Turbé H, Waeckel L, Dechelotte B
Biologie moléculaire et cellulaire, université Claude-Bernard Lyon 1, Lyon, France.
Biologie moléculaire et cellulaire, université Claude-Bernard Lyon 1, Lyon, France.
Encephale. 2020 Oct;46(5):404-407. doi: 10.1016/j.encep.2019.09.006. Epub 2019 Nov 20.
Autism spectrum disorders (ASD) represent a heterogeneous group of neurodevelopmental disorders which are both severe and frequent. Understanding its pathophysiology could lead to identifying promising new markers and treatments. For years, a growing number of studies have pointed to an important involvement of the immuno-inflammatory system in ASD. Extensive reviews have already addressed this topic. Yet, this field of investigations is not well known to practitioners even those working with ASD patients. Our main objective is to provide an introduction to these new insights through a mini review of the literature. A first field of antenatal studies connects fetal features and maternal infections to ASD by means of the participation of maternal immune activation (MIA) associated with the production of a particular pro inflammatory cytokinic profile with IL-1, IL-6 and TNF and IL-17. Maternal autoantibodies and other immune-related disorders can also lead to impairment of fetal neurodevelopment. Other postnatal studies have shown the correlation between ASD and autoantibodies and between ASD and inflammatory environment through impaired interleukin levels (IL-6 being the most extensively investigated). Disruption of intestinal microbiota appears to be a possible pathogenic mechanism of ASD. The growing paths opened recently between immunology and psychiatry appear to be promising in the understanding of ASD. It could eventually participate in the development of diagnostic markers and help the emergence of new personalized therapeutics suitable for these patients.
自闭症谱系障碍(ASD)是一组严重且常见的异质性神经发育障碍。了解其病理生理学有助于识别有前景的新标志物和治疗方法。多年来,越来越多的研究表明免疫炎症系统在ASD中起重要作用。已有大量综述探讨过这一主题。然而,即使是从事ASD患者治疗工作的从业者,对这一研究领域也并不十分了解。我们的主要目标是通过对文献的简要综述,介绍这些新见解。产前研究的第一个领域通过与特定促炎细胞因子谱(包括白细胞介素-1、白细胞介素-6、肿瘤坏死因子和白细胞介素-17)产生相关的母体免疫激活(MIA),将胎儿特征和母体感染与ASD联系起来。母体自身抗体和其他免疫相关疾病也可能导致胎儿神经发育受损。其他产后研究表明,ASD与自身抗体之间以及ASD与炎症环境之间存在关联,这是通过白细胞介素水平受损(白细胞介素-6是研究最广泛的)来体现的。肠道微生物群的破坏似乎是ASD的一种可能致病机制。最近在免疫学和精神病学之间开辟的新路径,在理解ASD方面似乎很有前景。它最终可能有助于开发诊断标志物,并推动适合这些患者的新型个性化治疗方法的出现。