Rheumatology/Allergy and Clinical Immunology, University of California, 451 E. Health Sciences Drive, Suite 6510 GBSF, Davis, CA, 95616, USA.
The M.I.N.D. Institute, University of California, Davis, CA, 95616, USA.
Mol Psychiatry. 2019 Feb;24(2):252-265. doi: 10.1038/s41380-018-0099-0. Epub 2018 Jun 22.
It has been estimated that autism spectrum disorder (ASD) now affects 1 in 59 children in the United States. Although the cause(s) of ASD remain largely unknown, it is becoming increasingly apparent that ASD can no longer be defined simply as a behavioral disorder, but is in effect a rather complex and highly heterogeneous biological disorder. Up until recently the brain was thought to be "immune privileged." However, it is now known that the immune system plays critical roles in the development and functioning of the brain throughout life. Recent evidence from multiple investigators has illustrated the deleterious role that dysregulation of the maternal immune system during gestation can play in the manifestation of changes in neurodevelopment, resulting in the development of neurobehavioral disorders such as ASD. One potential etiologic pathway through which the maternal immune system can interfere with neurodevelopment is through maternal autoantibodies that recognize proteins in the developing fetal brain. This mechanism of pathogenesis is now thought to lead to a subphenotype of ASD that has been termed maternal autoantibody related (MAR) ASD. This review provides an overview of the current research implicating the presence of brain-reactive maternal autoantibodies as a risk factor for MAR ASD.
据估计，自闭症谱系障碍（ASD）现在影响美国每 59 名儿童中的 1 名。尽管 ASD 的病因仍在很大程度上未知，但越来越明显的是，ASD 不能再简单地定义为行为障碍，而是实际上是一种相当复杂和高度异质的生物障碍。直到最近，大脑被认为是“免疫特权”。然而，现在已知免疫系统在大脑的发育和功能中起着至关重要的作用，贯穿人的一生。来自多位研究人员的最新证据表明，妊娠期间母体免疫系统失调会对神经发育产生有害影响，导致神经行为障碍的发生，如 ASD。母体免疫系统干扰神经发育的一个潜在病因途径是通过母体自身抗体识别发育中胎儿大脑中的蛋白质。这种发病机制现在被认为导致了一种被称为母体自身抗体相关（MAR）ASD 的亚表型。这篇综述概述了目前的研究，这些研究表明存在针对大脑的母体自身抗体是 MAR ASD 的一个风险因素。
