Tuesday, February 16, 2010

Hormone-infused nasal spray found to help people with autism

By Rob Stein
Washington Post Staff Writer
Tuesday, February 16, 2010; A02

A nasal spray containing a hormone that is known to make women more maternal and men less shy apparently can help those with autism make eye contact and interact better with others, according to a provocative study released Monday.

The study, involving 13 adults with either a high-functioning form of autism or Asperger syndrome, a mild form of the disorder, found that when the subjects inhaled the hormone oxytocin, they scored significantly better on a test that involved recognizing faces and performed much better in a game that involved tossing a ball with others.

Although more research is needed to confirm and explore the findings, the results are the latest in a growing body of evidence indicating that the hormone could lead to ways to help people with the often devastating brain disorder function better.

"This is the first study that looked at whether oxytocin has an effect on social behavior, which is a major deficit in autism," said Angela Sirigu, who directs the National Center for Scientific Research in France and led the study, published online by the Proceedings of the National Academy of Sciences. "It looks like it could be very helpful."

Researchers who were not involved in the study praised the work, saying the findings were promising and could lead to the first effective treatment for the central problems affecting people with autism.

"I think it's going to be a very exciting finding for a lot of people," said Alex Martin, chief of cognitive neuropsychology at the National Institute of Mental Health.

Because oxytocin does not last long in the body and produces its effects for a relatively brief period, some experts said the findings were more likely to encourage drug companies to develop alternative substances that had the same benefits.

"This paper suggests that's worth doing," said Thomas R. Insel, director of the institute. "It adds another brick in the wall that suggests there may be an opportunity to develop treatment for one of the core symptoms of autism. That's been the brass ring."

But Sirigu was among those who said the finding should encourage more research on the potential benefits of oxytocin itself, especially for children. Administering the hormone soon after a child's autism is diagnosed might help him or her develop more normally, she said.

"It's possible it can become a cure, if it's given early when the problems are detected in the little kids," Sirigu said. "We can change the way these patients interact with people from childhood."

Because previous research has indicated that some people with autism might have abnormally low levels of oxytocin, conducting tests to identify those people and administering them the hormone might help as well, said Karen Parker, an assistant professor of psychiatry at Stanford University School of Medicine.

"If you can find someone who appears to have deficits in oxytocin biology, giving them what you might argue would be replacement oxytocin may be helpful," Parker said.

Autism is a baffling disorder that can cause a variety of symptoms, including speech and learning problems and profound, disabling difficulties understanding emotions and social cues when interacting with people. The number of children found to have autism has been increasing for reasons that remain mysterious.

Oxytocin is produced naturally in the bodies of humans and animals. It plays a key role in social interaction, promoting maternal behavior and monogamy in animals. The hormone also heightens social sensitivity, social awareness, generosity and trust in people.

Previous U.S. studies found that people with autism who received the hormone intravenously were less likely to engage in repetitive behavior that is another hallmark of autism and were more likely to be able to identify emotions in voices. Another study being published in the journal Biological Psychiatry found that 16 autistic males in Australia ages 12 to 19 who received the hormone through a nasal spray were better able to recognize other people's facial expressions.

"All the data seem to suggest that manipulating the oxytocin system has a powerful effect on the core symptoms of autism," said Eric Hollander, director of the compulsive, impulsive and autism spectrum disorders program at the Montefiore Medical Center in New York.

While cautioning that more research is needed on children and additional patients to make sure oxytocin is safe and effective, advocates for families with children with autism welcomed the findings. Oxytocin has been in use for several years as an "alternative" therapy for autism.

"Many families are using it with success and reporting improvement," said Wendy Fournier, president of the National Autism Association. "Getting double-blind clinical studies like this one published helps to bring credibility to parental reports."

"We need to be mindful of the fact that the majority of human studies of oxytocin have been conducted using adults, including this study, and only one paper has included individuals between the ages of 12 and 18. We have to be careful about the safety and efficacy of oxytocin on pediatric populations," said Clara Lajonchere, vice president of clinical programs for Autism Speaks.

Research points to link between low vitamin D, mortality

A new study shows that people with higher levels of the vitamin D were less likely to die from a a variety of causes - including cardiovascular disease, the No. 1 killer of Canadians - following an eight-year study.

