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.

6 comments:

  1. Very Interesting! I know enzymes are key to health and enzymes are compromised in "autism"
    You may want to check out Dr. Theo's work. sites.google.com/site/fansof drtheo/finding-dr-theo

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  2. I don't know whether it means anything or not, but another name that is associated with CM-AT is LUMINENZ-AT, which is -

    "a lipid-encapsulated pancreatic enzyme concentrate (PEC) designed to release chymotrypsin and other proteases in the proximal small intestine. The intended indication of LUMINENZ-AT™ is for the treatment of irritability and hyperactivity, which includes abnormal body movements, in children ages 3-8 who have autism. Curemark’s findings indicate that a large subset of children with autism have an endogenous lack of chymotrypsin, as expressed by low fecal chymotrypsin levels. It is hypothesized that if there is an underlying defect in the digestion of dietary proteins, it would contribute to a deficiency in essential and semi-essential amino acids. This would leave the child unable to synthesize new proteins. Proteins such as neurotransmitters and other essential proteins needed for key bodily functions may not be able to be produced by the body due to a lack of essential amino acids. A partial or complete lack of protein digestion could further lead to allergy and/or other digestive dysfunctions."

    http://www.med.unc.edu/psych/aspire/previous-study-results

    A few other little tidbits -

    Children entering the study had to be removed from any special diets (such as the GFCF diet) and stop taking other supplements. The combination of this fact and the above blurb seems to suggest that CM-AT is going to help kids with autism digest proteins instead of having to remove them from their diet.

    An open-label extension study is still ongoing. http://clinicaltrials.gov/ct2/show/NCT00912691?term=CM-AT&rank=2

    The company seems to be very happy with the person in charge of the CM-AT study. He got a nice promotion -

    http://www.prnewswire.com/news-releases/curemark-announces-executive-promotions-162714296.html

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  3. Thanks for the extra info MJ.

    It is quite an exciting prospect what potentially might be added as a result of CM-AT. Dr Fallon seems also to have gone about it the right way - research, evidence and safety first - marketing and hype to follow.

    In view of the restrictiveness of the GFCF diet, anything that might offer similar effects without the dietary intervention part is well worth a look at.

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  4. The open-label study of CM-AT is being expanded to include older children -

    http://www.prnewswire.com/news-releases/curemark-to-enroll-children-9-12-years-of-age-into-medical-trial-of-cm-at-for-children-with-autism-165128016.html

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  5. Thanks MJ. Sounds like they're looking to see whether more children might benefit??

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