Metabolism of autism reveals developmental origins

https://medicalxpress.com/news/2024-05-metabolism-autism-reveals-developmental.html

by wglb • 2 years ago

171 326 2 years ago

The researchers discovered that a small number of biochemical pathways are responsible for the majority of these changes, which could help inform new early detection and prevention strategies for autism.

It won’t. Autism is a socioculturally bound diagnosis, not a single disease that exists in biology. It’s a label for those perceived by others in a certain light, defined in such a way that two with the same label can have remarkably little overlap in terms of observed behaviour. You diagnose autism based on how people act, not who they are. Any biological markers for autism are politically suspect as it would imply those without those markers are invalid, while also raising the spectre of eugenics for those with the markers.

More likely and productivity it might eventually REPLACE autism as a diagnosis with something scientifically valid and treatable, as if somebody displays no autistic behaviours as a result of treatment of a metabolic disorder, why diagnose them with autism?

furyofantares• 2 years ago

defined in such a way that two with the same label can have remarkably little overlap in terms of observed behaviour

I believed this until my daughter was diagnosed and then I was later diagnosed. My experience with (some) professionals was a surprise to me; a much wider variety of "observed behaviors" than I expected seem to stem from sensory issues for example. And I think it makes sense that humans might adopt a wide variety of ways to deal with for a much smaller variety of processing issues.

(Unrelated to the professional experience) Have you looked into monotropism? It's a fairly compact theory that ties a lot of behaviors together that might look like they have no overlap from the outside.

Also:

It’s a label for those perceived by others in a certain light

Lots of people self-diagnose.

faeriechangling12• 2 years ago

If you ask the majority of people if somebody who they do not perceive as engaging in autisitic behaviours, and was not diagnosed as autistic, but considers themselves autistic, is autistic, they will say no. Scientifically (which how it’s defined in the OP), it’s not defined by psychiatrist appraisal and self-assessment plays no necessary role in the process and alone holds no diagnostic validity. We can also invert this: self-denial doesn’t make one non-autistic if they’re seen as engaging in autistic behaviours and are diagnosed as autistic by a professional.

I’ll concede that a minority believe that autism is self-definable though. I’d prefer things that way myself, but the among other things it would make it impossible to gatekeep services for the autistic if self-diagnosis were held in the same esteem as physician diagnosis, so it won’t catch on anytime soon.

somenameforme8• 2 years ago

Here [1] is the DSM diagnostic criteria for autism. It's broad to the point of absurdity. The reason many people think autism is a faux disorder is because it includes everything from an individual who simply sits in the corner endlessly flapping his hands, completely unable to function as a human being, to Bill Gates or Elon Musk. The weaker diagnoses, which is an increasingly large chunk of all of them, often seem like an effect to pathologize normal behavioral differences within people. This is, IMO, one of those things people are definitely going to look back at think 'wtf were they even thinking?'

[1] https://a4.org.au/dsm5-asd

neom• 2 years ago

I mean I was diagnosed with a salad of things. And then different doctors tell me different things about how they're all related or unrelated. It was honestly a very amusing situation. The only sense I got out of the whole long ass process was: neurological sensory difference "combo" in the roll of the dice, some of it given hereditarily, some this that and the other. I really see why this stuff is so frustrating for people. I'm super lucky circumstances are such for me that I can give less shits about the social issues my autism causes, allowing me to explore it.I actually just started a blog last week to share as I explore this stuff, I'm a bit shy to share it as I've never blogged in earnest before, so I have no sense of if this is good, bad, silly, lame, boring, etc: https://b.h4x.zip/autism-thinking-and-whiteboards/

ninininino• 2 years ago

FTA:

"only 10–20% of children diagnosed before 5 years of age able to live independently as adults"

^ the article and the medical treatment is aimed at those so severely impacted/compromised that they cannot live independently.

Der_Einzige3• 2 years ago

People with high functioning autism make up a majority of the “people who died at 25 and didn’t know it until they were 80” crowd.

RobotToaster3• 2 years ago

IMO, it will probably end up like Ehlers Danlos, where you have 20 or so subtypes defined by certain genes.

Perenti7• 2 years ago

EDS is also highly associated with ADHD and ASD.

2four23• 2 years ago

I think most people understand that disease nomenclature changes rapidly. Even if the word "autism" is deprecated in the future and replaced by a litany of other terms for conditions, the research is still useful and interesting.

jncfhnb• 2 years ago

Because it’s fully possible and commonly understood that a medical condition can arise from multiple different circumstances

m00x6• 2 years ago

That's completely incorrect.

Autism has clear physiological differences in the brain. It's not just a personality difference. People like to call themselves autistic when it's just social awkwardness, and some doctors might even improperly diagnose them, but these are separate from the condition.

https://www.healthcentral.com/condition/autism/autism-brain-...

This could help us prevent autism completely.

faeriechangling12• 2 years ago

People like to call themselves autistic when it's just social awkwardness, and some doctors might even improperly diagnose them, but these are separate from the condition.

What makes such a diagnosis incorrect when various forms of social awkwardness satisfy criteria A and D of the diagnostic criteria [1], and all of the criteria for social pragmatic disorder[2]? In the DSM-V-TR era psychiatrists are instructed to not just judge somebody to not be autistic if they do not appear socially awkward, and to additionally ask if they find social interactions distressing, and observe them for longer in more naturalistic settings to find the deficit in social functioning[3] as part of a thus far continuously lowering diagnostic bar as to what is considered sufficient social awkwardness to be diagnosable.

Autism has clear physiological differences in the brain.

Which physiological changes in the brain make you autistic, or put another way, which physiological changes in the brain must you lack to NOT be autistic? I've heard of any autism diagnosis's and self-diagnosis's and I've never heard of any of them being based on a brain scan and yet people go around calling others and themselves autistic. I've never heard of a diagnosis being lost or gained due to a brain scan.

I've heard this insistence that we can infer the territory, the neurological conditions of peoples brains, from the map, the behaviourist diagnosis, and there may be a correlation but it can't be said that any given person with an autism diagnosis has any given specific neurological change. The only thing we test for IS behaviour, and infer biology from it.

[1] https://www.cdc.gov/ncbddd/autism/hcp-dsm.html [2] https://en.wikipedia.org/wiki/Social_(pragmatic)_communicati... [3] https://www.reddit.com/r/aspergirls/comments/th9hku/dsm5tr_n...

throwaway2562• 2 years ago

Here’s hoping. Autism is pure hell for some families. Unless of course self-declared leaders of the ‘neurodivergent community’ declare such efforts to be genocidal, modern eugenics, and so on.

Relatedly, I was struck to see the recent breakthrough in curing congenital deafness condemned by members of the ‘deaf community’ on Twitter. So we unfortunately have good reason to expect the same kinds of folly here.

mewpmewp27• 2 years ago

It's gross to hear that they want to prevent it.

ants_everywhere3• 2 years ago

Autism is a socioculturally bound diagnosis

This is untrue and unsupported by evidence

It's a label for those perceived by others in a certain light

This is untrue and unsupported by evidence

defined in such a way that two with the same label can have remarkably little overlap in terms of observed behaviour

This is untrue and unsupported by evidence

You diagnose autism based on how people act, not who they are

You diagnose all disorders based on observable phenomena, not some sort of metaphysical essence.

