are in explaining the rationale
behind the second dose. RESULTS: Concerning the second dose of the vaccine, 48%
of the professionals (220/460) had reservations and 3% (15) disagreed with the
policy of giving it. Over half the professionals nominated health visitors as
the best initial source of advice on the second vaccine. 61% of health visitors
(86/140), compared with 46% of general practitioners (73/158), reported feeling
very confident about explaining the rationale of a two dose schedule to a well
informed parent, but only 20% (28/138) would unequivocally recommend the second
dose to a wavering parent. 33% of the practice nurses (54/163) stated that the
MMR vaccine was very likely or possibly associated with Crohn's disease and 27%
(44/164) that it was associated with autism. Nearly a fifth of general
practitioners (27/158) reported that they had not read the MMR section in the
"green book," and 29% (44/152) reported that they had not received
the Health Education Authority's factsheet on MMR immunisation. CONCLUSIONS:
Knowledge and practice among health professionals regarding the second dose of
the MMR vaccine vary widely. Many professionals are not aware of or do not use
the good written resources that exist, though local educational initiatives
could remedy this.
PMID: 11154622 [PubMed - indexed for MEDLINE]
|
Lancet 2001 Jan 27;357(9252):290 |
UK starts campaign to reassure parents about
MMR-vaccine safety.
Ramsay S.
Publication Types:
·
News
PMID: 11214140 [PubMed - indexed for MEDLINE]
|
J Pediatr 2001 Feb;138(2):250-4 |
Risk of Guillain-Barre syndrome after
measles-mumps-rubella vaccination.
Patja A, Paunio M, Kinnunen E, Junttila O, Hovi T, Peltola H.
Hospital for Children and Adolescents, Helsinki University Central Hospital,
Helsinki, Finland.
OBJECTIVE: To assess the postulated causal association between
measles-mumps-rubella (MMR) vaccination and Guillain-Barre syndrome (GBS).
STUDY DESIGN: Active retrospective study based on linkage of the nationwide
hospital discharge register with individual vaccination records. All patients
hospitalized for treatment of GBS in Finland between November 1982 and December
1986 were included in the study. RESULTS: During the study period, 189 patients
were hospitalized for treatment of GBS, and approximately 630,000 vaccine
recipients received 900,000 doses of MMR vaccine; 24 of the 189 patients
represented the prevailing target population for MMR vaccination, of whom 20
were vaccinated. MMR vaccination did not cause any increase over the background
incidence of GBS, and no clustering of cases of GBS occurred at any time point
after administration of MMR vaccine. The interval between vaccination and onset
of symptoms of GBS exceeded the designated risk period of 6 weeks in all cases,
varying from 80 days to years. MMR vaccination after recovery from GBS did not
cause relapses of the illness.
Respiratory or gastrointestinal tract infection predated the onset of GBS by 3
to 30 days in 20 (83%) of the 24 patients. CONCLUSIONS: No causal
association seems to prevail between MMR vaccination and GBS.
PMID: 11174624 [PubMed - indexed for MEDLINE]
|
J Pediatr 2001 Mar;138(3):366-72 |
Colonic CD8 and gamma delta T-cell
infiltration with epithelial damage in children with autism.
Furlano RI, Anthony A, Day R, Brown A, McGarvey L, Thomson MA, Davies SE,
Berelowitz M, Forbes A, Wakefield AJ, Walker-Smith JA, Murch SH.
University Department of Paediatric Gastroenterology, the Inflammatory Bowel
Diseases Study Group, Royal Free and University College School of Medicine,
London, United Kingdom.
OBJECTIVES: We have reported colitis with ileal lymphoid nodular hyperplasia
(LNH) in children with regressive autism. The aims of this study were to
characterize this lesion and determine whether LNH is specific for autism.
METHODS: Ileo-colonoscopy was performed in 21 consecutively evaluated children
with autistic spectrum disorders and bowel symptoms. Blinded comparison was
made with 8 children with histologically normal ileum and colon, 10
developmentally normal children with ileal LNH, 15 with Crohn's disease, and 14
with ulcerative colitis. Immunohistochemistry was performed for cell lineage
and functional markers, and histochemistry was performed for glycosaminoglycans
and basement membrane thickness. RESULTS: Histology demonstrated lymphocytic
colitis in the autistic children, less severe than classical inflammatory bowel
disease. However, basement membrane thickness and mucosal gamma delta cell
density were significantly increased above those of all other groups including
patients with inflammatory bowel disease. CD8(+) density and intraepithelial
lymphocyte numbers were higher than those in the Crohn's disease, LNH, and
normal control groups; and CD3 and plasma cell density and crypt proliferation
were higher than those in normal and LNH control groups. Epithelial, but not
lamina propria, glycosaminoglycans were disrupted. However, the epithelium was
HLA-DR(-), suggesting a predominantly T(H)2 response. INTERPRETATION: Immunohistochemistry confirms
a distinct lymphocytic colitis in autistic spectrum disorders in which the
epithelium appears particularly affected. This is consistent with increasing
evidence for gut epithelial dysfunction in autism.
PMID: 11241044 [PubMed - indexed for MEDLINE]
|
West J Med 2001 Mar;174(3):197-8 |