Autism

Autism is a neurodevelopmental disorder characterized by different social and behavioral symptoms. The exact cause of autism is still not fully understood, but a combination of genetic predisposition and a perinatal brain insult/damage occurring around the time of birth has been suggested. Children with autism usually manifest with a combination of both social and behavioral problems including reduced social and communication skills, repetitive or restricted behaviors – including stereotypical repetitive speech and movements – ritualizing routine and despising changes, and abnormal reactivity to different sensory stimuli (ex. noise and light).

Autism is usually associated with additional features that might impair the functionality of the child including irritability, aggressiveness, hyperactivity, insomnia, and different mood disorders such as depression or anxiety (1, 2).

Autism has been suggested to occur due to a mixture of genetic predisposition and inflammatory or immune-mediated brain damage (3).

Autism has also been proven to have lots of comorbid conditions that contribute to worse behaviors and socialization including gastrointestinal disturbance (ex. chronic constipation), metabolic disorders, sleep issues, seizures, nutritional problems and selective eating, and psychological disorders (4).

Most often 3-6 months for the initial effect, with continuing improvement over the following 1 to 2 years. We have had parents notice a near-immediate difference or a noticeable difference within 2 weeks but should not be seen as typical or expected.

Despite there being lots of advancements aiming at diagnosing autism earlier in order to allow prompt management and to provide a better quality of life for children and adults living with such a lifelong condition, there has not been much progress in treating its core features. Current treatments only aim to alleviate unfavorable behaviors such as irritability and aggressiveness, and allow them to reach their full potential when it comes to their cognitive and social abilities. Commonly-used treatments include psychological therapy, nutritional therapy; and in extreme resistant cases, pharmacotherapy with medications (2, 5):

Psychotherapy/Behavioral Therapy These include different psychological and educational treatment approaches that aim to reinforce positive behaviors and reduce undesired ones. One commonly-used approach in autism is applied behavior analysis (ABA). ABA involves some psychological interventions that aim to reinforce positive behaviors through establishing a reward system and inhibiting undesired behaviors through establishing an active or a passive consequence. This process is repeated throughout the sessions in order to “shape” the autistic child’s behavior. It has been estimated that this method improves social and behavioral features of children with autism when used early; with some children showing visible improvement in their IQ. However, these sessions take a long time to work and the degree of improvement differs from one child to another according to the severity of their autism (2, 5).

Pharmacotherapy (Medical Treatment) Medications might be used to treat behaviors that have failed to respond to psychotherapy; including aggressiveness, anxiety, hyperactivity, or irritability. Some commonly used drugs include medications used in different psychological conditions (2, 5):

• Antipsychotics (ex. risperidone and aripiprazole): These drugs have been proven to improve irritability and impulsivity. However, they are commonly associated with multiple side effects that necessitate its use with extreme caution; especially given the age group they are used on.
• Antidepressants (ex. fluoxetine): Antidepressants have been proven in some studies to improve irritability and repetitive behaviors associated with autism.
• Stimulants (ex. Methylphenidate and atomoxetine): These are especially beneficial in autistic children with co-existing ADHD symptoms and hyperactivity and/or constant distraction.

Nutritional Therapy These are diets that have been proven to improve symptoms associated with autism. Some commonly-used diets include ketogenic and gluten-free diets. Additional use of supplements (ex. probiotics and antioxidants) has also shown some improvement in symptoms (6, 7).

Of course there are other numerous treatments and medications that have proven benefits in autism, which are not the main topic of this article; yet they all share one thing in common, which is that they are solely symptomatic in nature – i.e. they aim to improve different autistic features to a certain extent – with no role in addressing the original neurological abnormality leading to the autistic presentation. This is where stem cell therapy has been emerging as a possible therapeutic option that could actually improve or even repair the original brain changes or damage contributing to different features of autism.

To date, there has not been a single study – to our knowledge – that has compared different types of stem cells, concerning safety and efficacy, particularly in autism. There are currently many types of stem cells available to use in different conditions including embryonic stem cells, mesenchymal stem cells (ex. bone marrow and umbilical cord stem cells), hematopoietic stem cells, neural stem cells, as well as many other sources (8).

However, when looking at other similar neurodevelopmental disorders and at different stem cell therapy trials, the most feasible and safely-used stem cells that have been used and tested in autistic people and other neurological conditions include umbilical cord-derived samples, both cord blood and cord tissue, and bone marrow stem cells. These two types provide the best results with the lowest possible side effects (8, 9).

