MAR autism: a storm brewing?

It looks like a storm is brewing.

I refer to the commentary by Emily Underwood* titled: Alarm over autism test. The centre of the argument is the commercialisation of all that work coming out of the MIND Institute looking at maternal antibody reactivity to specific fetal brain proteins being fairly exclusively reported in mothers of children with an autism spectrum disorder (ASD). I've talked about this work a few times on this blog (see here and here); the important post seems to be the one on MAR autism (that's maternal autoantibody related autism to you and me) as per the papers by Melissa Bauman and colleagues** (open-access) and Dan Braunschweig and colleagues*** (open-access).

The regular readers of this blog might have seen a quite recent post extending the whole maternal immune activation link to autism (and other conditions). I don't think anyone can argue with the fact that this is a very, very interesting line of inquiry for at least some autism (or should that be some of the autisms?). Indeed, it's timely that another paper comes out with this field of study in mind: Rossi and colleagues****.

I'm not going to dwell too much on the Rossi findings aside from highlighting (a) they pretty much got the same results as previously reported but this time based on a cohort based in the Basque Country (yep, the same place that hosted IMFAR this year (2013), and (b) to quote: "plasma reactivity to fetal brain a combination of proteins at 37 and 73 kDa or 39 and 73 kDa was found exclusively in mothers of children with ASD". That and mention of one Joaquin Fuentes as part of the authorship group who I fondly remember as being the 'fingers of fire' as per his guitar skills at a conference in Ireland I attended many moons ago.

I'm not going to be drawn to deeply into the arguments about any 'alarm' over the proposed translation of the maternal autoantibody findings. I get the impression that for some, quite a bit of the 'alarm' is mention of the immune system being related to a behavioural condition like [some of] the autisms (who'd have thunk it...). I would however perhaps replace alarm with 'caution' in how this issue develops and the ethical questions that it raises as per pregnancy screening and previous examples of this line of investigation (see here). Indeed, in place of screening, the associated question is whether this line of work might have more therapeutic implications for at least some on the autism spectrum?

Update: 16-09-13. A full-text PDF of the original paper is available here.

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* Underwood E. Alarm Over Autism Test. Science. 2013; 341: 1164-1167.

** Bauman MD. et al. Maternal antibodies from mothers of children with autism alter brain growth and social behavior development in the rhesus monkey. Transl Psychiatry. 2013 Jul 9;3:e278. doi: 10.1038/tp.2013.47.

*** Braunschweig D. et al. Autism-specific maternal autoantibodies recognize critical proteins in developing brain. Transl Psychiatry. 2013 Jul 9;3:e277. doi: 10.1038/tp.2013.50.

**** Rossi CC. et al. Brief Report: Antibodies Reacting to Brain Tissue in Basque Spanish Children with Autism Spectrum Disorder and Their Mothers. J Autism Dev Disord. 2013 Sep 11.

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Rossi CC, Fuentes J, Van de Water J, & Amaral DG (2013). Brief Report: Antibodies Reacting to Brain Tissue in Basque Spanish Children with Autism Spectrum Disorder and Their Mothers. Journal of autism and developmental disorders PMID: 24022729