Autism and the Gut-Brain-Immune-Axis
by Kora Klapp
One of the hottest health topics is the increase of ASD (autism spectrum disorder), a broad range of neurological, social and physiological symptoms:
1. Huge need of structure and rituals, and often repetitive actions like when objects are lined up in straight order, and broken routines cause much distress. This seems to reflect overwhelm and an inner chaos which one aims to escape.
2. Social signals, such as a smile or a twinkle are not recognized, and limits are not set. Avoidance of eye contact is typical, so that may trigger unpleasant feelings.
3. The speech function can be disrupted, from delayed development to complete muteness. What is meant here is the social function of speech – whining and screaming is usually not impeded. However there are many people with autism with no speech malfunctions whatsoever.
4. Hearing is often hypersensitive in those with autism: noise and background sounds cannot be filtered out adequately, which leads to generally elevated stress levels and to challenges with concentration and focus on interaction with others.
5. Compulsive behaviour like head-banging and hand flapping, as well as aggressive behaviour against self or others, hint at pain and overwhelm.
6. Introversion and reclusion could be caused by the previously identified factors, or it could be a typical personality trait.
7. "High functional" people with autism can have extraordinary memory or mathematical talents (savant), like photographic memory. Derek Paravicini plays piano music just by memory. Stephen Wiltshire paints whole cities after a short overview. Many exceptional scientists as Albert Einstein, Sheldon Cooper, Vera Birkenbihl, Richard Borcherds, Jacob Barnett have been gifted a brain functioning inside the autistic spectrum (Aspergers).
8. Epileptic seizures can appear
9. Typical organ symptoms are abdominal pain and indigestion, and a destitute gut microbiome. Even control functions of defaecation can be impaired.
10. Faecal smearing can appear.
So, the intelligence is not generally restricted, but the social perception and ability to interact are impaired or low prioritized. The symptomatic characteristics often start spontaneously in childhood, and there have been cases where it disappeared completely after several weeks [1][2]. In most pathological cases however, this does not happen spontaneously.
The bio-psychological foundation
Dr Ryke Geerd Hamer observed in introverted, secluded patients, a constellation of several recurring conflict themes in social areas, which show in the brain as marked spots (Hamer foci) in the area of the fissura sylvii and the insula. He named this inner part of cerebral cortex the "territorial areas" and assigned them special features: conflict constellations here, move the influence of stressors from physical/organ symptoms towards drastic perceptional and behavioural changes, i.e. to psychological symptoms, to which belong even depressive and manic states that can alternate depending on current conflict weight ("Scale") [3][4].
The constellation referred to here, reflects themes of identity, belonging and position in the social environment ("territorial anger", "territorial fear"), as well as fear to communicate ("Fright, Speechlessness"). The moment of coincidence of at least 2 of those activated themes, triggers introversion and "autistic" behaviour. At the root of these are traumatic experiences that were perceived as unexpected, dramatic, isolating, without strategy nor resources. The behavioural pattern resulting from these significant emotional events however, becomes part of the personality and does not need traumas to trigger it anymore.
In brain studies of those with autism, cell proliferation (reduced size of nerve cells while augmented in number) was found in the limbic system, the area of the brain associated with evaluation and processing of strong emotions [5].
On the organ level, the "brain relays" for autism are connected to tissues in the middle part of the digestive tract (namely the stomach mucosa, liver and pancreas excretory ducts, and duodenum) and in the larynx, which can make these individuals more susceptible to infections and indigestion. When aggressive behaviour appears, even the rectum mucosa of the anal region, and the sphincter function will be affected. [4].
The above described features of diagnosed autism match remarkably with Dr Hamer’s findings. But an introvert personality deep-diving into an "intellectual digestion" of challenges doesn’t make one a pathologically autistic. Here we have to take more factors that can escalate this program, into account::
- In the brain of humans and animals sharing the typical symptoms, the neurotoxin aluminium [6] was found in elevated levels [7], as well as markers of chronic inflammation [8][9]. By injection with substances simulating infection, behavioural changes towards "autism" could be provoked in previously healthy rats [10].
- Since the famous and unjustly attacked and retracted "MMR-study" by Dr Andrew Wakefield et al [11], many studies confirmed a novel type of bowel inflammation to be found in autistic children, leading to abdominal pain, changes in the gut microbiome [12] and impaired digestion [13][14]. Based on various microscopic pictures, even parasitic infection is suspected [15].
- Inflammation is promoted by cytokines: small proteins that are important in intercellular communication. In those with autism, elevated levels of pro-inflammatory cytokines are reported [16].
