Sphingolin
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About the Author
Vijendra K. Singh received his doctorate from the University of British Columbia in neurochemistry and neuroimmunology. Dr. Singh describes the use of the MBP-containing myelin products for treating autistic patients. "Indeed, one such product known as Sphingolin has been used with success."
Immunotherapy in Autism
The aforementioned laboratory findings clearly point to an autoimmune pathogenic mechanism in autism. The idea that autism is an autoimmune disorder is further strengthened by the fact that autistic patients respond well to treatment with immune modulating drugs.
Immune interventions can produce immune modulation-a state of suppression or stimulation. Depending on the nature of the immune abnormality, the goal of therapy should be to normalize or reconstitute the immune response instead of inducing immune suppression or stimulation. This will maintain a balance within the normal immune response, avoiding major fluctuations of overt immune activity which could be detrimental to the patient. Immune therapy should always be done in consultation with physicians. The following immune interventions can be used:
Steroid therapy
Steroids such as Prednisone and/or ACTH (adrenocorticotropin hormone) are commonly used as anti-inflammatory and/or immunosuppressive drugs for treating patients with autoimmune diseases, inflammatory diseases, etc.
In autism, however, there is only one study that showed improvement of autistic-like symptoms in children when they were treated with an ACTH analogue. This result indicated that steroids are potentially useful in alleviating clinical symptoms of autism. Steroids are the first course of treatment for patients with autoimmune diseases and infantile spasm; however, their efficacy has not been evaluated in autism.
Intraveneous immunoglobulin (IVIG)
This type of treatment has been used to treat children with autism. Open-label trials of both low-dose and high-dose IVIG have shown that most but not all autistic children respond favorably to this treatment.
My collaborators and I recently found that the high-dose IVIG was better than the low-dose IVIG [1].
Clinically, children so treated have shown improvements in language, communication, social interaction and attention span. In a double-blind study, [2] the IVIG treatment was found to decrease brain autoantibody titers in five patients (they were positive pre-therapy but became virtually negative post-therapy) who also showed clinical improvement of autistic characteristics. In spite of the success of IVIG, this treatment is not for everyone. Before this treatment is administered, a proper immune evaluation is highly recommended to assess the nature of the immune problem.
Oral tolerance with autoantigens
This treatment is a means of inducing immune suppression by feeding patients autoantigen. I have shown that the candidate autoantigen in autism appeared to be a myelin basic protein (MBP); this suggested that the MBP-containing myelin products can be used to treat autistic patients. Indeed, one such product known as Sphingolin has been used with success. Recently, the parents, school psychologists, and other professionals have anecdotally reported tremendous improvements of autistic symptoms in their children. These reports are undoubtedly quite encouraging and promising, but a well-designed clinical trial is warranted.
Plasmapheresis
Although it is not commonly recommended, this procedure is used for treating patients with infections, autoimmune diseases, immune complex diseases, etc. Because this method removes harmful substances (e.g., autoantibodies) from the blood, it is considered a viable immune therapy. The method has been used to treat certain brain disorders, for example Rasmussen's encephalitis (RE) and obsessive-compulsive disorder (OCD), in which autoimmunity has been implicated as a basis of the disorder. Plasmapheresis produced positive responses in patients with these disorders, and the responses were much better with plasmapheresis when compared to the IVIG treatment. In each case, the benefit to the patient was associated with the lowering of the anti-neuronal antibody titers. Since autistic patients also have positive titers of brain autoantibodies, they should also respond to plasmapheresis. Although this treatment has long been suggested for use in autism [3], plasmapheresis has thus far not been tried in patients with this disorder.
Learn More
- Autoimmunity and Neurological Disorders
- Interview with V. K. Singh in Latitudes, newsletter of the Association for Comprehensive NeuroTherapy,vol. 4, no. 2, Spring 1999, by Sheila Rogers
- V. K. Singh: Selected Research on Autism: Findings in Immunology
- Vijendra K. Singh, Ph.D.: Selected Work on Alzheimer's Disease
References
- Singh, V. K., "Plasma Increase of Interleukin-12 and Interferon-gamma: Pathological Significance in Autism" (Journal of Neuroimmunology, vol. 66, pp. 143-145 [1996]).
- Singh, V. K., "Immunotherapy for Brain Diseases and Mental Illnesses," (Progress in Drug Research, vol. 43, pp. 129-146 [1997]).
- Singh, V. K., "Serological Association of Measles Virus and Human Herpesvirus-6 With Brain Autoantibodies in Autism" (Clinical Immunology and Immunopathology, vol. 89, pp. 105-108 [1998]).
- Singh, V. K., "Autoimmunity and Neurologic Disorders" (Latitudes, vol. 4, pp. 5-11 [1999]). Reprinted from AAPN, The Autism Autoimmunity Project Newsletter, vol. 1, number 2, December 1999.