Any biological markers for autism are politically suspect

What is this, Lysenkoism?

as it would imply those without those markers are invalid

Are you saying that in your view biology has some ability to mark people as valid or invalid? That's an extremist view and I wonder how you arrived at it. If your ideology requires you divide the world into "valid" and "invalid" people, then it's probably a good time to rethink your approach.

zer00eyz• 2 years ago

> defined in such a way that two with the same label can have remarkably little overlap in terms of observed behaviour
This is untrue and unsupported by evidence

Here is the diagnostic criteria for ASD: https://www.cdc.gov/ncbddd/autism/hcp-dsm.html ... It literally lays out a path that can generate a non overlapping diagnosis. It sort of has to because we lummped what were previously two disorders together because people are sensitive to nazi's having existed.

Now go to the UK where there is strong advocacy for a whole other set of diagnostic criteria for women. The DSM begins to look barbaric and/or sexist if not misinformed.

The moment there is a biological underpinning to something like ASD it gets interesting because what do you do with all the folks with a diagnosis who DONT fit that label. They have something that looks the same but isnt... and the whole psychiatry/psychology community looks like quacks. DO note that im not opposed to these fields but they need to get their shit together on reproducibility.

mahatofu• 2 years ago

Thanks for introducing me to quite a few different topics.

faeriechangling12• 2 years ago

Responding to all the "This is untrue and unsupported by evidence" statements. In the context of this thread, which is addressing a scientific article.

Autism is a socioculturally bound diagnosis

I'm making a normative claim here, so your criticism is correct, as this is not a scientifically testable claim at all. I'm loosely an adherent of the social model of disability[1].

It's a label for those perceived by others in a certain light

First, you later agreed with this statement later when you said "You diagnose all disorders based on observable phenomena" so this criticism is incoherent and I'm not convinced you even disagree with me so much as misunderstand me. Scientifically I'd point out the DSM-V-TR defines autism observationally[2] and the CDC's research on autism uses said definitions[9]. That is evidence supporting what I say.

defined in such a way that two with the same label can have remarkably little overlap in terms of observed behaviour

I'll again point to the DSM-V-TR[1] where two individuals can satisfy section B of the criteria with no overlap whatsoever. The only necessary behavioural commonality are various social deficits. I'll also point out there are three categories of autistics depending on support needs.

More blithely and common-sense like, I'll just point out most people do not see all that much common in the behaviour of Elon Musk and some autistic in a full time care home who cannot dress or bathe themselves. The Autistic Spectrum also literally used to be split into 3 separate diagnosis's diagnosed based partially on behaviour, and how was that ever even possible or contemplated if people never believed there was a significant difference in autistic's behaviours?

---

Any biological markers for autism are politically suspect - What is this lysenkoism

I have not scientifically researched this specific point, but some historical background: Autism genetics research projects have been cancelled by patient backlash [3] where autism genetics projects were scuttled upon popular backlash. "Autistic psychopaths" in the past were subject to Euthanasia, forced sterilisation, and encouraged to voluntarily sterilised themselves by the Nazi regime[4] which raises obvious questions as to the utility of biological testing to enable a future eugenics regime which may also include new technologies like pre-natal testing. While not biological testing, we can see that there is political backlash against cognitive testing[5] to determine social supports for autism. We have also seen the rise of self-diagnosis[6] with it defended as being more accessible than physician diagnosis and based on the lack of evidence that it's LESS accurate than physician diagnosis which historically has been subjected to multiple definitional changes[7] and bias in terms of access to diagnosis itself[8]. Ergo, unless this serves as a method of diagnosis more accurate than physician diagnosis, it will be subject to the same criticism.

as it would imply those without those markers are invalid - Are you saying that in your view biology has some ability to mark people as valid or invalid?

I'm making a claim about others belief if biology should be used to establish the validity or invalidity of autism. It's my belief that the recognition of biological markers of autism would be vigorously protested by patients and advocacy groups because of what I just brought up.

[1] https://en.wikipedia.org/wiki/Social_model_of_disability [2] (please forgive the source - DSM-V-TR is under copyright) https://www.reddit.com/r/aspergirls/comments/th9hku/dsm5tr_n... [3] https://www.scientificamerican.com/article/high-profile-auti... [4] https://www.goodreads.com/book/show/36236157-asperger-s-chil... [5] https://www.cbc.ca/news/canada/nova-scotia/direct-family-sup... [6] https://www.psychologytoday.com/us/blog/neurodiverse-age/201... [7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365987/ [8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924013/ [9] https://www.cdc.gov/ncbddd/autism/data.html

ModernMech26• 2 years ago

the same label can have remarkably little overlap in terms of observed behaviour.... You diagnose autism based on how people act, not who they are.

I'm able to mask until I'm alone. My meltdowns look exactly like the observed behavior you see in other people, I just hide it better.

I'm also verbal mostly, until I'm not and I'm dissociating. Then I look a lot what you're used to seeing, except i don't let you see that. I don't let you see me rocking and stimming.

I can talk for an hour in front of 100 people about my special interests at any depth, but I can't complete simple tasks that others can do every day like going to the grocery store and restaurants without extreme difficulty.

Some people are "high functioning" autists, meaning that they are able to suppress their negative autistic expressions for the benefit and comfort of people around them. This doesn't make them "not autistic" -- they still are even if you personally can't tell. It just means they're putting on an act for you, to make you happy, so that you don't respond in the negative way they are used to being received. You are witnessing a performance.

That suppression is not a constant, and it can't go on forever. Someone doing this long enough will go into autistic burnout, which is like an extended depression and comes with skill loss and an inability to function in society. If you were to see this person at that point, you'd "see" the autism then.

Is this all there is to being autistic though? No! Being autistic comes with a great capacity for curiosity, creativity, artistic expression, innovation, and excellence associated with committing fully (as in actually 100%, eschewing loved ones and society) to an endeavor.

These are things we don't want to "cure". Most of the problems I face related to my autism have to do with interfacing with society, and not understanding people or not being able to do things everyone else seems to be able to, without any compassion for my inability to do so.

As far as I can tell they come from being dysregulated, and being dysregulated comes from extreme sensory overload. If we can fix the sensory overload a lot of other things are fixed. But that doesn't mean we should be "curing" or "preventing" autism, and it doesn't mean people who aren't melting down and who can live by themselves aren't autistic -- they're just well regulated.,

faeriechangling12• 2 years ago

From the DSM-V-TR:

"Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life)."

"Core diagnostic features are evident in the developmental period, but intervention, compensation, and current supports may mask difficulties in at least some contexts."

"Individuals who have developed compensation strategies for some social challenges still struggle in novel or unsupported situations and suffer from the effort and anxiety of consciously calculating what is socially intuitive for most individuals. This behavior may contribute to lower ascertainment of autism spectrum disorder in these individuals, perhaps especially in adult women. Thus, longer assessments, observation in naturalistic settings, and inquiring about any tolls of social interaction may be needed(Cage and Troxell-Whitman 2019; Hull et al. 2017). If asked about the costs of social interaction, for example, these individuals might respond that social interactions are exhausting for them, that they are unable to concentrate because of the mental effort in monitoring social conventions, that their self-esteem is adversely affected by being unable to be themselves, and so forth."

Observation is STILL actually essential to a diagnosis, you can't merely just claim to be masking, but it's not technically considered disqualifying for symptoms to only appear in certain contexts.