We have also tested and published an article on the better efficacy of using both types of umbilical cord samples, umbilical cord mesenchymal cells and umbilical cord blood/hematopoietic cells, concomitantly – while maintaining safe administration (11). These results have contributed to establishing our current method of dual-type stem cell administration.

At Beike Biotechnology, we use umbilical cord stem cells for autism, both umbilical cord-related mesenchymal and blood/hematopoietic samples donated from healthy mothers after a normal birth. As previously mentioned, this concomitant administration of both types of stem cells provides better results (11).

Autism is generally diagnosed at around 3 to 4 years of age. Most studies assessing the efficacy of stem cell therapy had patients starting from the age of 3 – with no reported age-specific side effects (8, 9, 10). Additionally, human brains continue developing even after birth until early childhood; and it has been proven that early intervention in different neurodevelopmental conditions – including autism – was associated with better outcomes and quality of life. Therefore, we generally recommend undergoing the procedure during early school age (3-7 years) to allow for the best results.

Clinical benefit is not 100% guaranteed as is the case with any intervention, and consulting our specialists prior to undergoing the procedure is of utmost importance in order to gain more insight on the procedure.

No treatment is without complications, and stem cell therapy is the same. However, despite its novelty, stem cell therapy has limited side effects, if used properly, with comparable general side effects to those experienced with regular blood transfusion or foreign organ transplantation (ex. allergic reactions, cell rejection, or fever). Other side effects that have been specifically reported in clinical trials testing stem cell therapy in autism include:

• Headaches
• Pain at site of injection
• Gastrointestinal disturbances including nausea and/or vomiting
• Seizures
• Initial increase in the degree of hyperactivity for the first three months following stem cell therapy

However, none of these side effects reported were life-threatening or had life-long consequences, and they were easily managed medically at the time of their occurrence.

Below is a summary of the factors that might affect your response to stem cell therapy, and how we at Beike Biotechnology address each factor to ensure that we provide you with the highest efficacy using the safest procedure possible.

• Dose/Number of stem cells: The higher the dose of stem cells – within limits of course – the better the response. At Beike Biotechnology, we administer an optimum dose of around 120-280 Million Cells (depending on the child’s weight) for autism.
• Route/Method of administration: Studies have shown that intrathecal injection (through lumbar puncture directly within the brain’s CSF) provides better response than the traditional intravenous route (which causes stem cells to go to other organs than the brain before reaching the brain). At Beike Biotechnology, we use both intravenous and intrathecal routes concomitantly in order to obtain the maximal efficacy; while ensuring the least possible side effects or toxicity.
• Type of Stem Cells used: As previously mentioned, both umbilical cord-based stem cells, which we use at Beike Biotechnology, and bone marrow stem cells have better-proven efficacy in autism compared to other types of stem cells.
• Timing of stem cell transplantation: Early intervention is crucial for people with different neurodevelopmental disorders – including autism. Therefore, we recommend early intervention during early school years (around 3 to 7 years old).
• Follow-up Time: Significant benefits from stem cell therapy begin appearing around three months after stem cell therapy, and most people reach their full potential around 6-12 months after treatment. At Beike Technology, even after discharge, we provide you with a full follow-up program beginning as early as one month and up to one year after transplantation. You have complete access to our professional team even after you leave our center.

• The optimal age range for starting stem cell treatment for autism is not definitively established, but early childhood, typically starting between the ages of 2 and 5 brings the best results.
• There is no proven upper age limit for starting stem cell treatment as it remains experimental for all age groups.
• Older children may still benefit from improved social interaction, communication, and behavioral regulation, though research is ongoing.

Stem cell therapy for autism utilizes stem cells’ regenerative and modulatory abilities to address the neurological and immune factors associated with autism.

Stem cells, primarily derived from umbilical cord blood, are pluripotent, meaning they can develop into different cell types, including neurons. The therapy aims to:

• Replace damaged neurons: Stem cells differentiate into neurons, potentially repairing neurological damage.
• Reduce brain inflammation: Stem cells modulate immune responses, reducing inflammation believed to contribute to autism.
• Improve brain connectivity: Enhanced nutrient uptake and neurovascularization promote better brain function, aiding improvements in behavior and cognition.

Clinical studies suggest improvements in areas like social interaction, communication, hyperactivity, and mood regulation, though results are varied. Research is ongoing to fully understand the therapy’s efficacy and safety.

There is no evidence that vaccines cause autism, but there is growing evidence that autism is not only a genetic/hereditary condition but in fact, can be brought on by environmental factors. For example, bisphenol A exposure is currently being studied to determine its impact as a causative factor in Autism (12).