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3748 The Interaction of Environment and Genetics in Autism: Support for A Biomedical Approach


Friday, July 11, 2008: 1:45 PM-3:00 PM
Sun Ballroom B (Gaylord Palms Resort & Convention Center)
The incidence of autism has skyrocketed in the last 20 years. Once thought to be a purely genetic disorder, there is much recent evidence to support the premise that autism spectrum disorders arise at a nexus of environmental and genetic influences. Behavioral and educational interventions, along with nutritional and pharmacologic modulation of genetic expression, coupled with limitation of environmental exposures and individualized approaches to detoxification, can result in significant clinical improvements, and in some cases, even recovery. In the world’s industrialized, developed nations, epidemics of malnutrition, as well as the common childhood infectious illnesses, are almost a thing of the past, due primarily to the technological advances of our industrial era.  However, we are in the midst of a group of new childhood epidemics, which are directly related to this same industrialism, and to its associated pollution, environmental degradation, and toxicity.  One set of epidemics has, unfortunately, been replaced by another.  The incidence of autism has skyrocketed in the last 20 years.
 Once thought to be a purely genetic disorder, there is much recent evidence to support the premise that autism spectrum disorders arise at a nexus of environmental and genetic influences.  Environmental triggers in concert with genetic predispositions produce the phenotype (i.e., physical expression of signs and symptoms) that we refer to as the autism spectrum disorders. 
The primary underlying genetic vulnerability appears to be, in many children, an impaired ability to detoxify, which has left them unable to cope with the increasing toxicity to which they are exposed.  These environmental factors include heavy metals and chemical toxins, which, especially in the case of a child with an impaired ability to detoxify, can cause skewing of the immune system and create metabolic imbalances.  Many of these chemicals and heavy metals are neurotoxic, as well as toxic to the immune system.  Furthermore, recent information indicates that there is a phenomenon of synergistic toxicity among heavy metals and toxic chemicals.  This destructive synergy can cause serious problems, even when the threshold levels of individual toxins have not been exceeded.
Chronic inflammation is another primary causative factor that appears to underlie the new childhood epidemic of autism.  This inflammation occurs via a cascade of biological processes.  First, impaired detoxification leads to an overload of toxins in the body, and these excess toxins can then lead to oxidative stress, and to chronic inflammatory conditions.  In autism, there is ample evidence of increased oxidative stress and chronic inflammation, which negatively impacts not only the neurological system, but the gastrointestinal and immune systems as well.
The key to resolving inflammation, in an integrative approach, is to discover and remediate the root cause – not simply to treat its symptoms.  The driving force may be underlying infections, allergies or sensitivities to foods and inhalants, or it may be exposure to toxic heavy metals and chemicals.  These factors, frequently in combination, often underlie and contribute to chronic inflammation.  Therefore, they must be eliminated, or at least decreased.
Gastrointestinal issues of dysbiosis and hyperpermeability must also be resolved, because they can cause not only local inflammation in the gastrointestinal tract, but may also cause inflammation and allergies in distant sites.
To effectively overcome the inflammation, nutritional deficiencies, immune dysfunction, and the other disparate factors that often result in a diagnosis of autism, a comprehensive treatment program must be initiated.  This biomedical treatment program consists of four primary elements: reduction or (when possible) elimination of exposure to environmental toxins, dietary modification, nutritional supplementation and detoxification. 
Used in concert with appropriate educational and behavioral interventions, this treatment approach yields distinct long-term benefits for children with autism spectrum disorders as they grow into adulthood, and in a growing number of affected children, this program has led to recovery from autism spectrum disorders.   Although it appears that younger children respond more rapidly and fully to these biomedical interventions, it is encouraging to note that significant clinical improvements and/or lifestyle enhancements have also been seen in adolescents and adults.    

Learning Objectives:

  • Understand etiologies that may underlie autism spectrum disorders, which include environmental insults, such as toxins (including heavy metals and chemicals), genetic susceptibility, metabolic imbalances, allergies, sensitivities, immune dysregulation and chronic infection.
  • Understand the key roles that chronic inflammation and oxidative stress play in autism spectrum disorders.
  • Learn a multifaceted integrative biomedical treatment program for remediating autism spectrum disorders, utilizing modalities including environmental controls, dietary modifications, nutritional supplementation and detoxification.

Content Area: Medicine and Research

Presenter:

Kenneth A. Bock, M.D., FAAFP, FACN, CNS
Co-founder and Co-director
Rhinebeck Health Center

Kenneth A. Bock, M.D., received his medical degree with Honor in 1979. He is the author of Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies. Dr. Bock’s Healing Program is at the vanguard of the new biomedical approach to the treatment of children affected by autism spectrum disorders.