Some people are "high functioning" autists, meaning that they are able to suppress their negative autistic expressions for the benefit and comfort of people around them. This doesn't make them "not autistic" -- they still are even if you personally can't tell. It just means they're putting on an act for you, to make you happy, so that you don't respond in the negative way they are used to being received. You are witnessing a performance.

The research I've seen on the cat-q shows that [1]:

- Neurotypicals men mask a statistically insignificant amount more than autistic men

- Autistic women mask a statistically insignificant more than neurotypical women

- Autistic women mask a statistically significant amount more than autistic men

- Autistics "Compensate" more, copy others behaviour, copy behaviour they learned from movies

- Autistics "Assimilate" more, they will force themselves unwillingly more than others to be social or not be social.

We should also get over what gets somebody defined as having "high functioning" or "level 1" autism. It's a lack of severity of social impairments AND restricted & repetitive behaviours. With autistic men specifically, the evidence points to the "high functioning" as simply naturally exhibiting less autistic social interactions and behaviours than the "low functioning" without any exceptional effort beyond what the everyday non-disabled person does. Some of them may be tortured actors, but said people are no more prevalent than they are in the general population. It's things like imitation, and being in unwanted social situations, which is more characteristic of autism.

Being autistic comes with a great capacity for curiosity, creativity, artistic expression, innovation, and excellence associated with committing fully (as in actually 100%, eschewing loved ones and society) to an endeavor.

Those may correlate with autism, but aren't definitional of it. The DSM-V-TR's 1891 word diagnostic criteria briefly mentions "Special interests may be a source of pleasure and motivation and provide avenues for education and employment later in life" as the sole positive trait of autistics.

I don't mean to be a dick here - more activist. If these are qualities of autistics, they should either be part of the criteria for "Autism spectrum disorder" or autism should be conceptualised as being distinct from disorder similar to how we distinguish between being transgender and having gender dysphoria. Otherwise, one can say that all they wish, but they'll face negative stigmatisation from those who see autism as a definitionally negative mental disorder with no upside other than employability. "Autism" is quite the stigmatised word today and I blame psychiatry and The DSM for that more than anything else as they treat negatives associated with autism as definitional but not positives.

[1] ctrl-f "What it tests" "Average Scores" https://embrace-autism.com/cat-q/

squigz11• 2 years ago

Actual paper: https://www.nature.com/articles/s42003-024-06102-y

m00x6• 2 years ago

^^^^

Better to read the paper instead of the pop journals. Most writers don't understand the issues fully and make mistakes, or sensationalize the discovery.

cwillu2• 2 years ago

“This ^” style comments work very poorly on a site that doesn't maintain temporal ordering of comments.

quodestabsurdum2• 2 years ago

The paper is a super fascinating read, and lines up with several key features I've noticed in both of my professionally diagnosed autistic children (good luck getting access to a competent diagnostician who understands how the ASD criteria manifest in passing adults). It's really enlightening to see the association between Xanthine, one of the end-stage products of eATP metabolization, and the anxiety that is so prevalent within my own family.

From the Discussion[1] section of the paper:

These self-calming connections in metabolism failed to develop in ASD. The natural consequence of the loss of these metabolic safeguards to overexcitation is for children with ASD to seek sameness to avoid the anxiety produced by change91, and to be more sensitive to environmental changes across many sensory domains.

And a bit further on:

In the current study, xanthine was the purine that gained the most stimulatory (+r) correlations in 5-year-olds with ASD. Xanthine is one of the end-products of eATP metabolism97. Xanthine is known to trigger a cascade of events that leads to mitochondrial network fragmentation, reactive oxygen species and reactive nitrogen species (ROS and RNS), eicosanoid (e.g., leukotriene, HETE, and prostaglandin) signaling, immune activation, anxiety-associated behaviors, and consolidates long-term aversive memories that make the animal hypersensitive to future environmental changes that warn of environmental danger, cause fear, and trigger anxiety in mice, and is elevated in the blood of adults with anxiety disorders98. Anxiety is a common but under-recognized problem in autism99.

Another really important observation:

A major result of this research was that the developmental differences observed in ASD were not the result of an increase or decrease of one causal metabolite, or an isolated change in the gut-brain axis, or neuroendocrine, autonomic, cytokine, or immunologic circuits. Instead, it was the interconnectedness and developmental state of the metabolic network that underlies all these systems that was fundamentally changed.

In the last year, the All Brains Belong VT organization has been working on a collection of information they call "All The Things" [2], which lines up with the paper's observation that there is an underlying metabolic network at play. As a side note, All Brains Belong VT is a fantastic organization that focuses heavily on validation and support in a healthcare industry which often feels incredibly invalidating for individuals who have been reporting symptoms across a wide variety of siloed physician specialties.

[1] https://www.nature.com/articles/s42003-024-06102-y#Sec25

[2] https://allbrainsbelong.org/all-the-things/

huijzer• 2 years ago

So there is a clear result found and then post hoc there is an explanation made for why this makes sense. That's a bit of a red flag since you preferably hypothesize first, but let's look at the analysis. If I'm not mistaken, then these are the most important parts:

- 467 measured metabolites (features)

- 136 males and 69 females = 205 (data points)

- "To minimize overfitting, only correlations with q values < 0.05 were tallied."

Then the predictive performance in Fig. 3 looks very promising with a 0.88 AUC score. However, according to the methods: "Classifiers of 4–7 metabolites were selected and tested for diagnostic accuracy using area under the receiver operator characteristic curve and random forest analysis."

Then, those AUC scores do not provide so much value since they first used the data to select the best features and then used the same data to fit the model on the best features.

It also looks a bit like the authors have thrown the kitchen sink at these 200 samples since I see R, GraphPad Prism, Python, CIRCOS, Cytoscape, and MetaboAnalyst being used.

And the statement "Fifty (50) random samples at each subsample size were taken to estimate the population statistics based on the central limit theorem." is a bit weird because the central limit theorem shows up throughout many analyses including confidence intervals.

So all in all I'm not 100% sure, but I am skeptical. Anyone here who knows more about "Metabolic network and hub-and-spoke analysis" or "network growth" analysis? Or why it is reasonable to use so many metrics instead of being more selective?

elcritch• 2 years ago

So there is a clear result found and then post hoc there is an explanation made for why this makes sense. That's a bit of a red flag since you preferably hypothesize first, but let's look at the analysis.

Eh, this doesn’t look to be a P-hacking attempt. Scientific exploration doesn’t always hit the hypothesis first model. Ideally this paper should be a source of future specific hypothesis and experiments. Though, IMHO, their implicit hypothesis is that metabolism is a core feature of ASD.

The points about the predictive power in fig 3 are interesting.

Animats2• 2 years ago

"Of 50 biochemical pathways and 450 polar and lipid metabolites examined, the developmental regulation of the purine network was most changed. Purine network hub analysis revealed a 17-fold reversal in typically developing children. This purine network reversal did not occur in ASD."

That's a strong statement, and one which can be checked by others. Anyone trying to replicate this yet?

ta988• 2 years ago

The article was published today, and study like that take months to do and then months again to be published especially in this kind of journals (thankfully they don't accept replications most of the time so it can get published by more reasonable venues).

AnEro3• 2 years ago

I feel like this is going to be used by pseudo-science influencers to push trendy diets to prevent autism when this study is observations stage at best.

asdfman1235• 2 years ago

For stuff like this, overfitting is a given.

drewcon• 2 years ago

My only and immediate reaction as well.

throwup238• 2 years ago

Those people often link to papers that directly contradict the claims they make, assuming no one is going to check them. This won't make a difference.

