Building the case for the Support of Treatment of Autistic Spectrum Disorders with Molecular Hydrogen

Autism, or Autistic Spectrum Disorder is a neurodevelopmental disorder, the cause of which is unknown.  It is characterized by restricted, repetitive behaviours and impairment in socialization and communication.  The term spectrum refers to the range of difficulties people may experience and the degree to which they are affected.5.

 

There are various factors which are involved in the etiopathogenesis of autism or autism spectrum disorder (ASD) such as impaired immune responses, neuroinflammation, abnormal neurotransmission, oxidative stress, mitochondrial dysfunction, environmental toxins and stressors.

 

What is currently understood:

  • Oxidative stress plays a role1
  • Autistic people have higher levels of oxidative stress markers in their urine (a measure of oxidative stress), and the more severe the autism, the higher the levels are. 1
  • Lipid peroxidation is increased1
  • Glutathione levels are decreased1
  • Catalase is decreased1
  • Brain-derived neurotrophic factor (BDNF) in some children with autism is reduced (BDNF) is associated with oxidative stress in autism
    • Possibly mediated by SOD and Glutathione peroxidase1
  • Intestinal motility is reduced, with constipation occurring in about 33% of autistic children. 1
  • Autistic children have greater mitochondrial DNA dysfunction, thought to be associated with greater levels of oxidative damage.2
  • Intestinal inflammation is increased3
  • Central and peripheral inflammation levels are increased. With higher levels of TNF, IL-6 and mast cells all being found at higher levels in ASD.4
  • Dysregulation of dopamine and serotonin. 7

[i]

Current standard treatment of Autistic Spectrum Disorders

There is no curative treatment for Autism.  Most treatment involves behavioural therapy, educational therapies, sensory integration therapy and speech therapy.

At this point there is no standard medical treatment for ASD.  Drug treatment is limited and generally based on treating associated disorders, such as depression, anxiety, obsessive behaviours, aggression, tantrums and self-harm; and includes anti-depressants, anti-convulsives and antipsychotics.6 8

Neurochemical investigations have identified abnormalities in monoamines, glutamate, GABA, and neuropeptides.  There are indications that ASD involves imbalance / dysfunction of dopamine and serotonin in the CNS.  Thus the use of antipsychotics, which affect levels of these neurotransmitters, is indicated   As of 2012, no biological markers have been found to reliably diagnose autism in an individual patient. 8

As of 2008 the only approved drug  (USFDA) for the treatment of Autism was Risperidone, which is an antipsychotic. 7

A study published  in 2012 found that including an anti-inflammatory (Celoxicob, a COX2 inhibitor) to Risperidone treatment offered better outcomes than Risperidone alone. 10

Nutritional treatment includes: 9

  • Imroving mitochondrial function
    • Carnitine, CoQ 10, B vitamins
  • Antioxidants / treatment of oxidative stress
    • Vitamin C, E, cysteine, methylcobalamin, folinic acid
  • Improve methylation
    • Folinic acid, methylcobalamin
  • Improve glutathione levels
    • Methylcobalamin, folinic acid, N Acetyl cysteine

 

 

Current Understanding of the actions of molecular hydrogen:

  • Its small molecular size means it can reach the mitochondria of the cell and reduce oxidative damage to the mitochondria
  • It can cross the blood brain barrier and act and an anti-inflammatory and antioxidant in the CNS
  • Has antioxidant activity
  • Decreases lipid peroxidation
  • Indirectly leads to an increase in glutathione, catalase and SOD
  • My improve mitochondrial function
  • Has an anti-inflammatory action, by decreasing levels of TNF, IL-6 and possibly mast cells.
  • Has been found to improve bowel function and decrease symptoms of inflammatory bowel disease.
  • molecular hydrogen is non-toxic

 

molecular hydrogen should be considered as part of an overall treatment plan for people with Autistic Spectrum Disorders.  It is not considered as an alternative to conventional treatment, but as a safe method of potentially enhancing the effectiveness of such treatment.

[i] Physical exercise and intermittent administration of lactulose may improve autism symptoms through hydrogen production  Ahmad Ghanizadeh  Medical Gas Research 2012, 2:19

  1. Evidence of reactive oxygen species-mediated damage to mitochondrial DNA in children with typical autism Eleonora Napoli, Sarah Wong, and Cecilia Giulivi  Molecular Autism 2013, 4 :2
  2. Current Gastroenterology Reports 2002, Volume 4, Issue 3, pp 251-258 Autism and gastrointestinal symptoms Karoly Horvath MD, PhD, Jay A. Perman MD
  3. Focal brain inflammation and autism Theoharis C Theoharides , Shahrzad Asadi and Arti B Patel Journal of Neuroinflammation 2013, 10 :46 http://www.jneuroinflammation.com/content/10/1/46
  4. http://www.autismspectrum.org.au/content/what-autism Autism Spectrum Australia
  5. WebMD http://www.autismspectrum.org.au/content/what-autism
  6. Published in Volume 118, Issue 1 (January 2, 2008) J Clin Invest. 2008;118(1):6–14. doi:10.1172/JCI32483. Copyright © 2008, American Society for Clinical Investigation Science in Medicine Antipsychotics in the treatment of autism David J. Posey, Kimberly A. Stigler, Craig A. Erickson and Christopher J. McDougle
  7. Pharmacological Reports Volume 64, Issue 6, November–December 2012, Pages 1291–1304 Drug therapy in autism: a present and future perspective Baldeep Kumar, Ajay Prakash, Rakesh K. Sewal, Bikash Medhi, Manish Modi
  8. Frontiers in Pediatrics. 2014; 2: 66. Published online Jun 27, 2014. doi:  10.3389/fped.2014.00066 PMCID: PMC4073259 Treatments for Biomedical Abnormalities Associated with Autism Spectrum Disorder Richard Eugene Frye1,* and Daniel A. Rossignol
  9. Psychopharmacology January 2013, Volume 225, Issue 1, pp 51-59 Date: 11 Jul 2012 Celecoxib as adjunctive treatment to risperidone in children with autistic disorder: a randomized, double-blind, placebo-controlled trial Mahtab Asadabadi, Mohammad-Reza Mohammadi, Ahmad Ghanizadeh, Amirhossein Modabbernia, Mandana Ashrafi, Elmira Hassanzadeh, Saeedeh Forghani, Shahin Akhondzadeh