Autism, archetype of the
autistic spectrum disorders (ASD), is a
neurodevelopmental disorder characterized by socially aloof behavior and impairment of language and social interaction. Its prevalence has surged in recent years. Advanced functional brain imaging has confirmed pervasive neurologic involvement. Parent involvement in
autism management has accelerated understanding and treatment. Often accompanied by
epilepsy, cognitive deficits, or other neurologic impairment,
autism manifests in the first three years of life and persists into adulthood. Its etiopathology is poorly defined but likely multifactorial with heritability playing a major role. Prenatal toxic exposures (
teratogens) are consistent with
autism spectrum symptomatology. Frequent vaccinations with live virus and toxic mercurial content (
thimerosal) are a plausible etiologic factor. Autistic children frequently have abnormalities of sulfoxidation and sulfation that compromise liver detoxification, which may contribute to the high body burden of
xenobiotics frequently found. Frequent
copper-
zinc imbalance implies
metallothionein impairment that could compound the negative impact of
sulfur metabolism impairments on detoxification and on intestinal lining integrity. Intestinal hyperpermeability manifests in autistic children as
dysbiosis, food intolerances, and
exorphin (
opioid) intoxication, most frequently from
casein and
gluten. Immune system abnormalities encompass derangement of antibody production, skewing of T cell subsets, aberrant
cytokine profiles, and other impairments consistent with chronic
inflammation and autoimmunity. Coagulation abnormalities have been reported. Part 2 of this review will attempt to consolidate progress in integrative management of
autism, aimed at improving independence and lifespan for people with the disorder.