Summary of Biomedical Treatments for Autism, by James B. Adams, Ph.D.
page 17Immune System Regulation
Rationale: Several studies have found abnormal immune systems in autism, generally with shift to Th-2, and some evidence for auto-immunity.
Molloy et al., Elevated cytokine levels in children with autism spectrum disorder, J. Neuroimmunol 172 (2006) 198-205.
Treatments: More research on effective treatments for normalizing the immune system in children with autism are needed. If lab testing reveals abnormal immune system, current possible treatments include Actos (pioglitazone), intra-venous immunoglobulins (IVIG), and low-dose naltrexone.
Research:
IVIG: Gupta et al., found IVIG benefited 4 of 10 children, with 1 case of marked improvement. This is an expensive treatment, as the immunoglobulins need to be collected from hundreds or thousands of human donors.
Gupta et al., Treatment of children with autism with intravenous immunoglobulin. J Child Neurol. 1999 Mar;14(3):203-5. No abstract available.
Twenty six autistic children received intravenous gamma globulin (IVIG) every 4 weeks for 6 months at a dose of 400mg/Kg. Aberrant behaviors, speech, hyperactivity,inappropiate stims and social interactions significantly improved. However 22 of the 26 children regressed within 4 months after discontinuing IVIG.
Boris m, Goldblatt A, Edelson SM; Improvement in children with autism treated with intravenous
gamma globulin. Journal of Nutritional & Environmental Medicine, Dec 2005; 15(4): 169-176.
ACTOS: ACTOS (pioglitazone) has multiple effects, including the ability to decrease inflammation. An open study of ACTOS in 25 children with autism for 3-4 months found substantial improvements in irritability, lethargy, stereotypy, and hyperactivity, with greater benefits in the younger children. Doses were 30 mg (younger children) and 60 mg (older children)
Boris et al., Effect of pioglitazone treatment on behavioral symptoms in autistic children, accepted in J. Neuroinflammation 2007.
Low-dose naltrexone:
There have been 14 clinical trials of naltrexone for children with autism. A review paper by Elchaar et al. reported “Naltrexone has been used most commonly at doses ranging from 0.5 to 2 mg/kg/day and found to be predominantly effective in decreasing self-injurious behavior. Naltrexone may also attenuate hyperactivity, agitation, irritability, temper tantrums, social withdrawal, and stereotyped behaviors. Patients may also exhibit improved attention and eye contact. Transient sedation was the most commonly reported adverse event.”
Elchaar et al., Efficacy and safety of naltrexone use in pediatric patients with autistic disorder. Ann Pharmacother. 2006 Jun;40(6):1086-95. Epub 2006 May 30. Review.
It has been suggested that low-dose naltrexone, at about 3-5 mg/day (much lower than the doses mentioned above) may be beneficial to children with autism and may improve the regulation of their immune system. More research is needed.
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