AnEro3• 2 years ago

yea example now there are guys in this comment section claiming keto has cured their adhd/autism. Helped reduce symptoms, sure, but cure? (I've got both of them been on keto, like crazy strict ensuring i was in ketosis every two days type, and it only reduced brain fog personally)

0xcde4c3db2• 2 years ago

Probably, but it's hardly a requirement. There have been some doing it for decades, partly fueled by Wakefield's "autistic enterocolitis" pseudoscience and partly the usual organic/vegan/raw/paleo/keto bullshit.

dylan604• 2 years ago

Does this mean that they'll start getting their kids vaccinated?

AnEro3• 2 years ago

I fear it will be both that crowd and the anti-covid vaccine blind trust of joe rogan guest crowd

whimsicalism3• 2 years ago

Reveals developmental origins or merely an observational study of metabolites in children?

Der_Einzige3• 2 years ago

I know of at least one book written by and for autistic people who advocates for a gluten free diet. They claim in the book that this significantly reduces their symptoms.

I don’t know if I believe it or not, but the notion of gut-brain axis seems to imply that a good diet should help a bit, right?

jl6• 2 years ago

A gluten free diet may or may not help but it’s not synonymous with “a good diet”.

Der_Einzige3• 2 years ago

That’s what I thought too. It seems that the only general lesson we have in dieting which js reliable is “refined sugar bad” and that intermittent fasting works for getting blood sugar under control.

0xcde4c3db2• 2 years ago

And it might also help for reasons that have nothing to do with gluten. Almost any major dietary restriction tends to cause broader changes in diet than just the thing that is restricted.

dkga2• 2 years ago

Indeed. ASD or not, everyone would surely benefit from following a nutritionist-set diet based on the person’s own requirements.

dkga2• 2 years ago

Asperger here, who doesn’t eat gluten at all for almost 3 years now (due to allergy). I cant say it improved symptoms of autism but my life is divided between before/after stopping gluten consumption. I feel like I just started living for real.

switch007• 2 years ago

Interesting. Could you expand?

m00x6• 2 years ago

Celiac is an awful disease. My ex has it and it wrecked her life for years until she found out.

RobotToaster3• 2 years ago

Gut issues are a common comorbidity with autism, it could just be he had some kind of gluten sensitivity and treating it allowed more energy to compensate for autism.

Waterluvian2• 2 years ago

When “comorbidity” is used in this context, are we actually referring to people dying because of it? Or does it just mean “are found together when discussing this disease?”

TylerE4• 2 years ago

The other really big comorbidity one is ADHD - I’ve seen claims that the rate is high as 80%, maybe even 100% if you allow for very mild cases that probably wouldn’t be independently diagnosable.

anon848736285• 2 years ago

Well as the article says:

"Metabolism is the language that the brain, gut and immune system use to communicate, and autism occurs when the communication between these systems is changed"

So it's not unreasonable that for some people, dietary interventions can have some effect on this interplay between systems. Mostly a just a random "YMMV" shot in the dark at this point. But hopefully as this research advances, more targeted and predictable treatments will emerge.

r3trohack3r3• 2 years ago

Anecdotal, but we grow a heritage strain of wheat here in PHX (Sonoran White).

Its appearance gives me pause. Common commercial wheat is very short in comparison.

I have a friend who can’t eat “common” wheat products from the grocery store, having been diagnosed with severe gluten intolerance, but can eat Sonoran White without symptoms.

You can follow the same exact recipe but substitute Sonoran White flour for standard flower, and they can eat the final product.

I have absolutely no research to support my stance here. But given gluten intolerance is, from my understanding, a microbiome disorder. And Sonoran White grows tall and requires less pesticide/herbicide/fungicide, while common commercial wheat grows low to the ground and the head of wheat sits stewing in a bath of herbicide/pesticide/fungicide - I suspect the difference between the two strains’ impact on the microbiome is less genetic and more environmental.

ADHD research is showing similar early correlation between a mothers’ diet and the rate of ADHD (particularly caffeine consumption). I have a similar belief here that ADHD correlates with caffeine consumption because caffeine is often consumed in liquids containing additives that disrupt the mother’s microbiome.

I strongly suspect that, over the next 100 years, we are going to find that we’ve been waging war on the human biome through food preservatives and environmental contaminants. And that many common chronic disorders/illnesses (including ADHD, Autism, weight gain, etc) in our generation are actually attributable to a disfunctioning microbiome.

mandmandam• 2 years ago

I strongly suspect that, over the next 100 years, we are going to find that we’ve been waging war on the human biome through food preservatives and environmental contaminants. And that many common chronic disorders/illnesses (including ADHD, Autism, weight gain, etc) in our generation are actually attributable to a disfunctioning microbiome.

I suspect you're very right, and I further suspect that there's already research proving this that has been shelved and hidden behind NDAs by the people profiting from this, just as with big tobacco and big oil and big agri etc.

aitchnyu• 2 years ago

What is referred to cuisine today is partly preserving food in bacteria killing chemicals. Do you mean to hypothesize people ingesting more (traditonal) bactericide are sicker?

squigz11• 2 years ago

And that many common chronic disorders/illnesses (including ADHD, Autism, weight gain, etc) in our generation are actually attributable to a disfunctioning microbiome

All of those things have existed for ... ever

zamalek• 2 years ago

Gluten-free only makes a difference for those with an intolerance. Source: I am HF-ASD, my wife is gluten intolerant so my gluten intake is sporadic but bingey, gluten does nothing at all to me.

The only food that is objectively bad for every single human is processed food. Gluten tends to be processed, so people who needlessly go gluten-free may be incorrectly attributing improvements to that.

Also: if you're not actually intolerant, there is a high chance you're eating gluten without knowing it. Treat yourself to fast food fries? How sure are you that gluten (crumbed chicken) wasn't fried in the oil?

faeriechangling12• 2 years ago

I'll incidentally mention that gluten-free diets tend to incidentally be lower in FODMAPs which are another gut intervention, and autism has LONG correlated to digestive and dietary issues. Ketogenic/low-carb is also popular.

The gut-brain link I'm aware of three major theories. Gut issues could be causing a disorder of the brain. A disorder of the brain could be causing disordered lifestyle habits (Diet, exercise) causing digestive issues. A disorder of the brain could directly impacting digestive function.

I will however say, I would treat claims about the gut-brain axis and autism with the utmost scepticism as disgraced doctor Andrew Wakefield, who popularised the link between the MMR vaccine and autism to personally financially benefit from an undisclosed patent on a measles vaccine using fraudulent research, was a gastroenterologist and later anti-vax influencer who ended up popularising the gut-brain link of autism particularly among those who distrust scientific institutions. He notably influenced Jenny McCarthy who became a noted alt-medicine momfluencer in the '00s/'10s pushing gluten-free and anti-vax. Which is to say, research on the gut-brain link is done quite a lot by legitimate scientific researchers, quacks, and frauds alike so you have to be discriminating.

Additionally there have been various scientific reviews of dietary interventions, gluten-free being one of the most researched, and the evidence hasn't been shown ANY dietary intervention or gut intervention like fecal transplants is a silver bullet.

