The Role of the Immune System in Autism Spectrum Disorder
Neuropsychopharmacology. 2017 Jan; 42(1): 284–298. Published online 2016 Sep 21. Prepublished online 2016 Aug 18. doi: 10.1038/npp.2016.158
The Role of the Immune System in Autism Spectrum Disorder
Amory Meltzer1 and Judy Van de Water1,2,3,*
1Division of Rheumatology/Allergy and Clinical Immunology, Department of Internal Medicine, University of California, Davis, CA, USA
2The M.I.N.D. Institute, University of California, Davis, CA, USA
3NIEHS Center for Children’s Environmental Health, University of California, Davis, CA, USA
*Division of Rheumatology/Allergy and Clinical Immunology; 451 E. Health Sciences Dr, Suite 6510; University of California Davis
Abstract
Autism is a neurodevelopmental disorder characterized by deficits in communication and social skills as well as repetitive and stereotypical behaviors. While much effort has focused on the identification of genes associated with autism, research emerging within the past two decades suggests that immune dysfunction is a viable risk factor contributing to the neurodevelopmental deficits observed in autism spectrum disorders (ASD). Further, it is the heterogeneity within this disorder that has brought to light much of the current thinking regarding the subphenotypes within ASD and how the immune system is associated with these distinctions. This review will focus on the two main axes of immune involvement in ASD, namely dysfunction in the prenatal and postnatal periods. During gestation, prenatal insults including maternal infection and subsequent immunological activation may increase the risk of autism in the child. Similarly, the presence of maternally derived anti-brain autoantibodies found in ~20% of mothers whose children are at risk for developing autism has defined an additional subphenotype of ASD. The postnatal environment, on the other hand, is characterized by related but distinct profiles of immune dysregulation, inflammation, and endogenous autoantibodies that all persist within the affected individual. Further definition of the role of immune dysregulation in ASD thus necessitates a deeper understanding of the interaction between both maternal and child immune systems, and the role they have in diagnosis and treatment.
