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Abstract
This study was designed to investigate serum levels
of positivity for serum antiganglioside antibodies (anti-
GM1) as an index for autoimmunity to brain in autistic
children and their relation to some disease characteristics
such as (autistic severity, family history of autoimmunity,
allergic manifestations, mental retardation and EEG
abnormalities). For this purpose, 40 autistic children aged
4-10 years diagnosed according to DSM-IV behavioral
descriptors for PDDS were studied in comparison to 40
healthy aged and sex matched control children. According
to CARS, autistic children were subdivided into 2 groups;
group I included 24 children with mild to moderate autism,
and group II included 16 children with severe autism.
Besides clinical and neuropsychiatric evaluation, the
following investigations were performed: assessment of
intellectual function, serum anti-GM1 IgG and IgM
antibodies (ELISA) and measurement of brain electrical
activity of EEG.
Autistic children had significantly higher serum
levels of anti-GM1 IgG and IgM antibodies than healthy
controls. In addition, 50% and 40% of autistic children
were seropositive for anti-GM1 IgG and IgM antibodies,
respectively.
Children with severe autism had significantly higher
serum anti-GM1 IgG and IgM antibodies than children with
Summary and Conclusion
126
mild to moderate autism. In addition, both antibodies had
significant positive correlations to CARS.
Furthermore, female autistic children had
significantly higher serum levels of anti-GM1 IgG and IgM
antibodies than male autistic ones.
Eighteen autistic children (45%) had a first or a
second degree relative with an autoimmune disease. On the
other hand, a positive family history of autoimmune disease
was found in only 4 healthy children (10%). The frequency
of autoimmune disease in families of children with autism
was significantly higher than normal children. Autistic
children with a family history of autoimmune disease had
significantly higher serum anti-GM1 IgG and IgM
antibodies than those without such a history.
Allergic manifestations were found in 15 autistic
children (37.5%). This percentage was significantly higher
than that of healthy controls (4/40: 10%). Autistic children
with allergic manifestations had significantly higher serum
anti-GM1 IgG and IgM antibodies levels than those without
such manifestations.
Twelve autistic children (30%) had autistic
regression i.e., they underwent regression in language and
skills after a period of normal development. Children with
autistic regression had significantly higher serum anti-GM1
IgG and IgM levels than children without autistic
regression.
Summary and Conclusion
127
Eight autistic children (20%) where macrocephaliec.
The remaining 32 autistic children had normal skull
circumference. Macrocephaliec autistic children also had
significantly higher serum anti-GM1 IgG and IgM antibodies
levels than children with normal skull circumference.
Thirteen autistic children (32.5%) had EEG
abnormalities. Autistic children with such abnormalities
had significantly higher serum values of anti-GM1 IgG and
IgM antibodies than those with normal EEG.
In conclusion, 52.5% of autistic children were
seropositive for anti-GM1 IgG and/or IgM antibodies. In
addition, seropositivity for these antibodies had a
significant positive associations with a family history of
autoimmunity and important disease characteristics, in term
of disease severity, autistic regression, macrocephaly,
mental retardation and EEG abnormalities. Therefore,
studies considering the role of immunotherapy including
oral tolerance with GM1 as an autoantigen on amelioration
of autistic symptoms by inducing immunosuppression in
anti-GM1 positive subgroup of autistic children are
recommended.
Therefore, studies considering the role of
immunotherapy including oral tolerance with GM1 as an
autoantigen on amelioration of autistic symptoms by
inducing immunosuppression in anti-GM1 positive
subgroup of autistic children are recommended.