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Abstract This study was designed to investigate serum levels of positivity for serum antiganglioside antibodies (anti- GM1) as an index for autoimmunity to brain in autistic children and their relation to some disease characteristics such as (autistic severity, family history of autoimmunity, allergic manifestations, mental retardation and EEG abnormalities). For this purpose, 40 autistic children aged 4-10 years diagnosed according to DSM-IV behavioral descriptors for PDDS were studied in comparison to 40 healthy aged and sex matched control children. According to CARS, autistic children were subdivided into 2 groups; group I included 24 children with mild to moderate autism, and group II included 16 children with severe autism. Besides clinical and neuropsychiatric evaluation, the following investigations were performed: assessment of intellectual function, serum anti-GM1 IgG and IgM antibodies (ELISA) and measurement of brain electrical activity of EEG. Autistic children had significantly higher serum levels of anti-GM1 IgG and IgM antibodies than healthy controls. In addition, 50% and 40% of autistic children were seropositive for anti-GM1 IgG and IgM antibodies, respectively. Children with severe autism had significantly higher serum anti-GM1 IgG and IgM antibodies than children with Summary and Conclusion 126 mild to moderate autism. In addition, both antibodies had significant positive correlations to CARS. Furthermore, female autistic children had significantly higher serum levels of anti-GM1 IgG and IgM antibodies than male autistic ones. Eighteen autistic children (45%) had a first or a second degree relative with an autoimmune disease. On the other hand, a positive family history of autoimmune disease was found in only 4 healthy children (10%). The frequency of autoimmune disease in families of children with autism was significantly higher than normal children. Autistic children with a family history of autoimmune disease had significantly higher serum anti-GM1 IgG and IgM antibodies than those without such a history. Allergic manifestations were found in 15 autistic children (37.5%). This percentage was significantly higher than that of healthy controls (4/40: 10%). Autistic children with allergic manifestations had significantly higher serum anti-GM1 IgG and IgM antibodies levels than those without such manifestations. Twelve autistic children (30%) had autistic regression i.e., they underwent regression in language and skills after a period of normal development. Children with autistic regression had significantly higher serum anti-GM1 IgG and IgM levels than children without autistic regression. Summary and Conclusion 127 Eight autistic children (20%) where macrocephaliec. The remaining 32 autistic children had normal skull circumference. Macrocephaliec autistic children also had significantly higher serum anti-GM1 IgG and IgM antibodies levels than children with normal skull circumference. Thirteen autistic children (32.5%) had EEG abnormalities. Autistic children with such abnormalities had significantly higher serum values of anti-GM1 IgG and IgM antibodies than those with normal EEG. In conclusion, 52.5% of autistic children were seropositive for anti-GM1 IgG and/or IgM antibodies. In addition, seropositivity for these antibodies had a significant positive associations with a family history of autoimmunity and important disease characteristics, in term of disease severity, autistic regression, macrocephaly, mental retardation and EEG abnormalities. Therefore, studies considering the role of immunotherapy including oral tolerance with GM1 as an autoantigen on amelioration of autistic symptoms by inducing immunosuppression in anti-GM1 positive subgroup of autistic children are recommended. Therefore, studies considering the role of immunotherapy including oral tolerance with GM1 as an autoantigen on amelioration of autistic symptoms by inducing immunosuppression in anti-GM1 positive subgroup of autistic children are recommended. |