The focus is on autism

This is one of my more 'advertorial' posts I'm afraid, as I bring to your attention two important special supplements on autism published in two high-profile journals.

The first is yet another open-access special edition published in Nature (see link here), which complements their previous special edition from this time last year (2011). I'm impressed it has to be said, that Nature would choose to return to autism two years running, which really does tell you how much scientific and lay interest there is about the condition.

As to content, lots of interesting views and opinions but a few highlights to mention:

• Well it's nice to see that epigenetics (there's so much more to the genome) gets a mention as per this article by Sarah Williams*. The possible usefulness of systems biology is also discussed, albeit with more of slant on proteomics over my favourite, metabolomics. 
• Michael Eisenstein** talks pharmacotherapy which includes quite a bit about Fragile X syndrome chatter and all those glutamate-targeting advances (see here) which potentially offer so much. My attention however was more focused on the preliminary results from administration of N-acetlycysteine (NAC) in cases of autism and even some suggestion that the immune-inflammatory link to some cases of autism might be a target for therapy, and quite unconventional - helminthic - therapy at that. 
• Of course one cannot talk about autism nowadays with making some reference to DSM-V as per the article by Emily Singer*** which complements/is complemented by a recent piece by Jon Brock elsewhere.

The second special edition / supplement graces the journal Pediatrics, and a whole slew of articles on autism (see link here). Regular readers of this blog (hello, anyone there...) will have already been given a heads-up for one of the articles published as part of the Pediatrics supplement by a cracking group of researchers, all discussing gastrointestinal (GI) factors and autism (see here).

Some more interesting tidbits for your, pardon the pun, digestion:

• Perrin and colleagues**** discuss the use of complementary and alternative medicine (CAM) in autism. As someone who does not necessarily see dietary intervention as being anything like CAM - remember Hippocrates 'Let food be thy medicine' - it's nevertheless interesting to read about how CAM use seems to be more widespread among those children whose autism is present alongside other comorbidites such as GI problems and seizure disorders. I hate to use the term ' the bleeding obvious' but it does kinda stand to reason that GI issues might persuade someone to look at diet for example, as being a potential player to those issues. Or maybe it's just me? I note also that Dr Susan Hyman is among the authorship group to this paper, which got me wondering about the status of that gluten- and casein-free diet study that she was undertaking which still appears on the ClinicalTrials.gov website, albeit 'status unknown'. 
• Sikora and colleagues***** report some really interesting results based on what happens when ADHD and autism are comorbid. Again, probably not something completely unexpected in that quality of life is not great, or at least not as great as when ADHD symptoms are not present. If ever there was another example that comorbidity can be (a) present and (b) a real challenge for people with autism, here it is.
• Beth Malow and colleagues****** describe a potentially very informative tool, an insomnia practice pathway to help identify such issues in cases of autism. So, screening taking into account other medical factors, discussing various therapies which does not necessarily just mean introduce melatonin, and an important one here, follow-up and "evaluate effectiveness and tolerance of the therapy". It all sounds great in principle, but again I'm just going back to the 2010 Pediatrics guidance on GI conditions and autism******* and wonder how successful such best-laid plans turn out to be in practice.
• Final one, Ann Reynolds and colleagues******** talk iron and autism (as I have previously done on this blog) and report that issues with the availability of iron might not actually be all that widespread in autism after all. By saying this, I'm not taking away anything from the cases where iron availability is an issue. 

There is plenty of bedtime reading there for everyone and importantly, an ideal vehicle for keeping autism and autism research in the public consciousness. To close, a song that I think everyone would welcome, young and old, either first thing in the morning or last thing at night...

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* Williams SCP. Genetics: searching for answers. Nature. 2012; 491: S4-S6.

** Eisenstein M. Treatments: in the waiting room. Nature. 2012; 491: S14-S16.

*** Singer E. Diagnosis: redefining autism. Nature. 2012; 491: S12-S13.

**** Perrin JM. et al. Complementary and alternative medicine use in a large pediatric autism sample. Pediatrics. 2012; 130: S77-S82.

***** Sikora DM. et al. Attention-Deficit/Hyperactivity Disorder Symptoms, adaptive functioning, and quality of life in children with autism spectrum disorder. Pediatrics. 2012; 130: S91-S97.

****** Malow BA. et al. A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents With autism spectrum disorders. Pediatrics. 2012; 130: S106-S124.

******* Buie T. et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010;125 Suppl 1:S1-18.

******** Reynolds A. et al. Iron Status in Children With Autism Spectrum Disorder. Pediatrics. 2012; 130: S154-S159.

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