October 10th, 2022
"Summary of Immune Evidence in ASD–is Immune Dysregulation Causing or Contributing to these Disorders? Immune findings in individuals with ASD have grown from a few scant early studies to a plethora of extensive and varied research showing immune dysfunction that contributes to worsening behaviors. Familial autoimmunity is a common finding within families affected by ASD. In addition, individuals with ASD have significant immune dysregulation that contribute to altered
behaviors. These individuals also suffer more so than the general population from immune-mediated comorbidities such as allergies, asthma and gastrointestinal (GI) disturbances. Mechanistically, studies have shown that the gestational immune environment must be delicately balanced, and without such balance neurodevelopment can be altered. Whether these immune characteristics are causal or just sequelae of the overarching disorders remain to be determined; however, the evidence is building that the dysregulated immune response may be pathologically contributing to ASD."
(Hughes et. al. 2022)
I am putting my early eggs in this basket as it makes the most sense to me. The maternal child interface is the place where the dysfunction is occurring. This is in the womb and not afterward with the exception of some rare cases of genetic regressive diseases like Rhett Syndrome. The immune milieu of the maternal corpus is likely the ground zero for inflammation that is leading to the phenotype that is autism. This is a tricky possible truth as it has maternal guilt of health tied to it. We shall not and cannot judge but we must follow the data wherever it takes us.
The increased prevalence of familial, maternal autoimmunity coupled to early findings of maternal autoantibodies targeting pathways in the child's brain are the best evidence of a part of the causation. There are many other factors at play including abnormal bacterial GI microbiomes, changes in innate and inflammatory pathways with elevated cytokine levels and more.
The change from 1 in 10000 children 50 years ago to 1 in 40 now is proof that this is issue is not genetics so much as environmental. Thus, our work needs to focus on maternal and child immune solvency.