Download Jeff Bradstreet, MD, FAAFP

Autism 2001: Place for New
Medical Discoveries
BIOLOGICAL INTERVENTIONS IN THE
TREATMENT OF AUTISM AND PDD
Jeff Bradstreet, M.D., FAAFP
1. General Overview - Issues Related to the Treatment of Autism:
• Opioid/dopamine metabolism
• Gl inflammation
• The link between vaccinations and autism
• Pathogens (yeast, bacteria, viruses)
• Nutritional disorders
• Food allergies
• Autoimmunity and poor immunity
• Heavy metal toxicity
• Coagulation disorders
• Neurological issues (brain mapping)
• Vasospasm
2. Opioid/dopamine metabolism
• The first place to start is with gluten and casein elimination. 81 % of
children improve on a gluten-free, casein-free diet (Cade). The earlier the
diet is started, the better the results. Schools, relatives and caregivers
must be a part of the solution.
• High levels of opioids (gliadomorphin and casomorphin) are found in the
urine of many children with autism, according to urine peptide tests.
• Opioids are significant because they inhibit GABA at the dopaminergic
presynaptic locus and affect D2 G-peptide receptors, resulting in
stereotyped behaviors. One study showed that lab rats react to opioids
with predictable stereotypic movements, not unlike those found in autism.
• Peptidase enzymes may be somewhat beneficial in reducing the
production of these opioids, but the best solution is to implement a GFCF
diet.
3. Gl Inflammation
Wounding the gut in autism - suspected links:
• Inborn weakness that predisposes the gut to wounding (e.g. casein
intolerance)
• Immune injury (food allergy or gluten enteropathy)
• Nutritional problems (especially with zinc deficiency, which prevents the
development of a normal gut mucosa)
•
•
•
•
Viral and bacterial infections
Yeast and other pathogens
Vaccines
Metal toxicities
The most serious consequence of this is malabsorption, leading to significant
(and often severe) nutritional deficiencies.
Secretin therapy is often helpful for autistic children with Gl pathology.
• One study done by Horvath found that 75% of autistic children have
insufficient production of secretin, so secretin therapy is meant to repair
these deficiencies.
• The Eden study on secretin found that severely autistic children
responded much more dramatically to secretin therapy than kids who were
only mildly autistic. Improvements were seen in behavior, eye contact,
spontaneous communication, and other areas.
• Transdermal secretin is the easiest, although perhaps not the most
effective way of delivering secretin.
4. The link between vaccinations and autism
• There is growing evidence that certain vaccinations may have a
relationship to the Gl inflammation that is commonly found in autistic
children (Wakefield).
• Many parents believe that the MMR vaccine, in particular, led to the onset
of their child's autism. While no definite links have been established, it is
clear that multiple vaccines (such as the MMR and DPT) were unknown
prior to this generation. The components of several vaccines are capable
of producing autoimmune reactions.
5. Pathogens (yeast, bacteria, viruses)
• The majority of children with autism have significant Gl pathology.
Common symptoms include diarrhea and/or constipation, abdominal pain,
gas, bloating, and GERD.
• Stool cultures often reveal the presence of a variety of etiological agents,
including yeast, bacteria, viruses, and parasites. These organisms can
further irritate an already compromised intestinal tract, leading to a whole
host of systemic and Gl-related problems. In addition, many of these
organisms (especially yeast) generate a variety of toxins (detected on
Organic Acid Test) that can enter the bloodstream and have effects on
many neurological and immunological processes.
6. Nutritional Disorders in Autism
As most parents know, children with autism tend to be carbohydrate junkies and
have a very poorly balanced diet. This sets the kids up for significant nutritional
deficiencies, leading to a host of problems.
Some of the common nutritional disorders seen clinically in children with autism
include the following:
• Zinc deficiency seen in 90% (Among other things, zinc is needed for the
development of a healthy gut mucosa, for the formation of myelin, and for
the proper development of the immune system [thymus gland].)
• Copper excess seen in 90% (In excess amounts, copper acts as a prooxidant by increasing lipid peroxidation [destruction of fatty acids in cells,
especially brain cells].)
• Calcium and magnesium deficiency is very common and well
documented.