This isn't to say that there isn't anything to the idea that some people we've diagnosed as autistic or believe they're autistic, cannot be helped by dietary interventions. I would dare speculate, that a significant portion of those called "autistic" could make autistic symptoms fall into the sub-clinical range through gut interventions (diet AND exercise), and that such people may even be clinically distinct from other people considered autistic other than through their similar behaviour.

carom• 2 years ago

There are studies showing positive health outcomes for ASD on a gluten free diet, as well as for epilepsy and schizophrenia. Here [1] is a comment with some links, the featured article might also be interesting.

I have a lot of food allergies and a restaurant in Maryland that specializes in restricted diets pointed some of the research out to me. You can find scores of families with ASD children who have found dietary interventions to be beneficial.

The studies I have seen talk about something called exorphins, it sounded like people with ASD's bodies treat gluten like an opiate.

1. https://news.ycombinator.com/item?id=39194978

Aurornis• 2 years ago

The short answer is: No, there isn’t a simple treatment for Autism based on simple diet, lifestyle, or supplement changes. There are countless books, blogs, and social media influencers claiming to have unlocked something, but it never translates to something broadly useful.

There’s a long history of these claimed fixes. They follow popular trends that come and go. They’ve been attached to everything from eliminating dyes and food colorings to every possible alternate diet out there.

Placebo effect is a large part of it. People feel better when they feel like they have some control over their condition. They buy into the popular narrative and then they really do feel better, even if nothing has actually changed physically.

It’s also common for people with major medical diagnoses like Autism to start thinking that every one of their symptoms is attributable to Autism. Some of these people might have gluten intolerance as a separate issue, so going gluten free improves a number of issues for them. Instead of attributing the improvement to improving their gut problem, they assume they have treated their Autism.

yareal6• 2 years ago

As an autistic person, professionally diagnosed, this sounds like nonsense woo. Yes, gut bio can influence moods and managing your health can improve symptoms from autism (e.g. meditation might help manage anxiety).

But no amount of "don't eat bread" is going to help me understand faces or social cues. A good diet might help with self esteem, overall energy levels, and resilience to my symptoms (if I'm healthier, I shut down less). But that's it, it's not going to change the way I experience the world, just stretch my tolerance for it.

asdfman1235• 2 years ago

I'm hardly an expert on autism but I've fought ADHD for years, and good diet/lifestyle is essential.

Not sure how certain you are of your autism diagnosis, and I'm still not even sure where the line of demarcation is, but it may actually be ADHD. Worth considering.

imtringued4• 2 years ago

Digestive issues like IBS probably make anxiety worse but they don't cause the problem.

MagicMoonlight2• 2 years ago

I have a rock that cures autism.

I didn’t really know whether to believe it, but the effect that minerals have on the human body seems to suggest that the right mineral should help a bit, right?

ModernMech26• 2 years ago

"Prevention strategies"

As an autistic person, no thanks. Let people be autistic.

2four23• 2 years ago

Autistic as an identity and autism as a disease are different things that are difficult to uncouple. Similarly to obesity, it's difficult to talk about the health aspect without people being sensitive about the identity aspect. I find it's useful when reading about research to empathize with the authors and realize their work is an attempt to be constructive instead of providing social commentary.

mewpmewp27• 2 years ago

Autism is not a disease. It's a diverging feature.

ModernMech26• 2 years ago

I'm being productive by pushing back and saying that when people say that autism needs to be cured and prevented, that they shouldn't say that, because autism doesn't need to be cured and prevented.

It's not a disease, but in this society it is a disability, and there's a stigma and lack of understanding around autism in general.

What we can do today to make life better for autistic people everywhere is to spread awareness and acceptance of autism. Not talk about curing and preventing it. That's stigmatizing.

shipman05• 2 years ago

I understand the sentiment, but there's a reason it's called the autism spectrum.

I work with several software engineers with autism who are as capable as their peers. Sure they may have behavioral quirks, but not significantly more so than the normal variation in human behavior. Their brains don't seem to work in an inferior or problematic way, just different.

On the other hand, I have a close relative with more severe autism who could never read and understand this article, could never type a comment such as yours. She's incapable of holding a job or living on her own without assistance. Her mother passed away young, and her older sister, just 19 at the time, had to take on the responsibility of being her sole caregiver, and she will have that burden for the rest of their lives.

For some it may be a different variation of the human experience, but for cases as severe as my relative's, I find it hard to believe that a cure or prevention for autism wouldn't be a massive quality of life improvement for all involved.

ModernMech26• 2 years ago

Indeed, my ex wife was incapable of living on her own or holding a job. I have a whole social circle of autistic friends of different abilities. Some still live with their parents. Men in their 40s living with their parents. Women who left home for the first time at 30 only to have to move back within months. My one friend is a sex worker because she can't hold down a real job. She sells her meds and her body to get by.

I lived with my parents last year, at 36, but I moved out and got a 1 bedroom. It was touch and go for a while, I still can't cook for myself, but at least I can take care of my cats.

I'm never going to have children. I'm never going to have a house. A family like my parents had. My sister as well, well she just got a boy friend so maybe not.

The through line problem here is not autism. Despite the range of (dis)ability, the thing that makes it a problem is how autistic needs are unmet by a society that expects us to be worker bees.

My ability to type this message and read is not a constant. There are times when I am non verbal. There are times when I cannot read because the letters are all jumbled in my head. When I'm able to read and write and speak, society values me. When I'm not, society devalues me. You want to take autism out of the equation so that I can be valuable to society.

What I'm saying is that society needs to be reoriented so that autistic people are valued whether or not they can read or write or speak.

Although I have to say I'm unsettled by you speaking for someone who can't speak, and deciding unilaterally that "curing" them would be a massive quality of life improvement for "all involved". Did you ask them?

somenameforme8• 2 years ago

Then people should stop conflating the two. This whole "spectrum" nonsense is nonsense. Your coworkers are not autistic - they are weird or whatever other more PC term you might want to use, and that's great - many, if not most, great engineers are!. There is no need to pathologize differences in people. Your relative, by contrast, is. If you have a habit of feeling sleepy at work, it's not like we say you're on the narcolepsy spectrum. It's just a completely dumb concept.

People like your relative, or the kid who sits around flapping his hand and starts freaking out if anybody interacts with him - those people are obviously not just 'weird'. They clearly have severe mental disorders, and if we want to call whatever it is that they have autism - fine. But if we do, then we need to stop calling people like your coworkers, Bill Gates, or whoever else also autistic.

mewpmewp27• 2 years ago

The problem is there's no such thing as "Autism". It's a survey and observation of behaviors that "oh you don't quite behave like we see 90%+ of people to behave socially, so you must have a disease. Let's call it autism."

You are talking as if Autism was some sort of virus that you catch and it disables some people a bit, and others a lot.

Some people have hard time, then deal with those people and help them, based on the symptoms, but don't say you have to prevent some made up label to group certain set of behaviors which many are perfectly happy to be with those set of behaviors and perhaps even proud to be thinking differently than most.

jskdndbwkd• 2 years ago

or maybe your successful coworkers and your close relative have two completely distinct conditions that don’t actually exist along a continuum

oblio• 2 years ago

This is just ridiculous, just like some deaf people wanting their kids to be deaf to be part of the deaf community.

We were born with ears for a reason, same thing, our brains are to a huge percentage built for social skills for a reason.

We can call them however we want but all these are basically diseases of various forms.

