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Diagnosis Autism: Now what do I do?
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Chair of Cure Autism Now Scientific Advisory Board
Discovers Heritable Risk Factor for Autism
A study of 743 families, including the AGRE
collection, suggests that a common variant in the MET
gene may double the chance of developing autism
By Vlad Kustanovich, Ph.D.
Reporting in the current issue of the Proceedings of
National Academy of Science, an international team of
scientists led by Pat Levitt, Ph.D., chair of the Cure
Autism Now Scientific Advisory Board, has identified a
functional genetic variant significantly associated
with autism, which appears to double the risk for
autism and may explain some of the ancillary symptoms
associated with the disorder. The group of scientists
examined a gene called MET tyrosine kinase and found a
strong association between autism and a variant of the
gene that appears to result in a decreased production
of the protein it encodes.
Dr. Levitt, director of the Vanderbilt Kennedy Center
and a developmental neurobiologist, and Dr. Daniel
Campbell, a research associate in his laboratory, have
spent the last several years studying the role of the
MET gene in brain development. The team had previously
reported that mice having reduced levels of the gene
had anatomical abnormalities in the cerebellum and
cerebral cortex, and suffered from intermittent
seizures. Behaviorally, the mice showed signs of
increased anxiety as well as deficits in social
interactions. As all of these features are reminiscent
of the pathophysiology of autism, Dr. Levitt suspected
that MET may somehow be involved in autism. Moreover,
the MET gene is located on chromosome 7 in a genetic
region previously linked to autism. Yet, to Dr.
Levitt’s astonishment, MET had never been studied as a
potential candidate gene underlying autism
susceptibility.
“From our previous studies, MET seemed like a great
biological candidate for involvement in autism,”
explains Dr. Levitt. “What was intriguing to us was
the fact that the MET signaling protein, made by the
MET gene, is known to participate in immune system
regulation and gastrointestinal repair as well, so we
found it interesting that a significant number of
children with autism have reported symptoms related to
chronic gut and bladder control and frequent
infections and allergies. We recognized that it was a
bit unusual to think about a gene that participates in
several important biological processes, rather than
just brain development. We also realized that many
geneticists probably skipped over doing detailed
analysis of the gene because MET actually is
implicated in certain types of cancer as well.”
In an initial screen the research team examined the
association of autism and the MET gene in 243 families
by looking at how often specific variants of the gene
were passed through the generations from parents to
their affected children. In theory, there should be no
bias in which form of the MET gene gets passed down
from parents to their children. However, if a
particular form gets passed to affected individuals
significantly more often than another, an association
is thought to be present. In this way, a significant
association was found between one specific form of the
MET gene and autism. The researchers were then able to
confirm these findings using 500 families from the
Cure Autism Now Autism Genetic Resource Exchange
(AGRE) collection, determining that the association
especially holds true in families with more than one
affected child. Their analyses revealed that
individuals with two copies of this specific MET gene
variant ultimately have more than a two-fold increased
likelihood of developing autism.
Having identified the association with a particular
DNA change in the MET gene, the research group was
interested in finding out if the DNA change had any
functional consequence. The DNA change was located in
a region typically involved in the regulation of gene
expression, called the “promoter” region, which
controls the amount of the gene that is produced and
turned into protein. The research team was able to
determine that the gene variant associated with autism
resulted in the production of less than half the
amount of MET protein. Thus, the DNA change influences
how much of the MET gene is made, suggesting that
individuals who inherit the autism-associated form of
the MET gene may ultimately have less MET protein
signaling. Finally, it is known that certain types of
“regulatory” proteins can stick to the promoter part
of the gene to turn the gene “on” or “off”. Dr.
Levitt’s team went on to demonstrate that the
decreased MET gene expression is due to a reduction in
the ability of the regulatory proteins to bind to the
promoter of the autism-associated variant and turn it
“on”.
