School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Acta Neurobiol Exp (Wars). 2021;81(3):249-263. doi: 10.21307/ane-2021-023.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder, affecting communication and behavior. Historically, ASD had been described as a purely psychiatric disorder with genetic factors playing the most critical role. Recently, a growing body of literature has been emphasizing the importance of environmental and immunological factors in its pathogenesis, with the autoimmune process attracting the most attention. This study provides a review of the autoimmune involvement in the pathogenesis of ASD. The\r\nmicrobiome, the representative of the innate immune system in the central nervous system (CNS), plays a critical role in triggering inflammation. Besides, a bidirectional communicational pathway between the CNS and the intestine called the gut‑brain‑axis is linked to the development of ASD. Moreover, the higher plasma level of pro‑inflammatory cytokines in ASD patients and the higher prevalence of autoimmune disorders in the first‑degree family members of affected persons are other clues of the immune system involvement in\r\nthe pathogenesis of ASD. Furthermore, some anti‑inflammatory drugs, including resveratrol and palmitoylethanolamide have shown promising effects by relieving the manifestations of ASD. Although considerable advances have been made in elucidating the role of autoimmunity in the ASD pathogenesis, further studies with stronger methodologies are needed to apply the knowledge to the definitive treatment of ASD.
自闭症谱系障碍（ASD）是一种神经发育障碍，影响沟通和行为。历史上，ASD 被描述为一种纯粹的精神疾病，遗传因素起着最关键的作用。最近，越来越多的文献强调了环境和免疫因素在其发病机制中的重要性，其中自身免疫过程引起了最多的关注。本研究综述了自身免疫在 ASD 发病机制中的作用。微生物组是中枢神经系统（CNS）中先天免疫系统的代表，在引发炎症方面起着关键作用。此外，中枢神经系统和肠道之间的双向通讯途径称为肠脑轴，与 ASD 的发展有关。此外，ASD 患者的血浆促炎细胞因子水平较高，以及受影响者一级亲属中自身免疫性疾病的患病率较高，这些都是免疫系统参与 ASD 发病机制的其他线索。此外，一些抗炎药物，包括白藜芦醇和棕榈酸乙醇酰胺，通过缓解 ASD 的表现显示出有希望的效果。尽管在阐明自身免疫在 ASD 发病机制中的作用方面已经取得了相当大的进展，但仍需要采用更强有力的方法进行进一步的研究，以便将这些知识应用于 ASD 的确定性治疗。