People can choose their hair color, to grow their nails long, their clothes or the myriad other things that allow us to express our uniqueness, without making life stupidly difficult for no reason when it's already super hard.

squigz11• 2 years ago

If you don't mind being on the spectrum, that's great for you. Some of us are looking forward to more research like this. Many of us don't want to go through this struggle forever, or make another generation go through it, all while waiting for society to get its shit together and completely reorient itself to be neurodivergent-friendly? No thanks.

the_plus_one• 2 years ago

Speak for yourself. As an autistic person, if I could get rid of it, I absolutely would.

Perenti7• 2 years ago

I'm diagnosed ASD as well and I strongly disagree with your statement as it stands.

There are people who are profoundly impacted by autism. I _can_ go to a shopping center. I don't like it. I may have to hide in the bathrooms for a while a few times while visiting but I _can_ do it.

But I know people who spend most of their lives in fear, because there is just so damn much going on around them all the time. Their senses are turned up to the point that the sound of their own breath is like a lion roaring. The splash of light across the curtains as a car turns into the street is like a lightning flash. Sounds, sights, flavours, smells, tactile sensations all turned up to 15 on a scale of 1 to 10.

Often these kinds of people never learn to talk, or read. They end up living in homes (modern asylums) because they need constant care. And inside they're screaming in terror all the time. Sometimes they scream aloud.

I believe these people deserve better. Helping prevent the development of severe disability is what I believe the article is talking about, not eugenics.

softfalcon2• 2 years ago

Is anyone else reading this and seeing the worrying, “we can just medicate away the autism”?

They’re talking about a possible pharmaceutical “fix” for autism in children under 5.

Seems a bit premature for just recently finding a metabolic difference in a cohort of children.

m00x6• 2 years ago

That's not what the article suggests at all. It's during the developmental stage, which is by nature temporary.

somenameforme8• 2 years ago

Yes it is. It's exactly what the article suggests:

---

... Naviaux and his team completed early clinical testing for suramin. ... Now, the researchers hope that by revealing the specific ATP-related pathways that are altered in autism, their work will help scientists develop more drugs that target these pathways to manage the symptoms of ASD.

"Suramin is just one drug that targets the cell danger response," he said. "Now that we're closely interrogating how metabolism changes in ASD, we could be at the beginning of a drug renaissance that will create new options for treatment that never existed before."

---

This study [literally] brought to you by Pannex Therapeutics, Yuva Biosciences, Kuzani, and Paxmedica, MaraBio Systems, Inc and undoubtedly numerous other big pharma interests that were able to keep the study at arm's length enough to avoid disclosure requirements. [1]

[1] https://www.nature.com/articles/s42003-024-06102-y#Sec36

ldjkfkdsjnv4• 2 years ago

Used to have a mix of what could be considered ADHD/light asperbergers. I dont eat carbs and mostly stick to a keto diet, it resolved many symptoms. Our food is poison

2four23• 2 years ago

Lots of carbs make me fall asleep and kill my motivation. My lunches at work are light and carb-free for that reason.

manmal• 2 years ago

Do you have microbiome dysbiosis? A keto diet might improve things (eg lower LPS production), but long term can diminish microbial diversity. I’m not saying keto is bad at all - it’s just that microbial diversity is an important predictor in GI health and one should keep an eye on that too.

ldjkfkdsjnv4• 2 years ago

Yeah i mean i know that keto isnt great, but it has changed my life to some degree. When in ketosis, i feel like i have "agency", otherwise i am this foggy headed, sloth

electrondood• 2 years ago

I'm Broad Autism Phenotype (BAP) and prefer low carb because I feel better, but it doesn't change my personality traits or cognitive tendencies one iota.

ldjkfkdsjnv4• 2 years ago

I have a noticable ability to react quicker in social situations, im more "normal". Otherwise my brain is sluggish and i struggle to maintain conversation/things go over my head

ffjffsfr2• 2 years ago

what could be considered ADHD/light asperbergers

could be considered, or did you get a diagnosis from a specialist? Self diagnosis is not reliable. If you don't have an official diagnosis you can't be certain you really have ADHD. There may be several differe tfactors relevant for YOU that make keto diet work for you. Same diet can be harmful for similar people who have ADHD.

ldjkfkdsjnv4• 2 years ago

I have a diagnosis, i just dont trust doctors. please stop gaslighting me

throwaway092323• 2 years ago

Self diagnosis is not reliable

Professional diagnosis is not reliable either. ADHD and autism are often misdiagnosed as one-another, especially in girls.

If you don't have an official diagnosis you can't be certain you really have ADHD

A lot of the time, the mental health professional making the determination doesn't have specialty in ADHD/Autism. All they're doing is looking at symptoms and making their best guess. Which is exactly what people are doing when they make a self-determination. In many cases, people with high-functioning autism know more about autism than the people who are supposed to know. And it's not like the diagnoses can be validated when we're still figuring out what autism even is.

bluecalm• 2 years ago

If you knew anything about how "diagnosis from specialist" works in practice you wouldn't dismiss self dismiss diagnosis so easily. "The specialist" usually spend a few hours at most on the diagnosis (if even that) while people who self diagnose live with the symptoms their whole life.

It would be such an easy world of you could go to a doctor and get answers but it's not the world we live in unless it's common cold (and even then a lot of doctors can't be bothered and prescribe antibiotics just in case).

b800h• 2 years ago

"with only 10–20% of children diagnosed before 5 years of age able to live independently as adults"

Well this is nonsense for starters - circular logic. Doctors won't diagnose autism in most cases before the age of eight. For the diagnosis to have happened before the age of five would imply that the case is profound in the first place.

piker• 2 years ago

The stat seems accurate on that basis. True, it may be read to imply more.

willsmith72• 2 years ago

That's the whole point.

It's not like they took the age 5 at random, it's literally what was used in the study

ffjffsfr2• 2 years ago

there are other factors here. Children diagnosed with autism at the age of 5 must be adults now to determine if they can live alone. So they were diagnosed at minimum 13 years ago, with many diagnosed much earlier. Autism diagnostics is much more common now than it used to be, especially in families with higher economic status. Diagnostics tools evolved, more kids are tested and tests capture more kids. So I think this number will be completely different in 10-20 years from now. In my experience as a parent of ASD kid, many kids now considered ASD would not be considered ASD 20 or 30 years ago.

grumpy-de-sre3• 2 years ago

On the topic of metabolic disturbances in Autism, huge fan of the work Dr. Randy Blakely is doing on the links between Serotonin metabolism and Autism. One of the most surprising, and strongest (25-30% of patients), biomarkers for Autism is actually Platelet Hyperserotonemia (high levels of bound Serotonin in the blood).

For decades it's been without explanation but recently Dr Blakely has described a bunch of cases where it was narrowed down to SERT transporter polymorphisms and inflammation.

Worth a watch for those interested in the weeds of this stuff: https://www.youtube.com/watch?v=cpDtuKV5CJs

I've got a pet hypothesis that differences in Serotonin metabolism (and receptor hypersensitivity) might play a role in why SSRIs aren't generally considered a first line treatment for ASD symptoms, https://www.pnas.org/doi/abs/10.1073/pnas.1112345109

asdfman1235• 2 years ago

Genuine question: how do we know that's not just a side effect instead of a driver?

grumpy-de-sre3• 2 years ago

Dr. Blakelys lab has produced knock-in mice with the rare SERT variants described, and they have exhibited the behavioral and biochemical markers of ASD. It's actually a very remarkable finding. They also saw a reduction in ASD symptoms by pharmaceutically blocking the offending inflammatory pathways.

