Tuesday, 19 June 2012

Just wondering about CM-AT and autism


CM-AT. Ever heard of it? Well, if you haven't before you certainly might be hearing a lot more about it in the near future with autism in mind. I will from the outset stress that I am not writing this entry as some kind of 'advertorial' for CM-AT or anything like that, but rather because I am genuinely interested in this enzyme-replacement preparation developed by Dr Joan Fallon and how it might link in with some other favourite topics included on this blog. I would also refer you to a previous mention for CM-AT by MJ over at Autism Jabberwocky.


The details are still a little but sketchy about CM-AT in terms of exactly what it is and how it is supposed to benefit people with autism, some people with autism, but there are some clues in the literature so far. We know for example, that the formulation is intended as an enzyme-replacement therapy with autism in mind (see this excerpt published in Nature) which is probably designed to act on/supplement one or more enzymes; perhaps enzymes used in protein/peptide/amino acid metabolism? The digestive enzyme chymotrypsin seems to be a fairly big component of CM-AT as per the recent abstract reporting results at IMFAR 2012* and some details about the patent which has been filed (here). We even know that the results of a phase III randomised, placebo-controlled trial of CM-AT have been completed according to the ClinicalTrials.gov entry.


No doubt there will be other sides to CM-AT - other pancreatic enzymes? - but at the moment I have little or no clue what exactly the preparation is aside from a few patent applications which I assume are related, including the enzyme delivery system (here) and a patent titled 'Methods of treating pervasive developmental disorder' (here). I note that Dr Fallon has previously published quite a speculative article on antibiotics and autism a few years back** but whether this is related to CM-AT or not is not known yet.


Without wishing to seem like I am vying for position as and when the CM-AT splash finally touches the beach, I'd like to think that there is some common sense in looking at things like enzyme function in cases of autism bearing in mind the results produced so far (see Munasinghe and colleagues***) and recent history related to molecules like secretinI'm also thinking back to a post which attempted to look at stomach acid and autism and the potential consequences of hypochlorhydria for both enzyme function and things like gut bacteria. Speculative but potentially interesting (at least to me). 


While we are on the topic of food and enzymes, let us also not forget the important links being forged between carbohydrate metabolism and enzyme function in cases of autism. Once again I am taken back to the Brent Williams paper on autism, carbs and dysbiosis as a central case in point, bearing in mind that the topic of carbohydrates and the various enzymes involved in their digestion is quite a broad area. 


I'll be keeping my eyes and ears open for any further developments on CM-AT and will update accordingly. To finish, and for all the Wannabes out there, some Spice from the 1990s.


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* Fallon J. & Heil M. The role of a biomarker in the double blind placebo - controlled study of CM-AT in children with autistic disorder ages 3-8. IMFAR 2012.

** Could one of the most widely prescribed antibiotics amoxicillin/clavulanate "augmentin" be a risk factor for autism? Medical Hypotheses. 2005; 64: 312-315.

*** Munasinghe SA. et al. Digestive enzyme supplementation for autism spectrum disorders: a double-blind randomized controlled trial. JADD. 2010; 40: 1131-1138.