Autism, the Biome and Potential Treatments

Fist pump!  A paper that actually presents information that can help people who are sick!  Woopa!

As promised, here is a summary of that fantastic article[i] about autism and the biome that I discovered on Dr. MacFabe’s new website.  I’ve ranted enough over the last few months about ending suffering NOW for you to know that I am more than a little fed up with the lack of helpful science.  (Now that I think of it, I am definitely going to write a post soon about stupid science.  It will be hugely cathartic, spewing some vitriol!)

I’m a little less cranky than usual ’cause reading this paper was a little bit of a balm for my festering wound of anger.  (That same festering wound whose scab Dr. Mercola managed to pick off two weeks ago. (Yup.  Still brooding.))

The researchers start off by saying that “Many lines of research point to the importance of the development of the enteric microbiome during the first 3 years of life as being critical in the establishment of a healthy immune system.”  So, what is disrupting the biome (and thus, the immune system) of children to the point where now 1 in 68 children are autistic in the USA (with equally grim numbers around the industrialized world)?

Three potential mechanisms driving the autism epidemic are proposed, and these are most certainly not mutually exclusive.

1. Biome Depletion – “If there is disruption in any of these three areas [immune system, microbiome and macrobiome], the ecosystem becomes destabilized and can lead to proinflammatory, allergic, and/or autoimmune related conditions…alterations of the microbiome are a consequence of eradication of helminths, protozoans and other symbionts that co-evolved with humans to regulate, stabilize, and provide modulatory activity for our immune system…”
2. Propionic Acid Theory – “ASD’s may be the result of disturbances in the enteric microbiome resulting in the increased production of the short chain fatty acid (SCFA) known as PPA….PPA as well as other SCFAs can alter diverse metabolic and immune pathways, gene expression and synaptic plasticity, in a manner that is consistent with findings of ASD.”  (See my post on Dr. MacFabe’s work for more on this.)
3. Cell Danger Response Theory – “…refers to an adaptive response by the cell to a perceived threat. The potential pathological nature of this response occurs when CDR becomes chronic.”  Over time, this permanent “fight or flight” on the cellular level leads to changes in a host of physiological processes.  Interestingly, the “proposed triggers for the CDR in contemporary society include changes in human migratory patterns, diet, toxin exposures and cultural activity” which certainly overlap with the changes that have led to biome depletion….

Call me crazy, but I wouldn’t be surprised if all three of these were major factors.  After all, we know that the loss of helminths, for example, leads to alterations in the microbiome, which certainly could lead to an excess of PPA-producing bacteria.  And toxin exposure, like PPA getting into the blood stream, could lead to CDA.  And since there is growing laboratory evidence supporting all these mechanisms…yeah, I’m going for the whole poop show.

The paper then goes on to enumerate specific potential triggers for autism and – my favorite part – potential therapeutic interventions.  This is too lengthy to get into in detail for a blog post (and you can download the whole paper for free here  so don’t think I’m leaving you in the lurch!), but to give you a small taste with a few examples:

1. Acetaminophen – avoid it whenever possible!  For more on this, see Dr. William Parker and colleagues’ paper on this, published this month, which you can read here.
2. Folate metabolism – “treat with reduced folates (i.e. folinic acid) and avoid folic acid”
3. Poor diet – “Eat foods high in microbiota accessible carbohydrates [prebiotics!] along with fruits and vegetables.”
4. Helminths – “Re-introduction of helminths into the intestinal ecosystem is necessary to re-establish the balance of the ecosystem.”

The paper concludes on a positive note:

“The promising news is that there may be many disease modifying strategies that are at our disposal that could be implemented potentially reduce ASD symptomatology or prevent ASD altogether by targeting the enteric microbiome.”  Amen to that. As I have repeatedly stated in this blog, while we don’t yet know how to optimize all these things, and we are light years away from knowing all the answers, there is NO DOWNSIDE, ONLY POTENTIAL UPSIDE, TO DOING THESE THINGS NOW.  Remember my mantra:  If it can’t hurt, and it could help, do it.
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[i] Slattery, J, MacFabe, DF, Kahler, SG, Frye, RE. Enteric ecosystem disruption in autism spectrum disorder: can the microbiota and macrobiota be restored? Current Pharamceutical Design. 2016:22,6107-6121.