UC Davis researchers have launched several major new studies to unlock
the mysteries surrounding autism.
They hope to answer a fundamental question: Do environmental factors
combine with genetics to cause the disorder?
The research, expected to break ground in an area where little is known,
will take place over the next few years.
Next month, investigators from the UC Davis Center for Children's
Environmental Health will begin enrolling 2,000 California children in the
study.
They plan to include 700 autistic children, 700 who have mental
retardation or developmental delay but not autism, and 600 who have
developed normally.
Researchers will then analyze blood, urine and hair samples from the
children and their family members to search for the presence of toxic
substances.
They will compile comprehensive histories on the mother and child,
looking at exposure to everything from vaccines containing a mercury
preservative to pesticides, PCBs and chemicals used in industrial processes.
The work will be much like fitting together the pieces of a giant jigsaw
puzzle without knowing what the final picture looks like. Investigators will
search for patterns of differences between the children with developmental
problems and those without.
"We're casting a really wide net and that's because we really don't know
a lot about autism," said Irva Hertz-Picciotto, a UC Davis professor of
epidemiology and preventive medicine who oversees one of the studies.
"This is really the first big, comprehensive effort to enroll a lot of
children and look at a combination of environmental and genetic factors,"
she added. "It's likely that both play a role."
Autism, a severe developmental disorder that undermines a child's ability
to connect with the world, has no known cause and no cure.
Autistic children often have difficulty making eye contact and carrying
on a conversation. Many engage in ritualistic behavior such as hand-flapping
and obsessively following routines.
The search for answers takes on added urgency because of a recent
explosion in the numbers of autistic children in the United States, England,
Scotland and elsewhere.
While some experts believe the increase is a result of better diagnosis,
others note that a recent study by UC Davis researchers concluded that it
appears to be a real phenomenon.
Scientists now believe as many as five to 15 genes play a role in causing
autism, said Isaac Pessah, a UC Davis professor of pharmacology and
toxicology who directs the center.
But Pessah and other experts wonder if an unknown environmental factor
pushes genetically vulnerable children over the edge into autism.
"We know that genes by themselves don't cause epidemics," said Rick
Rollens, the father of an autistic boy. "There must be something else going
on."
A couple of years ago, Rollens joined other parents of autistic children
in urging Kenneth Olden, director of the National Institute of Environmental
Health Sciences, to establish several autism research centers around the
country.
"Really for the first time, autism research has been expanded to include
new disciplines and new ideas about possible causes of autism," Rollens
said.
UC Davis officials succeeded in obtaining grant money to open the center
in late 2001.
With an annual budget of $1.6 million, it receives funding from the
National Institute of Environmental Health Sciences, the Environmental
Protection Agency and UC Davis' Medical Investigation of Neurodevelopmental
Disorders (M.I.N.D.) Institute.
Investigators at the M.I.N.D. Institute, who do research on autism,
collaborate closely with those at the center. Together, the two institutions
place the Davis campus at the forefront of those seeking to unravel the
disorder.
Hertz-Picciotto's study will focus on children between the ages of 2 and
5 living in Solano County, the Central Valley, Sacramento and Napa areas,
and Los Angeles.
Researchers selected these areas to include children likely to be exposed
to pesticides and other chemicals found in agricultural regions, as well as
those from urban centers.
"We want a real dichotomy of environmental exposures," Pessah said.
The autistic children will be recruited from those who receive services
through the state Department of Developmental Services regional centers.
The normally developing children will be selected at random from state
birth certificate files.
Hertz-Picciotto hopes to have some preliminary results within two years.
But the study has funding for five years and could last much longer.
After obtaining blood samples, researchers will analyze if the immune
systems of autistic children function differently than those of other
children. They will look at cell-to-cell communication and metabolism.
Other researchers at the center have begun to tackle one of the most
controversial theories surrounding autism: Could it be triggered by
thimerosal, a mercury-containing preservative in several vaccines until the
U.S. Food and Drug Administration asked manufacturers to voluntarily phase
it out in 1999?
Vaccine manufacturers insist thimerosal is safe. But it has spawned
class-action lawsuits in California and at least 10 other states by scores
of parents who blame the preservative for their child's slide into autism.
To find answers, center investigators have begun to ask if thimerosal
influences social behavior in mice. The question is significant because
social behavior is a key criteria for diagnosing autistic children.
Center researchers have injected mice with thimerosal at about the same
rate that children received it as part of their routine vaccination
schedule, with an adjustment to account for the smaller size of the mouse.
Researchers then analyze if the behavior of the mice changes.
Most mice like to huddle with their mother and littermates after they're
born and will emit ultrasonic cries of distress if separated from the group,
Pessah said. Researchers hope to discover if mice who have received
thimerosal no longer want to huddle with others, echoing the isolation
exhibited by autistic children.
Center officials hope to release some findings on thimerosal early next
year, Pessah said.
Parents around the world eagerly await answers on autism.
"We think it's not going to be one single factor that's going to turn out
to explain it all," Hertz-Picciotto said. "It may be a combination of
things. We're really at the very beginning of understanding this complicated
disorder."