Approximately 1 in 88 children are diagnosed as being somewhere on the autism spectrum. One hypothesis about autism is that a hyperactive immune system results in elevated levels of inflammation and may contribute to the disorder. Approximately one third of those on the autism spectrum, slightly above placebo levels, show a clinical improvement in symptoms in response to a fever.

Eric Hollander MD, a professor at Albert Einstein College of Medicine in New York, discussed the effects of two novel treatment approaches that modify aspects of inflammation at the American College of Neuropsychopharmacology (ACNP) Annual Meeting: Using a hot bath to raise body temperature and thereby mimic the effects of infection - yes, the same premise as homeopathy - or using worm eggs to stimulate the production of immunoregulatory factors in the gut to diminish inflammatory signals. 

The small sample size and unusual treatment approach means that caution should be exercised when interpreting the studies.

Hollander
says fever may trigger the release of protective anti-inflammatory signals in the body, and so the effects of raising body temperature to mimic fever on ASD symptoms were assessed. It was found that children with ASD and a history of positive behavioral response to fever had improved social behaviors when bathed each day in a hot tub at 102 degrees Fahrenheit compared with water at 98 degrees. 

Second, adults with ASD were treated for 12 weeks with Trichuris suis ova (TSO), which are the eggs of the worm helminth trichura (whip worm). This worm is safe in humans as it does not multiply in the host, is not transmittable by contact, and is cleared spontaneously. However, the worms can inhibit immune-mediated responses and diminish inflammation.  

The subjects for this study were 10 high functioning ASD patients who were able to give informed consent and who had a history of allergies or a family history of immune-inflammatory illness. Patients were treated for 12 weeks with the worm eggs (2500 eggs every two weeks) but were also subjected to a 12 week placebo phase in a randomized order. It was found that adults with ASD had improvement in repetitive and ritualistic behaviors in response to treatment with the worm eggs.

Worm eggs have been used successfully to treat immune-related diseases in humans such as Crohn's Disease. As noted by Dr. Hollander, "TSO has been shown to improve various immune inflammatory illness by shifting the ratio of T regulator/T helper cells and their respective cytokines."

Hollander believes the findings support the idea that inflammation may contribute to the symptoms of autism, at least in some individuals, and highlight novel treatment approaches.  "Future studies in autism spectrum disorders are needed to replicate and expand these findings, and to study younger subjects with more severe irritability"