Abstract
Autism spectrum disorders (ASD) are a group of neurodevelopmental conditions whose incidence is reaching epidemic proportions, afflicting approximately 1 in 166 children. Autistic disorder, or autism is the most common form of ASD. Although several neurophysiological alterations have been associated with autism, immune abnormalities and neural hypoperfusion appear to be broadly consistent. These appear to be causative since correlation of altered inflammatory responses, and hypoperfusion with symptology is reported. Mesenchymal stem cells (MSC) are in late phases of clinical development for treatment of graft versus host disease and Crohn's Disease, two conditions of immune dysregulation. Cord blood CD34+ cells are known to be potent angiogenic stimulators, having demonstrated positive effects in not only peripheral ischemia, but also in models of cerebral ischemia. Additionally, anecdotal clinical cases have reported responses in autistic children receiving cord blood CD34+ cells. We propose the combined use of MSC and cord blood CD34+cells may be useful in the treatment of autism.
Highlights
Autism spectrum disorders (ASD) are reaching epidemic proportions, believed to affect approximately 1 in 166 children
In this paper we examine two pathologies associated with autism – hypoperfusion to the brain and immune dysregulation – and propose a novel treatment: the administration of CD34+ umbilical cord cells and mesenchymal cells
Given the potency of cord blood CD34+ cells to induce angiogenesis in areas of cerebral hypoperfusion, we propose that this cell type may be useful for the treatment of autism, in which ischemia is milder than stroke induced ischemia, and as a result the level of angiogenesis needed is theoretically lower
Summary
Autism spectrum disorders (ASD) are reaching epidemic proportions, believed to affect approximately 1 in 166 children. We believe mesenchymal stem cell administration may be used for this purpose This cell type, in allogeneic form, is currently in Phase III clinical studies for Crohn's disease and Phase II results have demonstrated profound improvement [121]. Supporting the potential clinical utility of such cells, it was previously demonstrated that administration of mesenchymal stem cells inhibits antigen specific T cell responses in the murine model of multiple sclerosis, experimental autoimmune encephalomyelitis, leading to prevention and/or regression of pathology [131]. The ability of mesenchymal stem cells on one hand to suppress pathological immune responses but on the other hand to stimulate hematopoiesis leads to the possibility that these cells may be useful for treatment of the defect in T cell numbers associated with autism. We believe that through development of a potent clinical study with appropriate endpoints, much will be learned about the pathophysiology of autism regardless of trial outcome
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