Inflammation in principle is a meaningful reaction steering metabolic and microbial actions; however, chronic foci indicate recurring or lasting damage of the affected tissue.
The gut-brain-immune-axis
The gut is equipped with it’s own autonomic nerve system that receives sensory input via receptors in the mucosa. The co-evolution of nerve system and microbiome has recently been established [17][18]. Intertwined with that, is the immune system, the endogenous leukocytes, lymphocytes and phages, defining and maintaining the inner integrity of the body by recognizing, interpreting and interacting with foreign substances and cells.
Gut microbes and the immune system, originate during and shortly after birth [19] and can be altered by long-term nutritional and lifestyle changes. Their balance is sensitive to stress, but it also determines the reaction when stressed [20]. The mediator of this gut-brain-axis is the vagus nerve [21].
Stress even leads to increased permeability of the gut wall, the so-called "leaky gut" [22], a condition in which products of gut bacteria are found in the blood [23][24]. One can discuss if this could be interpreted as an emergency functional change in the sense of "excretory ducts", but it can lead to a series of other symptoms like enhanced mucus degradation in the gut, food intolerances, strain on the liver, and metabolic disorders.
Cytokines especially – endogenous signalling proteins for cellular interaction, that induce and exacerbate inflammatory reactions, are markedly elevated in brains of those with autism [16], which explains the sensitivity in the intestinal tract. We identify a chain reaction, of stress, sensitivity, functional change in the gut wall, and detoxifying and repair mechanisms, that accompany the social and mental traits in autism. From these, supportive and therapeutic approaches can be deduced helping those affected in dissolving the pattern.
How those with autism can be helped
Beginning with gut health, it has been proven that both the condition and behavioural symptoms benefit from bowel cleanse and building of a healthy microbiome. Positive experiences have been made with activated sodium chlorite (NaClO2) [25][15], avoidance of products containing gluten and casein [23], and supply with prebiotic and probiotic food [26][27].
The endocannabinoid system plays a critical role in the physiological interpretation and regulation of the gut-brain-immune axis – this means we look at our endogenous resilience system which we maintain by motion, enough sleep and meditation, as well as by supplementing it with compounds of the cannabis plant which have neuro-protective, stress and cytokine regulating, anti-inflammatory and regenerative effects. Both social symptoms of autism and gut wall permeability could be reduced after ingestion of cannabidiol (CBD) and tetrahydrocannabidiol (THC) [28][29].
A similar effect on the behaviour is oxytocin, the "empathy- and safety hormone". In a trial with autistic children, inhaling oxytocin generally led to a significant temporary improvement in social interaction [30]. In 2 of 44 cases however, episodes of hyperactivity and aggression were prompted – the concept of the "scale" in social constellations could explain these exceptions. Oxytocin is naturally released when flirting, cuddling and inducing labour in giving birth, when it is regulating stress.
Even more effective is oxytocin in conjunction with serotonin, targeting the reward centre (nucleus accumbens) in the brain [31].
Oxytocin release and stress regulation belong to the influence of the (ventral) vagus and the SES (Social Engagement System, referring to Stephen Porges‘ Polyvagal Theory). Porges showed that depression, epilepsy and signs of autism respond to vagus stimulation. He found out that sound therapy with frequencies of human voices, has a positive influence [32].
Directly in the brain, treatment with transcranial magnetic stimulation also showed temporary positive results [33].
The (partial) successes on all these levels indicate their connection, as well as the various factors that could lead to escalation of a biological exit-strategy.
The META-perspective connects the dots
There is no homogeneous autism. An introverted personality is mostly created at a very early age and a familial disposition is possible. Introversion is a stress strategy for avoiding or coping with challenges in the social environment. According to Dr Hamer, it is activated in 2 areas of the peri-insular cerebral cortex situated in both hemispheres, which triggers an altered frequency and interference in the way of brain functioning. The activation by conflicts of social position and belonging, which seem to weaken the endocannabinoid system and inhibit the release of oxytocin, also sensitizes the stomach and intestines and can lead to mucosa degradation and changes in the release and composition of digestive juices. This seems to reflect the picture of "leaky gut". When these conflicts become irrelevant, also the digestion can eventually, regenerate sustainably.
