Much autism research focuses on the disorder as centered in the brain, a condition that's based on genetics, is forever with you, and is treatable, but incurable. But what if that's not the whole picture required to understand the causes of autism and treatment options? What if you took a broader lens, one that considers other organs of the body, and the way they relate to each other, and to genes and the biochemical processes that run among them? And what if one also includes environmental factors, especially the tons of hazardous chemicals developed and released onto our planet and atmosphere every day?
That's a layman's translation of the approach that Dr. Martha Herbert, a pediatric neurologist at Massachusetts General Hospital, takes in her research. This evening, Herbert spoke to the Autism Alliance of Metrowest, a Boston area family support group, about her research and her paper "Autism: A Brain Disorder, or a Disorder That Affects the Brain?" (from Clinical Neuropsychiatry, 2005).
What's interesting about Herbert's research is her willingness to challenge assumptions that, she argues, underlie much of current medical thinking about autism as a fate, something that's hard-wired into children and remains a static disability which is sometimes treatable with therapies, but essentially incurable. She argues that with the vast quantities of chemicals industrialized nations like the United States release into the atmosphere and environment, we all are walking around with toxins in our systems; these pollutants increase our risk for autism, and a host of other diseases like cancer and Alzheimer's.
And so Herbert builds upon the myriad studies in anatomy -- of the brain, the gastrointestinal system, and the immune system -- as well as those in genetics and environmental hazards to public health. Contemplating these factors together makes the picture more complex, but she said the approach also holds promise for understanding the biochemistry and genetic tendencies of people with autism whose bodies may be more susceptible than the general population to pollutants. And gaining that understanding should lead to treatment options for short, medium and longer term benefits. (When? That is not clear.)
Herbert travels the world sharing ideas with researchers and making presentations, including to conferences held by groups such as the Autism Society of America and Defeat Autism Now. And for parents who may have trouble following the steady onslaught of autism research, her remarks, peppered with references to dozens of studies published and forthcoming, made her sound authoritative. She cited a 2004 paper by Johns Hopkins researcher Diana Vargas (see press release) as "the most important autism paper" she had seen because it showed that some people with autism exhibit signs of brain inflammation, suggesting that the condition is linked to the triggering of the immune system. This kind of evidence makes studies of environmental factors urgent, she said.
And Herbert's environmental points were striking. She cited research that shows, for example, that U.S. chemical production doubled pesticide manufacturing between 1964 and 1982. A study in Texas showed a potential correlation between clusters of autism cases and the presence of toxic chemicals in the environment. A study of blood taken from umbilical cords of newborn babies showed the presence of 287 chemicals such as those used for flame retardant clothing, pesticides and other pollutants. These findings and her own brain scan research, lead her to study the biochemical mechanisms that link genetics, the brain and behavior.
"There's enough things going on, that we should include a strong component of environmental factors [in autism research] to find out what is going on and how people are getting sick," Herbert said. "I don't think the scientific community admits that we have a problem."