Department of Paediatrics, Gastroenterology and Allergology, Medical University of Bialystok, Poland.
Arch Med Sci. 2012 May 9;8(2):324-31. doi: 10.5114/aoms.2012.28561.
Immune system dysfunction is considered to be one of many medical disorders found in children with autism. The primary objective of the study was to assess if blood tests reflecting humoral immunity (IgA, IgG, IgM, IgE) are useful in identifying children with regressive autism. The secondary objective was to evaluate a part of the cellular arm of immunity (CD4/CD25 Tregs, CD4/CD23 cells) in those children.
Using a clinical case-control design, the systemic levels of immunoglobulins and lymphocyte subpopulations analysed by flow cytometry were compared in children aged 3-6 years old with a new diagnosis of regressive autism (n = 24; mean age: 4.25 ±1.70 years; male 23/24) and in sex- and age-matched healthy children (n = 24; aged 4.25 ±2.20 years; male 23/24).
The humoral immunity profile, described by three binary variables, IgA < 0.97 g/l, IgE > 36 IU/ml, and IgG > 6.3 g/l, with a sensitivity of 79% and a specificity of 83% (p < 0.0001), was able to identify children with autism. The highest risk of autism diagnosis was associated with IgA < 0.97g/l (OR - 23.0; p < 0.001). A higher number of CD19/CD23 was found in children diagnosed with autism than in the control group (36.82 ±6.72% vs. 18.20 ±3.95%; p < 0.02). No correlation between the number of CD23-positive cells and serum IgE levels was observed.
A subtle shift of serum immunoglobulins consisting of low-normal IgA and B cell activation expressed by an increase of CD23-positive cells may characterize children with regressive autism aged 3-6 years old.
免疫系统功能障碍被认为是自闭症儿童存在的众多医学障碍之一。本研究的主要目的是评估反映体液免疫（IgA、IgG、IgM、IgE）的血液检查是否有助于识别退行性自闭症儿童。次要目的是评估这些儿童部分细胞免疫（CD4/CD25 Tregs、CD4/CD23 细胞）。
使用临床病例对照设计，对 3-6 岁新诊断为退行性自闭症儿童（n=24；平均年龄：4.25±1.70 岁；男 23/24）和性别、年龄匹配的健康儿童（n=24；年龄 4.25±2.20 岁；男 23/24）的系统免疫球蛋白水平和淋巴细胞亚群进行分析。
体液免疫特征由三个二项变量描述，IgA<0.97g/l、IgE>36IU/ml 和 IgG>6.3g/l，其灵敏度为 79%，特异性为 83%（p<0.0001），能够识别自闭症儿童。自闭症诊断的最高风险与 IgA<0.97g/l 相关（OR-23.0；p<0.001）。与对照组相比，自闭症诊断儿童的 CD19/CD23 数量更高（36.82±6.72%比 18.20±3.95%；p<0.02）。未观察到 CD23 阳性细胞数与血清 IgE 水平之间的相关性。
3-6 岁退行性自闭症儿童的血清免疫球蛋白略有变化，包括正常低值的 IgA 和 B 细胞激活，表现为 CD23 阳性细胞增多。
