Autism in children through maternal autoantibodies?

    

    

Doctors newspaper online, 02.10.2019

    

        
        
        

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brain development

Autoantibodies in pregnancy, according to one study, can trigger behavioral problems in the child.

BERLIN. Autoantibodies formed during pregnancy could lead to impaired brain development in the unborn child, resulting in autism, schizophrenia, and ADHD.

This is suggested by studies by the German Center for Neurodegenerative Diseases (DZNE) and the Charité – Universitätsmedizin Berlin based on laboratory experiments and human findings ( Ann Neurol 2019; online July 20 ).

The study, conducted by Privatdozent Dr. med. Harald Prüß, focused on autoantibodies to the NMDA receptor, which is essential for nerve cell circuitry and normal brain development. "The NMDA receptor antibody is a relatively common autoantibody. Data from donated blood suggest that up to one percent of the population carry this particular autoantibody in their blood. The reasons for this are largely unclear, "Prüß is quoted in a statement by the DZNE.

Severe inflammations may arise

If this autoantibody reaches the brain, severe inflammation can occur. However, the blood-brain barrier for antibodies is usually barely passable, unless this barrier is damaged or not fully developed as in the embryo.

"We hypothesized that NMDA receptor antibodies enter the brain of the embryo, leading to subtle but sustained disruption in this important phase of brain development," said Prüß.

In fact, in mice, the maternal autoantibodies reached a high level in the brain of the embryo. As a result, NMDA receptors, altered physiological functions and impaired neuronal development were reduced. The offspring showed behavioral problems and some brain areas were smaller compared to healthy animals.

"This previously unknown form of pregnancy-related brain disease is reminiscent of psychiatric disorders caused by rubella or chickenpox. Even with such infections, there is only a short-term effect on the brain, but can have lifelong consequences, "said Prüß.

Blood-brain barrier probably protects mothers

In humans, initial analysis of data from 225 mothers suggests that autoantibodies are indeed more common in women with a developing neurobiological or psychiatric disorder. The mothers seem to be protected by the blood-brain barrier.

"Further studies are needed to confirm the link between maternal NMDA receptor antibodies and human psychiatric disorders," says Prüß. "However, if future research confirms our thesis, a search for such antibodies in pregnant women would have to be taken into account. Then, if necessary, a treatment to remove the autoantibodies could be initiated to prevent the otherwise lifelong health effects on the child. " (eb)

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