A diagnostic tool that treats autism like cancer

An Israeli pediatric oncologist believes that immunology is key to diagnosing and treating many cases of autism spectrum disorder (ASD).

Dr. Benjamin Gesundheit readily admits that it sounds crazy to treat a neurological condition the way one could treat cancer.

But international reports from as early as 1962 show that children with autism can have autoimmune diseases in their families.

In addition, treating ASD children for autoimmune diseases, such as asthma, sometimes also improves their ASD symptoms – typically reduced social and communication skills and unusually repetitive behavior.

Intrigued by this anecdotal evidence, Gesundheit left his practice in 2011 to investigate the link between autism and immune disorders.

“I sat in the library for a year looking at the literature on autism and consulted people including a pediatrician who has a son with autism and asthma and when the asthma was treated the autism decreased,” he tells ISRAEL21c.

“It became clear to me that there was a connection. Many important insights into the literature and from people I knew pointed in exactly the same direction. “

His discoveries led to the founding of his start-up, Cell-El Therapeutics in 2014.

To go fishing

Animal studies he did in Israel confirmed that autoimmune antibodies present in some mothers of children with ASD bind to fetal brain proteins and may be a marker or risk factor for ASD.

In 2013, Gesundheit was lead author of a multinational review of epidemiological, serological and epigenetic evidence for the relationship between the immune system and many cases of ASD, published in the Journal of Autoimmunity. A co-author was immunologist David Naor of the Hebrew University.

Dr. Benjamin health. Photo courtesy of tehillim.org

Gesundheit received approval from the Ministry of Health to “go on a fishing expedition” for immunological biomarkers of triple-A (autoimmune antibody associated) autism in the blood of 360 ASD children, with typically developed children as control, aged from 3 to 11 years old.

“I asked each parent if they had an autoimmune disease, and many of them told me that no one had asked them before, but we actually have a lot of autoimmune diseases in our family,” he tells ISRAEL21c.

The RayBiotech lab in Atlanta confirmed that of the 1,000 markers studied, about 30 showed significant statistical differences between ASD and non-ASD children.

Israeli biostatisticians found that in 88% of more than 200 blood samples, ASD could be objectively diagnosed by the immune profile they identified as diagnostic markers.

“An accuracy of 88% is not medically perfect,” says Gesundheit. “I think the other 12% have not been proven to be related because there is some other cause or because we have not identified all the markers.”

First objective diagnostic tool for ASD

Still, he found the results encouraging enough to begin the development of what could be the world’s first objective medical diagnostic tool for ASD.

Today, ASD is diagnosed by observational behavioral tests performed by neurologists, psychologists, and psychiatrists. Because these tests assess communication, they cannot be performed until a child is two or three.

“Autism was first described in 1943 and since then there has been nothing significant new to understanding the disease mechanism as a basis for diagnosis and treatment,” Gesundheit says.

“The word ‘spectrum’ doesn’t biologically tell me why something in the synapses between neurons doesn’t signal. We have no idea and it is a disaster. Many divorces, depressive disorders, unemployment and suicide surround families with an autistic child. “

Gesundheit will now take “the top five markers of the 30” and develop them into a diagnostic blood test in the coming years. This test could be given to babies with typical early signs of ASD – such as not smiling or poor eye contact at six months of age – to provide biological evidence for observational tests performed in toddlerhood. The blood test could also provide a basis for early intervention.

“If we can sort out immunological markers in the blood sample, we enable an objective diagnosis and that is the basis of many therapeutic approaches. The diagnostic tool can also be used to monitor the success of a treatment. This is an exciting new chapter for the world for autism. “

Immunotherapy

The other goal of Cell-El Therapeutics is to develop an immunotherapy protocol for triple-A autism. Currently, there are no FDA-approved treatments for the core symptoms of ASD.

A promising option is to infuse autologous stem cells (from the patient’s own cells) with mesenchymal stem cells, which restore normal immune function.

Gesundheit published a study on this and is collaborating with medical experts in Europe who have seen remarkable improvements in ASD children after stem cell transplants.

“I’m not sure we can target treatments for specific social or communicative symptoms, but we can open an interesting avenue for future research,” he says.

“Optimal dosage, ideal age for treatment, number and timing of treatments remain open questions for our clinical research. We do know that younger children respond better to immunomodulation. “

It may also be possible to look for immunological biomarkers in the blood of mothers of autistic children and to treat the mother before further pregnancies. “If we can do prevention, it would be absolutely incredible,” says Gesundheit.

According to the World Health Organization, one in 160 children is on the autism spectrum and this number is growing every year.

The team

The Cell-El team consists of two seasoned PhDs: Chief Scientific Officer Ronald Ellis, who has helped bring several key vaccines and therapies to the market over the past 35 years (and one of ISRAEL21c’s experts was in our webinar on the Covid- 19 vaccine) and Fred Samuels, chief of diagnostics, with 35 years of senior management experience in the commercialization of diagnostic products.

Swiss-born Gesundheit (whose name is German for ‘health’) previously worked at the Hospital for Sick Children in Toronto and Soroka and Hadassah medical centers in Israel.

Gesundheit is also leading a startup called Rapo Yerapeh that is exploring the use of oncolytic viruses to treat metastatic tumors and is investigating an existing antiviral treatment for Covid-19.

Click here for information about the Cell-El diagnostic studies.

Click here for information on another subset of autism discovered at the Israel Center for Autism Research.

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