Evaluation of atopy and immune functions in children with autism spectrum disorders (ASD): Identification of an ASD subset with distinct clinical and immunological findings

Abstract

This study assessed prevalence of atopy, food allergy (FA), and recurrent otitis media/chronic rhinosinusitis (ROM/CRS) in 91 ASD children referred to the Allergy/Immunology Clinic along with their TLR responses (assessed by cytokine production) in comparison with non‐ASD children [ROM/CRS (N=23), FA (N=21), and healthy controls (N=48)]. Among ASD children with recurrent exacerbation of behavioral symptoms and loss of cognitive skills following infection (ASD‐RE, N=16), their TLR responses was evaluated with normal and ASD case controls. Non IgE mediated FA was highly prevalent (69.2%) in ASD children but not atopy (30.8%), ROM/CRS (14.3%), or known primary immunodeficiency (PID) (2.2%). In contrast, PID was highly prevalent in ROM/CRS children without ASD (47.8%). ASD‐RE children had a high prevalence of ROM/CRS despite absence of PID and also revealed altered production of IL‐1ß, IL‐6, and sTNFRII with TLR7/8 agonist with or without LPS pretreatment. They also revealed altered IL‐10 production with TLR2/6 agonist. Thus ASD‐RE children revealed distinct clinical features and laboratory findings not associated with atopy or PID. Their aberrant TLR 7/8 and 2/6 responses may be associated with recurrent infection and possibly impaired stress responses, given roles of these cytokines in neuro‐immune network. Funded by Jonty Foundation/ARI.