Maternal infection and immune involvement in autism
Open accessAbstract
Recent studies have highlighted a connection between infection during pregnancy and the increased risk of autism in the offspring. Parallel studies of cerebral spinal fluid, blood and postmortem brains reveal an ongoing, hyper-responsive inflammatory-like state in many young as well as adult autism subjects. There are also indications of gastrointestinal problems in at least a subset of autistic children. Work on the maternal infection risk factor using animal models indicates that aspects of brain and peripheral immune dysregulation can begin during fetal development and continue through adulthood. The offspring of infected or immune-activated dams also display cardinal behavioral features of autism, as well as neuropathology consistent with that seen in human autism. These rodent models are proving useful for the study of pathogenesis and gene-environment interactions as well as for the exploration of potential therapeutic strategies.
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There is substantial evidence that the immune response alters the development of the CNS during fetal life.
“There is substantial evidence that the immune response alters the development of the CNS during fetal life8, 9”
From Elevated maternal C-reactive protein and autism in a national birth cohort (2014) · cites this paper as [8]
Prenatal infection and immune dysfunction are biologically plausible potential causes of autism.
“Prenatal infection and immune dysfunction are biologically plausible potential causes of autism7, 8.”
From Elevated maternal C-reactive protein and autism in a national birth cohort (2014) · cites this paper as [8]
Maternal inflammation may represent a pathway by which infectious and other insults may give rise to neurodevelopmental disorders.
“it has been proposed that maternal inflammation may represent a pathway by which infectious and other insults may give rise to neurodevelopmental disorders8, 10.”
From Elevated maternal C-reactive protein and autism in a national birth cohort (2014) · cites this paper as [8]
Numerous animal studies demonstrate that prenatal or early postnatal infections can result in both acute and persistent neurological and behavioral abnormalities in offspring resembling autistic traits or schizophrenia.
“Numerous animal studies demonstrate that prenatal or early postnatal infections can result in both acute and persistent neurological and behavioral abnormalities in offspring resembling autistic traits or schizophrenia (Asp et al., 2009; Meyer et al., 2007; Patterson, 2011).”
From Maternal hospitalization with infection during pregnancy and risk of autism spectrum disorders (2015) · cites this paper as Patterson, 2011
ASD incidence increased from 0.05% to 8-13% in children of mothers exposed to the 1964 rubella pandemic during pregnancy.
“ASD incidence increased from 0.05% to 8–13% in children of mothers that were exposed to the 1964 rubella pandemic during pregnancy85–87.”
From Immune mediators in the brain and peripheral tissues in autism spectrum disorder (2015) · cites this paper as [85]
These data provide support for a mechanistic connection for viral-infection hypotheses for autism with neural over-growth hypotheses through the novel identification of exaggerated M2 activation states in autism brain tissue.
“These data provide support for a mechanistic connection for viral-infection hypotheses30 for autism with neural over-growth hypotheses31 through the novel identification of exaggerated M2 activation states in autism brain tissue.”
From Transcriptome analysis reveals dysregulation of innate immune response genes and neuronal activity-dependent genes in autism (2014) · cites this paper as [30]
A well-established non-genetic model system for studying ASD pathophysiology is the prenatal maternal immune activation (MIA) model.
“A well-established non-genetic model system for studying ASD pathophysiology is the prenatal maternal immune activation (MIA) model [114–116].”
From The ASD Living Biology: from cell proliferation to clinical phenotype (2019) · cites this paper as [114]
MIA can be induced experimentally via immunogens such as polyinosinic-polycytidylic acid (poly(I:C)) and lipopolysaccharide (LPS).
“MIA can be induced experimentally via immunogens, such as polyinosinic-polycytidylic acid (poly(I:C)) and lipopolysaccharide (LPS).”
From Maternal immune activation dysregulation of the fetal brain transcriptome and relevance to the pathophysiology of autism spectrum disorder (2018) · cites this paper as [28]
MIA-induced disruption may work in a manner similar in directionality to rare highly penetrant ASD mutations, and may act as 'priming' or fetal programming mechanisms that enhance risk of later developing ASD.
“MIA-induced disruption may work in a manner similar in directionality to rare highly penetrant ASD mutations, and may act as ‘priming’27, 28, 29, 30 or fetal programming21, 22 mechanisms that enhance risk of later developing ASD.”
From Maternal immune activation dysregulation of the fetal brain transcriptome and relevance to the pathophysiology of autism spectrum disorder (2018) · cites this paper as [28]
Infections during pregnancy are correlated with increased frequency of neurodevelopmental disorders in offspring.
“Prior literature has substantiated that infections during pregnancy have been correlated with increased frequency of neurodevelopmental disorders in offspring [16, 17, 76–78].”
From Gut microbiota changes in children with autism spectrum disorder: a systematic review (2020) · cites this paper as [76]
There is an association between ASD and maternal infection requiring hospitalization during pregnancy.
“Specifically, there is an association between ASD and maternal infection requiring hospitalization during pregnancy, elevated C-reactive protein, and a family history of autoimmune diseases.”
From Gut microbiota changes in children with autism spectrum disorder: a systematic review (2020) · cites this paper as [76]
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- Authors
- Patterson, P. H.
- Affiliations
- California Institute of Technology (US)
- Corresponding author
- Patterson, Paul H.
- ORCID
- Patterson, Paul H.
- Venue
- Trends in Molecular Medicine
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 17
- Issue
- 7
- Pages
- 389-394
- ISSN
- 1471-4914 (ISSN-L)
- PMC
- PMC3135697
- OpenAlex
- W2100463268
- Cited by
- 520
- References
- 46
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 25 · 2023: 20 · 2022: 37 · 2021: 30 · 2020: 46 · 2019: 41 · 2018: 49 · 2017: 43 · 2016: 41 · 2015: 40 · 2014: 35 · 2013: 49 · 2012: 31
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Trends in Molecular Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- CaltechAUTHORS (California Institute of Technology) (submittedVersion)
- Funders
- Autism Speaks (AS1606)
- National Institute of Mental Health (R01MH086781)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- autism spectrum disorder, maternal infection, prenatal infection, immune dysregulation, neuroinflammation, gastrointestinal problems, animal models of autism, gene-environment interaction, autism pathogenesis, maternal immune activation
- MeSH terms
- Animals, Autistic Disorder, Brain, Disease Models, Animal, Female, Humans, Phenotype, Pregnancy, Pregnancy Complications, Infectious, Prenatal Exposure Delayed Effects, Risk Factors, Autoimmunity, Gastrointestinal Tract, Fetal Development, Gene-Environment Interaction
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