When the root traumas happen in childhood, they can affect a more or less obvious standstill or regression in social development. In many children, a spontaneous regression was observed shortly after immunization by vaccination [34][35]. One can speculate whether the conflicts were triggered by the situation surrounded by superior strangers, or by the powerless experience of injury. Moreover it is assumed that substances and adjuvants from the vaccine accumulate in tissues like the brain and lymphatic cells [36][37]{38] and create a toxic load which exacerbates sensitivity for stressors and conflicts. Through vaccination, the immune response is stimulated and antibodies are built; however this could also participate in creating overreactions and hypersensitivity [38], in which the endocannabinoid resilience system [39] shows reduced function.
When neuro-protection through the endocannabinoid system is not given, the SES (social engagement system) is also suspended, followed by information overload as seen in hyperacusis: the stapedius and tensor tympani muscles regulating hearing and protecting the inner ear, which are innervated by parts of the ventral (social) vagus, are inhibited in favor of the freeze or the sympathetic (fight or flee) reaction. By specific sound therapy and vagus stimulation, e.g. through breath control as in the Buteyko method [40][41], a changeover can be aimed for, which can further be supported by cannabinoid supplements.
The most natural way to open up new self and social experience for children, is play under supervision of an experienced facilitator like in "Original Play – Playing by Heart" [42][43]. The pioneer O. Fred Donaldson and his colleagues (also) attend to children with autism and ADHD, to enable them to dissolve the "knot in the brain" by exploring, fulfilling play, free from competition. The children gain certainty in self-expression and self-determination inside clear boundaries, and this empowers them to revise the strategy imprinted in their brain in their own time, to the appropriate extent.
References:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772235/
[2] M. Zappella, "Autistic regression with and without EEG abnormalities followed by favourable outcome," Brain and Development, vol. 32, no. 9, pp. 739–745, 2010
[3] http://www.neue-medizin.de/html/schizophrenie.html
[4] Dr mag R.G.Hamer Wiss. Tabelle der Germanischen Neuen Medizin Ausg.2006 S.96-103
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410529/
[6] http://pubs.rsc.org/en/content/articlepdf/2013/em/c3em00374d
[7] http://www.sciencedirect.com/science/article/pii/S0946672X17308763
[8] http://onlinelibrary.wiley.com/doi/10.1002/ana.20315/abstract
[9] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1393597
[10] https://www.sciencedirect.com/science/article/pii/S0889159112002188
[11] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(97)11096-0/abstract
[12] https://asunow.asu.edu/content/clues-about-autism-may-come-gut
[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408485/
[14] https://news.nationalgeographic.com/news/2014/11/141114-autism-gut-brain-probiotic-research-biology-medicine-bacteria/
[15] https://andreaskalcker.com/en/pp-parasitical-protocol/
[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554862/
[17] https://www.sciencedaily.com/releases/2017/09/170926105425.htm
[18] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685587/
[19] http://www.nature.com/nrgastro/journal/v9/n10/full/nrgastro.2012.165.html
[20] http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2004.063388/full
[21] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179073/
[22] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253991/
[23] https://www.ncbi.nlm.nih.gov/pubmed/20683204
[24] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129651/
[25] https://andreaskalcker.com/en/remissions/
[26] http://news.nationalgeographic.com/news/2014/11/141114-autism-gut-brain-probiotic-research-biology-medicine-bacteria/
[27] https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-016-0225-7
[28] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253991/
[29] http://drbogner.com/endocannabinoid-system-autism-cannabis-part-1/
[30] https://www.nature.com/articles/mp2015162
[31] https://www.autismspeaks.org/science/science-news/study-provides-new-clues-oxytocin-autism-connection
[32] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117928/
[33] https://www.autismspeaks.org/blog/2016/03/25/transcranial-magnetic-stimulation-autism-evidence-benefit
[34] https://www.focusforhealth.org/can-cdc-easily-dismiss-stories-regression/
[35] https://www.autismspeaks.org/science/grants/vaccination-regression-study
[36] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318414/
[37] https://www.ncbi.nlm.nih.gov/pubmed/22235057
[38] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615573/
[39] https://www.ncbi.nlm.nih.gov/pubmed/17369778
[40] https://www.ncbi.nlm.nih.gov/pubmed/25924910
[41] http://buteykoclinic.com/anxiety/
[42] http://www.turningonthelight.com/visionamanda.html
[43] http://www.originalplay.eu/what-is-quotoriginal-playquot,4
pictures:
https://pixabay.com/en/meltdown-autism-autistic-child-1312488/
Kora Klapp
User BallenaBlanca via Wikimedia Commons
https://commons.wikimedia.org/wiki/File:Increased_intestinal_permeability.png
https://pixabay.com/en/autism-autistic-pieces-of-the-puzzle-2930455/