• Omega-3 fatty acid deficiency is seen in nearly 100%.
• Fiber deficiency is present in nearly 100% (Fiber is essential for the
healthy development of the Gl system.)
• Antioxidant and other vitamin deficiencies are also seen in close to 100%
of children with autism (mainly due to poor diet).
The consequences of these nutritional disorders are brain, immune and Gl
disasters. Even without autism, these kids would be in bad shape because of the
severe nutritional deficiencies resulting from their poor diets.
7. Food allergies
• Food allergies are a common consequence of the various Gl pathologies
described above. As the intestinal mucosa becomes inflamed and irritated,
a condition known as "leaky gut syndrome" develops and causes large
food proteins to be released into circulation. The immune system
recognizes these proteins as toxins and mounts an immune response,
which manifests clinically as food allergies.
• Food allergies are significant in autism because they can place a huge
burden on an already compromised immune system. In addition, eating
allergenic foods can exacerbate Gl pathology and can often result in the
worsening of a child's behavioral symptoms.
8. Autoimmunity and poor immunity
• In many children with autism, there is an autoimmune component to brain
and nervous system tissue. Studies have demonstrated a high occurrence
of anti-Myelin Basic Protein (anti-MBP) autoantibodies in children with
autism, Landau-Kleffner Syndrome Variant, and other neurological
disorders. Myelin is needed by nerve cells for the proper conduction of
nerve impulses. Dr. Connolly of Washington University in St. Louis has
also shown the existence of autoantibodies to brain blood vessels.
• There are also some indications, based on a number of studies, of an
association between measles virus and human herpesvirus-6 with brain
autoantibodies in autism.
Intravenous Immune Globulin (IVIG) has been shown to have some benefits in
treating autistic children with autoimmunity and poor immunity. Since IVIG is in
very limited supply, priority for treatment is given to kids who:
ƒ Exhibit failure to thrive
ƒ Have significant serum autoantibodies
ƒ
ƒ
Have significant immune dysfunction
Have seizure disorders and/or Landau-Kleffner Syndrome Variant
9. Heavy metal toxicity
• There is a clear link between heavy metal toxicity and various types of
neurological dysfunction. Many autistic children have been found on urine
provocation tests to have significantly elevated levels of one or more
heavy metals, such as mercury, lead, arsenic, tin, aluminum, and others.
• Heavy metal toxicity can cause a whole host of problems in many different
organ systems. For example, mercury toxicity can have some of the
following consequences:
- Can disrupt the balance of immune cells and cause high IgE
- Can alter the immune responses to food (IgG and IgE)
- May inactivate the enzyme DPPIV, causing problems with opioids
- Leads to Zinc and Selenium deficiency (already low in autism)
- Can interfere with proper myelination of nerve tissue
• Removing toxic metals from the body through chelation is an essential part
of the treatment of autism. Many years of study and research have led to
the development of a protocol which, when used properly, can safely and
effectively remove most toxic metals from the body. Many children with
autism have shown dramatic improvement in their symptoms during and
after the chelation process.
10. Coagulation disorders
• Many autistic children (and their family members) show significant
abnormalities in blood coagulation. Lack of oxygenation due to
compromised blood supply might explain some of the symptomatology
seen in autism.
• Data is currently being gathered at the International Autism Research
Center on coagulation abnormalities in children. Testing is being done
through Hemex Laboratories and Specialty Laboratories. Panels being
drawn include the ISAC ("Immune System Activation of Coagulation")
Panel and the Hereditary Thrombosis Panel.
• A number of natural supplements can be used in the treatment of these
coagulation disorders.
11. Neurological issues
• Recently, the International Autism Research Center, in conjunction with Dr.
Joel Lubar of the University of Tennessee, has started using a QEEG
machine to identify abnormal brain wave patterns that might be unique to
individuals with autism. Dr. Lubar has already identified such a "signature"
brain wave pattern in children and adults with ADD, and we are hoping to
further this research to include Autism Spectrum Disorders.
12. Vasospasm
• Another new area of inquiry is into the potential role of vasospasm in the
symptoms of the Autism Spectrum Disorders and Landau-Kleffner
Syndrome.