Mast cell activation and autism

Theoharides TC, Angelidou A, Alysandratos KD, Zhang B, Asadi S, Francis K, Toniato E, Kalogeromitros D.

Biochim Biophys Acta. 2010 Dec 28.


Autism spectrum disorders (ASD) are neurodevelopmental disorders characterized by varying degrees of dysfunctional communication and social interactions, repetitive and stereotypic behaviors, as well as learning and sensory deficits. Despite the impressive rise in the prevalence of autism during the last two decades, there are few if any clues for its pathogenesis, early detection or treatment. Increasing evidence indicates high brain expression of pro-inflammatory cytokines and the presence of circulating antibodies against brain proteins. A number of papers, mostly based on parental reporting on their children's health problems, suggest that ASD children may present with "allergic-like" problems in the absence of elevated serum IgE and chronic urticaria. These findings suggest non-allergic mast cell activation, probably in response to environmental and stress triggers that could contribute to inflammation. In utero inflammation can lead to preterm labor and has itself been strongly associated with adverse neurodevelopmental outcomes. Premature babies have about four times higher risk of developing ASD and are also more vulnerable to infections, while delayed development of their gut-blood-brain barriers makes exposure to potential neurotoxins likely. Perinatal mast cell activation by infectious, stress-related, environmental or allergic triggers can lead to release of pro-inflammatory and neurotoxic molecules, thus contributing to brain inflammation and ASD pathogenesis, at least in a subgroup of ASD patients. This article is part of a Special Issue entitled: Mast cells in inflammation.

Copyright © 2010. Published by Elsevier B.V.

Prevalence Of Allergies In Us Children With Autism 

M Altarac  Annals of Epidemiology.  Volume 8, No. 9.  September 2008, pg 708-741.


M Altarac, Department of Maternal and Child Health,

University of Alabama at Birmingham, Birmingham, AL

PURPOSE: To explore association between autism and

respiratory, food or digestive and skin allergies.

METHODS: Prevalence of allergies in US children with and

without autism were calculated using data from the 2003 Na-

tional Survey of Children’s Health (NSCH). The NSCH was

designed to produce national and state-speciļ¬c prevalence

estimates for a variety of health indicators and measures of

children’s health. Data analyses were done by SAS callable

SUDAAN in order to account for the complex survey design

and to calculate accurate variance statistics.

RESULTS: Prevalence of respiratory allergy in children

with autism was 26.4% (95% CI 19.9, 34.2) compared with

14.9 % (95% CI 14.5, 15.2) in children without (OR Z 2.1,

95% CI 1.4, 3.0). Prevalence of food or digestive allergy in

children with autism was 14.0% (95% CI 9.8, 19.57), vs.

3.5% (95% CI 3.3, 3.7) in children without (OR Z 4.45,

95% CI 3.0,6.7). Prevalence of skin allergy in children with

autism was 14.9 (95% CI 10.5, 20.8) compared with 9.8%

(95% CI 9.5, 10.1) in children without (OR Z 1.6, 95%

CI 1.1,2.4). In the adjusted logistic regression model, only

food or digestive allergy was associated with autism, with au-

tistic children being almost four times as likely to have a food

or digestive allergy than other children (OR Z 4.7, 95% CI

3.1, 7.2), after adjusting for age, gender, health insurance

status, household education and poverty.

CONCLUSION: Children with autism are about four

times more likely to have a digestive allergy than other

US children. The association between food or digestive al-

lergy and autism deserves more in-depth exploration.