Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Med Hypotheses. 2013 Jul;81(1):26-35. doi: 10.1016/j.mehy.2013.04.002. Epub 2013 Apr 25.
Autism spectrum disorders (ASD) are disorders of the central nervous system characterized by impairments in communication and social reciprocity. Despite thousands of studies on this topic, the etiopathogenesis of these disorders remains unclear, apart from a general belief that they derive from an interaction between several genes and the environment. Given the mystery surrounding the etiopathogenesis of ASD it is impossible to plan effective preventive and treatment measures. This is of particular concern due to the progressive increase in the prevalence of ASD, which has reached a figure as high as 1:88 children in the USA. Here we present data corroborating a novel unifying hypothesis of the etiopathogenesis of ASD. We suggest that ASD are disorders of the immune system that occur in a very early phase of embryonic development. In a background of genetic predisposition and environmental predisposition (probably vitamin D deficiency), an infection (notably a viral infection) could trigger a deranged immune response which, in turn, results in damage to specific areas of the central nervous system. If proven, this hypothesis would have dramatic consequences for strategies aimed at preventing and treating ASD. To confirm or refute this hypothesis, we need a novel research approach, which unlike former approaches in this field, examine the major factors implicated in ASD (genetic, infections, vitamin D deficiency, immune system deregulation) not separately, but collectively and simultaneously.
自闭症谱系障碍(ASD)是一种中枢神经系统障碍,其特征是在沟通和社交互惠方面存在障碍。尽管针对这个主题进行了数千项研究,但除了普遍认为这些障碍源自几个基因和环境之间的相互作用之外,其病因仍然不清楚。鉴于自闭症的病因学如此神秘,因此不可能计划出有效的预防和治疗措施。这一点尤其令人关注,因为 ASD 的患病率呈渐进式增长,在美国已高达 1:88 名儿童。在这里,我们提出了支持 ASD 病因学新统一假说的证据。我们认为,自闭症是免疫系统的疾病,发生在胚胎发育的早期阶段。在遗传易感性和环境易感性(可能是维生素 D 缺乏)的背景下,感染(尤其是病毒感染)可能会引发失调的免疫反应,进而导致中枢神经系统特定区域的损伤。如果得到证实,这一假设将对预防和治疗 ASD 的策略产生重大影响。为了证实或反驳这一假说,我们需要一种新的研究方法,这种方法与该领域以前的方法不同,它不是分别而是集体和同时研究与 ASD 相关的主要因素(遗传、感染、维生素 D 缺乏、免疫系统失调)。