Brief Report: “Allergic Symptoms” in Children with Autism Spectrum Disorders. More than Meets the Eye?

Asimenia Angelidou, Konstantinos-Dionysios Alysandratos, Shahrzad Asadi, Bodi Zhang, Konstantinos Francis, Magdalini Vasiadi, Dimitrios Kalogeromitros, Theoharis C. Theoharides

Many children with Autism Spectrum Disorders (ASD) have either family and/or personal history of "allergic symptomatology", often in the absence of positive skin or RAST tests. These symptoms may suggest mast cell activation by non-allergic triggers. Moreover, children with mastocytosis or mast cell activation syndrome (MCAS), a spectrum of rare diseases characterized by increased number of activated mast cells in many organs, appear to have ASD at a rate tenfold higher (1/10 children) than that of the general population (1/100 children). Mast cell activation by allergic, infectious, environmental and stress-related triggers, especially perinatally, would release pro-inflammatory and neurotoxic molecules. We speculate these could disrupt the gut-blood-brain barriers, thus contributing to brain inflammation and ASD pathogenesis. Increased mast cell responsiveness may define at least a subgroup of ASD subjects, who could benefit from inhibition of mast cell activation.