Autism, a chronic condition believed to be incurable, is found to be responding better to stem cell therapy than other conventional treatments. The encouraging outcomes were reported by doctors as well as in clinical trials.

In children, autism is described as a neuro-developmental disorder that hinders the ability to communicate and affects the cognitive, emotional, and neuro-behavioural domains. Till now, symptoms of autism showed improvement through early intervention by special educators, occupational therapists and speech therapists, but the best results have come by administering stem cell therapy.

Dr. Kulkarni referred to the US’ Duke University clinical trials, which showed that among 25 children, aged between two to five years, more than two-thirds appeared to show improvements in speech, socialisation, and eye contact, as reported by parents and assessed by researchers. “Along with improvement in quality of life, functional independence was observed,” he says.

How does it work?

Dr. Alok Sharma, neurosurgeon from Mumbai, is one of the leading doctors, who has administered stem cell therapy for autistic children, has verified its merits. In this regard, he is one of the first people to publish papers on the subject.

"Stem cell is actually the origin of all cells. They have the potential to transform into other cell types. In case of autistic children, they have hypometabolism of a few cells in their brains. When these stem cells reach the brain, these cells which are functioning less get activated," said Dr. Sharma.

Pointing out that autism is caused by genetic, epigenetic and environmental factors leading to synaptic dysfunction and poor development of the neuronal system, Dr Kulkarni says that stem cell therapy concentrates on reversing the root cause by acting on the immune system as well as on neurogenesis of affected neuronal systems. Which is different from conventional methods of treatment where approach is symptomatic only and do not address the root cause of the disorder, he explains. He claims to have treated about 1200 patients, 90% of whom have shown dramatic improvements.

According to Dr Kulkarni, stem cells possess the hallmark property of differentiation into neuronal cell types. Especially, mesenchymal stem cells (MSCs) possess immune modulation properties, thereby correcting the course of the immune system in autism.

He says that MSCs could exert a positive effect in Autism Spectrum Disorder (ASD) through stimulation of repair in the damaged tissue. He gives the example of inflammatory bowel disease, where these cells help in synthesising and releasing anti-inflammatory cytokines and survival-promoting growth factors.

“These integrate into the existing neural and synaptic network and restore plasticity,” he adds. The other type of cells the doctor mentions is the hematopoietic stem cells (HSCs), which also play a significant role in controlling chronic inflammation in autism.

“Both MSCs and HSCs have the potential to migrate to the site of inflammation by the mechanism of paracrine action exerted by the affected cells or tissues. Pro-inflammatory molecules released in the case of ASD would be able to recruit HSCs to the sites of major inflammation processes, where these cells could exert their beneficial actions against inflammation,” he explains.

When should the treatment be considered

Dr. Alok Sharma has said that there aren't any hard and fast rules when a parent is considering this treatment for their child. However, there give a few pointers that a parent should keep in mind.

Autism is considered an irreversible life-long developmental disorder. So, conventional treatment suggests that early intervention (2 to 8 years) is the only way to improve the symptoms of the disorder. "In stem cell therapy it shows positive results in people aged between they are first diagnosed to 12 years of age and even beyond that till 20 years," he said. After 20 years of age, witnessing drastic positive results is less, he said.

The parents must inform the doctor about the child's medical history. Autistic children are predisposed to autoimmunity. So, if the child already has other auto-immune diseases, a treatment plan is prepared keeping these in mind.

Why this therapy?

Other drug therapies that are available for children with autism involves, anti-inflammatory agents, antibiotics and hyperbaric medicine. However, most of these fail to address the root causes of lack of oxygen in the brain and the gastrointestinal symptoms in autistic children.

Gastrointestinal symptoms are visible in children with Autism Spectrum Disorder (ASD). This clashes with other symptoms of ASD causing an overlap which is detrimental to the child. Administering stem cell therapy helps in reducing these gastrointestinal symptoms by reducing the incidence of diarrhoea, constipation and abdominal pain and improving the child's tolerability of food.

Stem cell therapy includes autologous (where the individual is a source) and allogenic stem cells. Allogenic stem cells are cells where an individual is not the same source and is treated to the requirement of individuals in need. Dr. Alok Sharma says that you should always prefer autologous stem cells as there are lesser chances of the body rejecting this.

He does not discard the importance of occupational therapy or speech therapy. However, he added that stem cell therapy works intrinsically and hence, it is effective. "Stem cell therapy along with rehabilitation using speech therapy and occupational therapy helps an autistic child," he said. He also added that following this therapy, a large number of autistic children were easily mainstreamed in conventional schools.

Availability & cost

Stem cells are readily available from sources such as bone marrow, peripheral blood, umbilical cord blood, perinatal tissues (chorion, cord tissue and placenta), adipose tissue and dental pulp. The doctor pointed out that stem cell therapy does not have any serious side-effect, neither does it involve any surgical procedure. “It, at the most, involves drawing of stem cells from the bone marrow and then injecting it in the child’s spinal canal,” he says.

The cost of stem cell therapy depends on the severity of the ailment and the number of doses. “Excluding hospitalisation and doctor charges, the treatment can cost between Rs 2 lakh and Rs 4 lakh,” Dr Kulkarni says. The number of visits to the hospital depends on the response of the patient to stem cell therapy. Generally, the doctor says, it would involve two to six visits and three to four months for progress to show. The treatment would also require the patient to follow up with occupational and speech therapists.

The stem cell procedure is already routine in countries such as the US, Germany, Italy, Austria, Finland, UK, Spain and Sweden, and has been in practice for a decade.