Autism Spectrum Disorder from the Womb to Adulthood: Suggestions for a Paradigm Shift

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Authors: Cristina Panisi, Franca Rosa Guerini, Provvidenza Maria Abruzzo, Federico Balzola, Pier Mario Biava, Alessandra Bolotta, Marco Brunero, Ernesto Burgio, Alberto Chiara, Mario Clerici, Luigi Croce, Carla Ferrer, Niccolò Giovannini, Alessandro Ghezzo, Enzo Grossi, Roberto Keller, Andrea Manzotti, Marina Marini, Lucia Migliore, Lucio Moderato, Davide Moscone, Michele Mussap, Antonia Parmeggiani, Valentina Pasin, Monica Perotti, Cristina Piras, Marina Saresella, Andrea Stoccoro, Tiziana Toso, Rosa Anna Vacca, David Vagni, Salvatore Vendemmia, Laura Villa, Pierluigi Politi , Vassilios Fanos
Journal: J. Pers. Med. 2021, 11(2), 70
The wide spectrum of unique needs and strengths of Autism Spectrum Disorders (ASD) is a challenge for the worldwide healthcare system. With the plethora of information from research, a common thread is required to conceptualize an exhaustive pathogenetic paradigm. The epidemiological and clinical findings in ASD cannot be explained by the traditional linear genetic model, hence the need to move towards a more fluid conception, integrating genetics, environment, and epigenetics as a whole. The embryo-fetal period and the first two years of life (the so-called ‘First 1000 Days’) are the crucial time window for neurodevelopment. In particular, the interplay and the vicious loop between immune activation, gut dysbiosis, and mitochondrial impairment/oxidative stress significantly affects neurodevelopment during pregnancy and undermines the health of ASD people throughout life. Consequently, the most effective intervention in ASD is expected by primary prevention aimed at pregnancy and at early control of the main effector molecular pathways. We will reason here on a comprehensive and exhaustive pathogenetic paradigm in ASD, viewed not just as a theoretical issue, but as a tool to provide suggestions for effective preventive strategies and personalized, dynamic (from womb to adulthood), systemic, and interdisciplinary healthcare approach.

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