Dear Professor Winston

My question is not related to IVF or fertility but to ask your expert opinion on stem cell therapy and autism. As a mother of an profoundly autistic son I’m frustrated about the lack of support and treatment of this condition. I would like your expert opinion on this issue and available options for the treatment. I had a traumatic pregnancy and labour, baby was small is there a co relation? H

Reply…

Dear H,

As I know you appreciate, this website is not really designed to answer queries not concerned with infertility, so I am not in a position to give you definitive advice about autism or its treatment. However, I really sympathise with what you face. Stem cell research is indeed a key area of research which the Genesis Research Trust undertakes. Also, as autism is likely to be a problem related in some way to early human development, and it is the intention of the trust to set up an important new professorial chair with a research base at Imperial College looking at problems related to this, let me give a brief answer.

The diagnosis of autism involves a wide range of possible disorders. One problem in making any diagnosis is establishing a clear understanding of what the features of this condition are, and how they vary from individual to individual. And sadly, when there is such a wide range of ill-defined features of any medical condition, no one medical treatment is likely to be really useful. Because we are such a long way from defining what we mean by ‘autism’ we are still a long way from effective treatments in many cases. There is a UK charity (www.researchautism.net) which may give you further information and also the Autism Society (www.autism.org.uk) which may be able to offer you more help, particularly about your son’s condition.

You ask whether there was any cause associated with your pregnancy, birth or delivery of your son. This is highly relevant to our research and to this important new professorial team we are establishing. Whilst there are no real clues in what you say about your own particular case, they are strong pointers which suggest some environmental influence before or during pregnancy may increase the likelihood of conditions like autism and we believe that this is such an important area for the future that we aim to raise £2 – 3 million pounds to support this kind of research through this unique professorship.

With regard to stem cell treatment, at the moment it seems rather unlikely there it is going to be great breakthrough with stem cells in autistic children in the foreseeable future. Two broad strategies have been tried – one is to inject bone marrow stem cells (or similar cells) into people with autism into the blood stream – in the hope they will affect brain function eventually. There are reports that autistic symptoms were improved, but these trials have not been properly controlled and long-term results are not reported. Frankly I am very sceptical that the evidence is good that these cells led to any kind of ‘repair’ of brain tissue in such cases. Also the treatment may not be without considerable risk and I certainly would not encourage one of my family to try this highly experimental treatment. The other strategy which seem even more risky is the injection of cells directly into the fluid around the spinal cord in the hope they will migrate to the brain. As far as I am aware, this has been tried in one or two individuals only and it is unclear whether there was really any benefit.

I am sorry not to give you more positive information but it is important that charities like our are supported. Better diagnosis and treatment of these demanding conditions which affect so many many children is urgently needed.

My best wishes
Robert Winston

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