By developmental-behavioral pediatrician Kathleen Angkustsiri, the lead investigator in a new study investigating the role of maternal antibodies in the prenatal development of some forms of autism. Dr. Angkustsiri practices at the University of California, Davis, MIND Institute. Her study on maternal antibodies and autism is supported by a Developmental-Behavioral Pediatrics Young Investigator Award.
I’m so pleased to tell you about our research collaboration with the Autism Speaks Autism Treatment Network (ATN).
In particular, we are grateful for the participation of families at the ATN sites at Children’s Hospital of Philadelphia and Arkansas Children’s Hospital. Like all the voluntary participants in the ATN Patient Registry, these families are advancing our understanding and treatment of autism and its related medical conditions.
In our new study, we are investigating the role that maternal antibodies play in the development of autism in a subset of children. In particular, we hope to better understand the relationship between specific maternal antibodies and the severity of a child’s symptoms.
Ultimately this work may lead to treatments that can reduce the risk of autism by blocking harmful maternal antibodies during pregnancy.
We also hope that this research will help us better understand what treatments – new and old – are particularly helpful for children, or even adults, whose autism developed in this manner.
Maternal Antibodies and Autism
As families affected by autism know well, we can seldom identify exactly what caused a given person’s autism. However, research continues to identify factors that increase risk. These influences include genetics and differences in the prenatal environment.
In recent years, a growing body of research has suggested that one important risk factor involves the pregnant mother’s immune system. This has been the research focus of my advisor Judy Van de Water, at the UC Davis MIND Institute.
To learn more about Dr. Van de Water’s Autism Speaks-funded research, see “Study IDs Brain Proteins Targeted by Autism-related Antibodies.”
Antibodies are proteins created by the immune system to fight infections and other threats to health. However they sometimes mistakenly turn against healthy tissue. This is what happens in auto-immune diseases such as lupus and rheumatoid arthritis. We call these rogue immune molecules “autoantibodies.”
We also know that autoantibodies sometimes cross the placenta during pregnancy. For instance, when a mother has Graves’ disease, her thyroid-stimulating autoantibodies can cause symptoms in the fetus.
In their research, Dr. Van de Water and her colleagues found that nearly one-fourth of mothers with a child on the autism spectrum have antibodies that react with proteins in the developing brain. They did not find these antibodies in the mothers of typically developing children.
A number of animal studies have likewise supported the idea that maternal immune activation during pregnancy can cause autism-like behaviors. In one study, researchers isolated antibodies to brain proteins from mothers of children with autism. They then injected these antibodies into pregnant monkeys. The monkeys’ offspring showed repetitive behaviors and reduced social behavior.
The presence of these same antibodies in human mothers has been associated with more severe language delay, irritability and self-injurious behavior in their children with autism.
Our collaboration with the ATN will expand Dr. Van de Water’s research beyond the UC-Davis MIND Institute to include the ATN centers in Arkansas and Philadelphia. We will explore whether the presence of particular types of maternal autoantibodies is related to milder versus more-severe autism symptoms. We will likewise explore how the presence of different types of maternal autoantibodies relates to other aspects of a child’s development.
We hope this work will advance us to the day when we might be able to screen for problematic antibodies in mothers who have had a child with autism or other signs of delayed development. Potentially, this might lead to treatments that block these antibodies from reaching the fetus during her next pregnancy.
Hopefully, this research will also lead to earlier and improved screening and tailored treatments for this subset of children with autism. It may be that certain behavioral interventions work better – or not so well – with these children. There may likewise be opportunities for new immune-based treatments that could ease their symptoms.
We are so appreciative of our partnership with the ATN and the families volunteering to participate in our work. Pediatrician Amanda Bennett is our principal investigator at the ATN site at Children’s Hospital of Philadelphia. Pediatrician Jill Fussell is our principal investigator at the ATN site at Arkansas Children’s Hospital. In addition to Dr. Van de Water, my advisors for this study include pediatrician Robin Hansen.