So I think at-least for the tiny fraction of ASD patients with these rare SERT variants there's actually a chance that they are a major driver of the disorder. Regardless it provides a tantalizing look at some of the upstream pathways that could be involved more generally.

I think we're going to find the disorder is very heterogenous and there will be many different subtypes and pathways involved.

john01dav6• 2 years ago

Pathologizing autistic behaviors is not the right approach here. Most autistic behaviors are harmless except insofar as allistic (non-autistic) people provide unnecessary consequences for it and through incompatibilities. We don't say that a Linux workstation in a network of Windows computers is broken or needs to be fixed (or visa-versa), but rather we recognize that the problems are due to the differences. As such, attempts to "cure" or "prevent" autism are actually an eugenic attempt to remove harmless variation that many people irrationally deem to be objectionable.

For example, it is commonly stated that autistic people have communication deficits, but this is just a communication difference. We can see this because if a communication task is given to a group of only autistic people they perform comparably to when the same task is given to a group of allistic people. Problems only take place when the group is mixed with both autistic and allistic people being present. The keyword "double empathy problem" can be used to find more information about this. (https://doi.org/10.1177/1362361320919286)

As another example, allistic people tend to very harshly judge autistic people for extremely subtle cues that they are different. When allistic people are shown recordings of autistic people communicating and of allistic people doing similiar tasks they, within less than a second, judge the autistic people very harshly. This effect persists when controlling for the content of the communication. (https://doi.org/10.1038/srep40700) Of course, doing anything that actually warrants such a judgement in a context like that is impossible so this is a bias against autistic people. I think that this can be compared to implicit racial bias: it is something that most people need to learn to consciously identify and then not perpetuate and is not due to any faults with the victim.

Good resource on this: https://www.youtube.com/watch?v=A1AUdaH-EPM

There are higher support needs autistic people who need help with activities of daily living. In my opinion, though, in many cases this is not autism but rather autism with an accompanying intellectual disability and the intellectual disability is the reason for higher supports needs. In some cases this could also be caregivers unnecessarily pathologizing behavior and then convincing someone that they need more support than they really do, which I have seen in real life.

anon848736285• 2 years ago

There is a big difference between "neurodiverse" people and severely autistic people facing huge challenges in their life. Are you seriously dismissing the idea of helping treat that latter group?

" this is not autism but rather autism with an accompanying intellectual disability and the intellectual disability is the reason for higher supports needs. "

This is a self-contradictory statement. But what do you think people are researching if not those intellectual disabilities -- why they occur and how they can be prevented.

john01dav6• 2 years ago

There is a big difference between "neurodiverse" people and severely autistic people facing huge challenges in their life. Are you seriously dismissing the idea of helping treat that latter group?

The people who you are referring to as neurodiverse also face huge challenges. When everyone hates you just for being yourself and not hurting anyone, that is a huge challenge. This can threaten peoples ability to make a living. This can result in people having to live in abusive situations due to lack of financial — not practical — ability to live on their own. When you need to do stimming to feel internally at piece but most other people will perceive this as a threat, that is a challenge. When you need protection (e.g., headphones) from sensory input in the outside world, but the world does not allow this in some cases (for example a job may deem it to be "unprofessional") that is also a threat. Supports are needed in this case, and these supports are for the world to lighten up about allowing these things.

Also, there are, perhaps more challenging, problems that what you call "severely autistic" people face. We should also support these people. For these people, the supports could be similar as above (the world lightening up, perhaps about the requirement that everyone be productively employed) or they could be different (a medical treatment that increases intelligence). Such a medical treatment needs to be performed ONLY with the informed consent of the patient, to the degree that that is possible with the communication difficulties.

This is a self-contradictory statement. But what do you think people are researching if not those intellectual disabilities -- why they occur and how they can be prevented.

I think that this type of research is unnecessarily lumping intellectual disabilities with the traits in what you call neurodiverse people. I am much more open to helping people with intellectual disabilities, to the extent that these people want that help, than I am to treatments that attempt to normalize neurodiverse people. The word "autism" refers to both groups, so research that is about "curing autism" is at least in part about normalizing neurodiverse people.

shutupnerd00002• 2 years ago

In my opinion, though, in many cases this is not autism but rather autism with an accompanying intellectual disability

That's just like, your opinion, man.

If autism warrants needing help with daily living then it's a disorder by definition.

john01dav6• 2 years ago

There are two ways that something can lead to needing help with daily living:

- society rejects the trait without good reason, so then someone needs help to deal with this rejection

- the trait leads to an inability to do something that the person wants to do, irrespective of any societal concerns

I am okay with calling the latter a disorder, but not the former. The traits that are recognized as part of autism (social incompatibilities, stimming, special interests, hyper or hyposensitivity — these are the DSM traits for autism rephrased more politely) are clearly in the former case. Traits that lead to being unable to function (such as an inability to feed one's self) are not on this list, but rather are characterized by intellectual disability.

jprete3• 2 years ago

I think you're engaging in the no-true-Scotsman fallacy with the claim that highly autistic people with a lot of special needs are really "autistic with intellectual disabilities". I disagree. They're simply more autistic and more impacted than either of us.

john01dav6• 2 years ago

See here for why I think that it is different: https://news.ycombinator.com/item?id=40329752

pseudalopex5• 2 years ago

They did not say no true autistic person are intellectually disabled. They said they are overlapping groups. Like Scotsmen and people who put sugar in porridge.

P_I_Staker2• 2 years ago

Do you have autism or ADHD? This is actually a really contentious issue. Tons of people with the condition are happy to let others be themselves, but want to be cured.

With ADHD, it's actually a little crazy to me that people consider it "harmless". There's a ton of tangible ways that it hurts relationships and goals. I can't even make dinner and tidy house; doesn't matter how much time I have.

I will say the medicine made me a little more robotic and took a bite out of my personality; but this was a small nibble compared to not being able to do almost anything comfortably, and the consequences of that.

It's really damaging to your personality to not be able to conversate with people and understand each other. It's really damaging to your personality to not be able to practice your hobbies with friends. I really don't feel like my "true" self, and see others able to effortlessly be that person.

tsoukase5• 2 years ago

Autism is rooted during fetal brain development. Behavioural and metabolic changes show up later. There is no an egg and chicken problem. The primary disease starts in the CNS and everything else follows

computerphage• 2 years ago

How do you know that?

tsoukase5• 2 years ago

Schizophrenia, Alzheimer's, Parkinson's have links with the gut too. But I "know" they start from the brain. No advanced or complicated hypothesis

MajimasEyepatch6• 2 years ago

There’s so much brain development that happens in the first few years after birth that there’s absolutely no way you can say that with confidence.

tsoukase5• 2 years ago

No developmental anomaly can start after birth. It must preexist but is not detected. Proof: heavy cases of autism are diagnosed at birth, so the beginning lies sometime in uterus. The same holds for the lighter cases too.

mrangle• 2 years ago

suramin

They're investigating the use of a drug that they don't understand to treat a condition that they don't understand, through the lens of one model that variously competes with or incompletely conforms to a myriad of other models of the condition.

In order to what? Nebulously "manage" a complex neurological difference that will always defy reversion to anything else?

It sounds like they want something that they can prescribe, period. And it sounds like it has the potential to further complicate already difficult lives.