Although other candidate genes have been associated
with autism, the vulnerability imparted by the gene
variant described by Dr. Levitt’s team is greater than
that of any of the other genes so far associated with
autism. It is also one of the first to have an obvious
functional consequence, which can now be studied in
detail to understand its biological impact. However,
as Dr. Levitt notes, “This is a very common genetic
variant. Approximately 47% of the population carries
it, which means that inheriting this particular form
of the MET gene does not in itself cause autism. We
are now in a position to identify further risk
factors, genetic or environmental, that cooperate with
MET to trigger autism. For example, we would like to
know whether carrying the ‘at-risk’ form of the MET
gene makes one more susceptible to certain kinds of
environmental factors that may be part of the trigger
for autism. Because we know that autism is a highly
inherited disorder, doing studies on environmental
factors without considering genetic risk is less
likely to yield the kind of critical information that
might help get us closer to causes of autism.”
In this elegant set of experiments, Dr. Levitt and his
colleagues have demonstrated that a specific DNA
change in the MET gene acts as a heritable risk factor
that contributes to autism susceptibility. Although
having this specific form of MET is not diagnostic nor
predictive, it may help screen for individuals at-risk
for developing autism, especially in families in which
there are already affected individuals. Most
importantly, identifying a specific gene, especially a
functional variant of that gene, provides clues to the
critical cellular pathways that may be involved in
causing autism, but have so far been difficult to
uncover. For those already afflicted, an understanding
of the affected biology will allow us to design
treatments that can compensate for the disrupted
biochemical pathways, such as those that could be
involved with MET protein signaling. The MET gene will
now be placed into models of how autism may develop,
given both the alterations in brain development and
the ancillary symptoms in some children with autism,
such as potential digestive system sensitivities and
hyperimmune status. Future analyses will focus on
other candidate genes that are involved in MET
function and that are also located at chromosomal “hot
spots” for autism, the construction of a mouse model
to more accurately determine the biological effects of
carrying this specific MET variant, and identification
of further risk factors that synergize with its
inheritance.
Dr. Levitt has served as the Chair of the Cure Autism
Now Scientific Advisory Board for the past four years,
and has been a strong supporter of Cure Autism Now for
many more. Cure Autism Now wishes to publicly
congratulate Dr. Levitt on his research, as well as on
his recent appointment by the U.S. Department of
Health and Human Services to the National Advisory
Mental Health Council. The work described in this
article was supported by the National Institute of
Mental Health, National Institute of Child Health and
Human Development, the Marino Autism Institute,
Telethon-Italy, Cure Autism Now (Dr. Persico only),
National Alliance for Autism Research, The Foundation
Jerome Lejeune, and National Alliance for Research on
Schizophrenia and Depression.
Books/Resources:
Evidence of Harm : Mercury in Vaccines and the Autism Epidemic: A Medical Controversy
by David Kirby
Unraveling the Mystery of Autism and Pervasive Developmental Disorder : A Mother's Story of Research & Recovery
by Karyn Seroussi
The Autism Sourcebook: Everything You Need to Know About Diagnosis, Treatment, Coping and Healing
by Karen Siff Exkorn
Children with Starving Brains: A Medical Treatment Guide for Autsim Spectrum Disorder
by Jacquelyn McCandless
Autism: Effective Biomedical Treatments
by Sidney Barker, MD and Jon Pangborn, PhD
A Parents Guide to Asperger Syndrome and High Functioning Autism
By Ozonoff, Dawson and McPartland, PhDs
A Real Boy : A True Story of Autism, Early Intervention, and Recovery
by Christina Adam
Son Rise: The Miracle Continues
by Barry Neil Kaufman
When the Brain Can't Hear
Teri James Bellis, PhD
Emergence, Labled Autsitic: A True Story
by Temple Grandin, PhD
Thinking In Pictures : and Other Reports from My Life with Autism
by Temple Grandi
Social Skills Training: For Children with Asperger Syndrome and Social Communication Problems
by Jed Baker, PhD.
Educating Children with Autism
National Academic Press
Facing Autism : Giving Parents Reasons for Hope and Guidance for Help
by Lynn M. Hamilton
The Out-of-Sync Child: Recognizing and Coping with Sensory Integration Dysfunction by Carol Stock
Kranowit
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