Frye Richard E
Department of Child Health, College of Medicine-Phoenix, University of Arizona, Phoenix, AZ 85004, USA.
Section on Neurodevelopmental Disorders, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ 85016, USA.
J Pers Med. 2022 Mar 14;12(3):464. doi: 10.3390/jpm12030464.
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder without a known cure. Current standard-of-care treatments focus on addressing core symptoms directly but have provided limited benefits. In many cases, individuals with ASD have abnormalities in multiple organs, including the brain, immune and gastrointestinal system, and multiple physiological systems including redox and metabolic systems. Additionally, multiple aspects of the environment can adversely affect children with ASD including the sensory environment, psychosocial stress, dietary limitations and exposures to allergens and toxicants. Although it is not clear whether these medical abnormalities and environmental factors are related to the etiology of ASD, there is evidence that many of these factors can modulate ASD symptoms, making them a potential treatment target for improving core and associated ASD-related symptoms and improving functional limitation. Additionally, addressing underlying biological disturbances that drive pathophysiology has the potential to be disease modifying. This article describes a systematic approach using clinical history and biomarkers to personalize medical treatment for children with ASD. This approach is medically comprehensive, making it attractive for a multidisciplinary approach. By concentrating on treatable conditions in ASD, it is possible to improve functional ability and quality of life, thus providing optimal outcomes.
自闭症谱系障碍（ASD）是一种复杂的神经发育障碍，目前尚无治愈方法。当前的标准治疗方法侧重于直接解决核心症状，但效果有限。在许多情况下，ASD患者多个器官存在异常，包括大脑、免疫和胃肠道系统，以及多个生理系统，如氧化还原和代谢系统。此外，环境的多个方面会对ASD儿童产生不利影响，包括感官环境、心理社会压力、饮食限制以及接触过敏原和有毒物质。虽然尚不清楚这些医学异常和环境因素是否与ASD的病因有关，但有证据表明，其中许多因素可调节ASD症状，使其成为改善核心及相关ASD相关症状和改善功能限制的潜在治疗靶点。此外，解决驱动病理生理学的潜在生物紊乱有可能改变疾病进程。本文描述了一种利用临床病史和生物标志物为ASD儿童个性化医疗的系统方法。这种方法在医学上具有全面性，使其对多学科方法具有吸引力。通过关注ASD中可治疗的病症，有可能提高功能能力和生活质量，从而提供最佳治疗效果。