Type 1 Autism may serve a general human gene pool function in terms of edge-dripping a specific intelligence trait into it (low probability of reproduction, protecting general social skill in the pool, but adding a divergent pattern solving skill at the edges).

While autism is difficult, I'm not sure that solving for it in the context of industrial medicine is wise. We don't want to solve for Nicola Tesla, for example.

Type 2 and 3 Autism could be genetically unsuccessful attempts at Type 1 autism development, to spitball. Assuming they are actually related, in most cases. Such management theoretically could be helpful here, but I think that these people deserve a lot better than injected parasite medicine with a lot of side effects. Besides, try getting an autistic child used to regular injections.

Though a low-side effect oral or transdermal medication that would, say, specifically enhance energy support to the Autistic PFC with few side effects could be game changing. Likely for many more conditions than autism.

Inventing such a medication that doesn't lead to a worse baseline would be critical and perhaps unlikely.

Then again its possible that the unique pattern solving ability of the Autistic mind is related to the relative lack of energy supply to an increased volume of PFC neurons; and the subsequent failure of inhibition. Possibly accounting for increased environmental information perception, at least in-part. Which may in turn be mirrored in expanded cognition involved in pattern identification.

The ideal, which again I think is unlikely, would be a PRN medication that could "quiet" the autistic mind via providing more energy to the PFC; while having no withdrawal semi-permanent side effects.

Broken_Hippo• 2 years ago

They're investigating the use of a drug that they don't understand to treat a condition that they don't understand...

You'd probably be shocked to figure out how often this happens - and it used to happen a lot more in no small part because we didn't have the tools we have today: MRIs and better microscopes and other tech has really helped our understanding of the body. We are still figuring out how exactly the body works, after all, to the point that we occasionally discover a new body part. Of course we are going to do things we don't understand. Yet.

This isn't limited to medicine, either.

Maybe they want something to prescribe. For a lot of diseases, that's better than nothing. For example, I have MS. They know more than they used to about MS, but most of my life they've not known enough. I have medicine that isn't a cure, but I'll take it. Modern medicines mean that modern folks with MS have a much better quality of life than folks that didn't have medications. I'm more likely to have mobility and things like that. I'll take it.

My ex was schizophrenic. Medicine gave them a life. They still couldn't work, but they weren't suffering as much either. Again, not a cure, but help.

Imperfect cures or medicines that treat the symptoms are so much better than no help at all. This is where a lot of medicine starts - treating a symptom, and by doing so learning a bit more about the disease or affliction.

ModernMech26• 2 years ago

My ex was schizoaffective. They thought BP1 for a while, but then she started hallucinating while baseline. Anyway, I've seen her take all the meds. Some work sometimes. Then they don't. Most of the time we'd be dealing with symptoms of the meds, which are not easy. When she was completely manic even the highest dose of some meds would not work for her. Actually a side effect of one of the meds had the same symptoms as schizophrenia, so in that case what was even the point?

https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_sy...

  Neuroleptic-induced deficit syndrome (NIDS) is a psychopathological syndrome that develops in some patients who take high doses of an antipsychotic for an extended time... characterized by the same symptoms that constitute the negative symptoms of schizophrenia

You're right, a lot of times it seems like they just wanted to give her a pill and strap her down to a bed. Good sleep was far more important to regulating her wellbeing, but that was very difficult with the side effect of akathisia, which is common of antipsychotics. So it became a matter of upping the dose until it would make her pass out after hours of writhing pain. A daily occurrence.

So I could see why taking the meds were difficult.

If you told me I could take a pill to cure my autism but it would have the same symptoms as an antipsychotic, no thank you I wouldn't do it.

bloqs• 2 years ago

Thats exactly what existing psychomotor stimulants do for adhd

Netcob• 2 years ago

I don't have a lot of experience with using research papers, but I feel like people writing these articles don't either.

In 2017, Naviaux and his team completed early clinical testing for suramin, the only drug approved in humans that can target ATP signaling and which is normally used to treat African sleeping sickness.

What's even the point of writing this? I found two papers, and the effects were so weak that it's hard to tell whether it even makes sense to pursue this further. Most results were not statistically significant, and the one that was did not come from a higher dosage.

But it's this sort of reporting that makes desperate parents give their children bleach enemas and horse dewormer.

hcfman• 2 years ago

Yay! We can prevent another brilliant scientist from coming into existence. Nice work fellows!

zazazache3• 2 years ago

As some one who is let’s say “autism adjacent” it really bothers me when people discuss a cure or prevention. I mean I get it, but this is also who I am and I wouldn’t want to be someone else.

ModernMech26• 2 years ago

I have no problem with discussion about making some issues people face better with medication, although I think autistic people should be centered in those discussion.

However “prevention” talk is a whole separate issue and that one does give me eugenics vibes.

Perenti7• 2 years ago

I'm on the spectrum (diagnosed), and also like being me (most of the time).

But what about the poor sods who have so much happening all the time that they don't get the chance to learn to speak, or read, and scream in terror continually at the unending sensory deluge they try to live through? If there was a way to prevent that kind of presentation of ASD I think everyone would be better off. I took "prevention" to be about prevention of the life restricting developments of the condition.

On the other hand, if "prevention" is about culling the gene pool, I'm dead set against that.

gizmondo2• 2 years ago

On the other hand, if "prevention" is about culling the gene pool, I'm dead set against that.

Well, you can be against it by raising autistic children yourself, it seems you're in a perfect position for that. Why people feel they have the right to demand that from others is beyond me.

Thorrez• 2 years ago

The article seems to be focused on people who are unable to live independently.

For the majority of people with ASD, the condition is a significant disability, with only 10–20% of children diagnosed before 5 years of age able to live independently as adults.

Log_out_• 2 years ago

Its also missing how speacalists with traits and hyperfocus are the driving force behind a ton of research. Then again having a retarded kid is like having a 60 ton weight attached to you for life. Yes, yes, we are not allowed to say this, but thats easily said by those who don't wear the weights.

RCitronsBroker• 2 years ago

as someone who’s also autism adjacent and content with it, let’s still recognize that it’s not called spectrum for nothing. Yes, one’s norm of "functioning" can be more dependent on society than you’re own opinion, but I’ve witnessed several individuals on the "lower functioning" end of the spectrum who really didn’t seem like they were content with the way they’re living life. I’m not infallible, but it definitely seemed that way.

ModernMech26• 2 years ago

At minimum we should center such people in these discussions rather than talk about them with pity or only when using them to advance a rhetorical point. I want to hear from people with the highest support needs on this issue the most.

bratbag• 2 years ago

How much of that is rational and how much of that is because of you being unable to handle change due to the side effects of what you are enduring?

cwillu2• 2 years ago

As someone who has been diagnosed, it really bothers me when people tell me I'm not allowed to want to not be this way. For some people, it's a hell.

zazazache3• 2 years ago

That’s even worse, of course you are allowed your own feelings. What gives me the creeps is when people start talking about prevention it easily slides into eugenics or other things that deny poeople agency or even their humanity.

There is a similar thing for deaf people. Or how screening for Down’s has changed the reality of raising a child with it.

viraptor2• 2 years ago

Nobody's forcing you to get a cure. But denying it to others is a really weird idea. Until we can tell apart kids who will develop fun quirks from those who won't be able to live independently, prevention doesn't sound bad either.

Metabolism of autism reveals developmental origins

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