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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2019.00849

Review of Clinical Studies Targeting Inflammatory Pathways for Individuals with Autism

 Sina Hafizi1, 2*, Dina Tabatabaei2 and  Meng-Chuan Lai3, 4, 5
  • 1Max Rady College of Medicine, University of Manitoba, Canada
  • 2School of Medicine, Tehran University of Medical Sciences, Iran
  • 3Centre for Addiction and Mental Health (CAMH), Canada
  • 4Department of Psychiatry, University of Cambridge, United Kingdom
  • 5Department of Psychiatry, National Taiwan University Hospital, Taiwan

Immune dysfunction and abnormal immune response may be associated with certain mechanisms underlying autism spectrum disorder (ASD). The early evidence for this link, was based on the increased incidence of ASD in children with a history of maternal infection during pregnancy. Observational studies show increased prevalence of immune-related disorders – ranging from atopy, food allergy, viral infections, asthma, primary immunodeficiency, to autoimmune disorders – in individuals with ASD and their families. Evidence of neuroglial activation and focal brain inflammation in individuals with ASD implies that the central nervous system immunity may also be atypical in some individuals with ASD. Also, both peripheral and central inflammatory responses are suggested to be associated with ASD-related behavioral symptoms. Atypical immune responses may be evident in specific ASD subgroups, such as those with significant gastrointestinal symptoms. The present review aimed to evaluate current literature of potential interventions that target inflammatory pathways for individuals with ASD and to summarize whether these interventions were associated with improvement in autism symptoms and adaptation. We found that the current literature on the efficacy of anti-inflammatory interventions in ASD is still limited and large-scale randomized controlled trials are needed to provide robust evidence. We concluded that the role of immune-mediated mechanisms in the emergence of ASD or related challenges may be specific to subsets of individuals (e.g. those with concurrent immunological disorders, developmental regression, or high irritability). These subsets of individuals of ASD might be more likely to benefit from interventions that target immune-mediated mechanisms and with whom next-stage immune-mediated clinical trials could be conducted.

Keywords: Autism (ASD), Inflammation, Neuroinflammation, ASD, Immune System

Received: 16 Oct 2018; Accepted: 28 Oct 2019.

Copyright: © 2019 Hafizi, Tabatabaei and Lai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Sina Hafizi, Max Rady College of Medicine, University of Manitoba, Winnipeg, R3E 3P5, Manitoba, Canada, sina.hafizi@gmail.com