The two-year grant awarded to Feinstein researchers Dr. Betty Diamond and Dr. Peter Gregersen is part of a larger effort to identify the combination of genetic and environmental risk factors that might predispose a child to autism.
“We know that there’s a genetic component and we know that there’s an environmental component, and we know that the mother confers most of the environmental component,” Diamond said. “We're very interested in environmental components because the incidence of autism is increasing and so that's probably not due to genetics; that’s due to probably something environmental.”
Autism spectrum disorder is a group of complex disorders that affect neurodevelopment. The latest issue of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes autistic disorder, Asperger’s syndrome and pervasive developmental disorder within the autism spectrum disorders.
Data from the Autism and Developmental Disabilities Monitoring Network released by the Centers for Disease Control has shown that autism rates are rising. In 2002, one in 150 children were diagnosed with ASD, in 2012 that number had risen to one in 68, or 14.6 percent of the population.
The award is part of the NIH Environmental Influences on Child Health Outcomes Program. On Sept. 21, the NIH announced awards of more than $150 million for research into environmental influences on child health from conception through early childhood.The Feinstein Institute, which is located in Manhasset, New York, is one of the pediatric cohorts that will analyze existing data and follow children over time to address the environmental origins of identified health outcome areas: upper and lower airway, obesity, neurodevelopment and prenatal, perinatal and postnatal outcomes.
In their earlier research, Diamond and Gregersen found that the antibodies in patients with systemic lupus, a difficult-to-diagnose autoimmune disorder, could alter brain development in a fetus. That research led them to the question of whether other disorders, including autism, might also be impacted by maternal antibodies.
“We did some studies of this question and showed that, in fact, women who have a child with autism spectrum disorder are more likely to have [these] antibodies,” Diamond said.
Diamond and Gregersen’s new study will take blood tests of 4,500 pregnant women and then follow them for two years after their delivery at Northwell Health Hospitals in New York. The goal is to identify the presences of autoimmune diseases and what effects related antibodies might have on the child.
According to the CDC, autism can be diagnosed in children as early as age 2, but most children are not diagnosed until age 4.
Diamond is hopeful that some of the assessments they’re doing may shed light on diseases outside the autism spectrum as well. “I think that that may help understand more than neurodevelopmental disorders; it may help understand food allergies, asthma. These parameters in the mother may be involved in lots of different outcomes for the child.”
Members of the pediatric cohort are set to meet in November. Diamond said the study should begin soon after.
If their research uncovers an antibody that contributes to autism, the next step will be to find a way to ameliorate its effects.
“Our hope is that we could develop a sort of decoy antigen that we could give the mother that would sponge up the antibodies and never get to the fetus,” Diamond said.
Additional research would have to identify any potential health risks for the mother. “It’s always a slow process,” Diamond said.