BY CANWEST NEWS SERVICEJUNE 23, 2008


In the latest run of good news for vitamin D comes a new study showing that people with higher levels of the “sunshine” vitamin were less likely to die from any cause - including cardiovascular disease, the No. 1 killer of Canadians - after eight years of tracking.

The finding held even when researchers took coronary artery disease, exercise and other factors into account.

Low vitamin D levels “can be considered a strong risk indicator for all-cause mortality in women and in men,” researchers report Tuesday in the journal Archives of Internal Medicine.

By the time the paper had been accepted for publication, the team had dug deeper and found low vitamin D status “had other significant negative effects in terms of incidence of cancer, stroke, sudden cardiac death and death of heart failure,” lead author Dr. Harald Dobnig, of the Medical University of Graz in Austria, said in an e-mail.

It’s still not “ultimate proof” of the harmful effects of too little vitamin D, he says. “But the evidence is just becoming overwhelming at this point.”

Researchers can’t rule out that sicker patients had lower vitamin D levels and, therefore, were already at an increased risk of dying to begin with.

But, “this was not a bedridden, immobile or very sick population that we studied,” Dobnig says. People with an acute illness other than cardiac disease were excluded from the study.

“Low levels of vitamin D may carry a potential health risk,” Dobnig says. “Physicians should be aware of the widespread problem of low vitamin D status.”

He says those at high risk for vitamin D deficiency - including the elderly, nursing home residents and people who work night shifts or spend a lot of time indoors - should take 800 international units of vitamin D3 daily. “Whether we can go to higher (or even much higher) doses is unclear at the moment.”

About 50 to 60 per cent of older adults in North America are low in vitamin D, and it also seems to be a widespread problem in children as well.

In the past year, studies have linked low vitamin D to an increased risk of cancers, notably breast, colon and endometrial cancers, as well as multiple sclerosis - a disease more common in northern countries. And, in back-to-back studies this month, researchers reported that men with too little vitamin D appear to be at increased risk of heart attacks, while colon cancer patients with abundant vitamin D were less likely to die during followup.

The new study is based on 3,258 consecutive patients scheduled for an angiogram - an X-ray to check for abnormalities in the arteries — at a medical centre in Germany between 1997 and 2000.

Before and after the test, their blood was measured for vitamin D3, and a compound called 25-hydroxyvitamin D, considered the best indicator of a person’s vitamin D status.

After an average followup of nearly eight years, 737 people (about 23 per cent) had died, including 463 who died of cardiovascular causes.

People who had 25-hydroxyvitamin D levels in the lower half of the vitamin D range were up to twice as likely to die during the followup period compared with those in the highest. Similar results were found in people with the lowest levels of vitamin D3.

Overall, two-thirds of the patients had coronary artery disease. But whether or not they had signs of congestive heart failure or artery disease, low levels of vitamin D were “always significantly associated” with a higher risk of death, Dobnig says.

People with low vitamin D had signs of inflammation and oxygen-related damage to cells, “which all points towards a higher vascular risk profile,” Dobnig says.

“This is the first study showing a significant association between serum (blood) vitamin D levels and risk of all-cause and cardiovascular mortality,” he says.

But it’s just that - an association, cautions Dr. Beth Abramson, a cardiologist at St. Michael’s Hospital in Toronto and spokeswoman for the Heart and Stroke Foundation.

People with higher vitamin D levels tended to be healthier and more fit. Rather than focus on a “trendy risk factor,” Abramson says Canadians should be aware of traditional risk factors for heart disease, such as high blood pressure, high cholesterol, smoking, diabetes and a family history of the disease.

Roughly 80 to 90 per cent of 25-hydroxyvitamin D is derived from exposure to sunlight, the rest from foods, such as fatty fish and eggs, Dobnig says. But in Canada, our bodies can’t make the vitamin under weak fall and winter sunlight, and experts say more research is needed about the amount of sunlight exposure needed to achieve the optimum vitamin D levels.

As well, sun exposure increases skin cancer risk. “Don’t sit and bake. There’s no evidence that’s helping you in the long run,” Abramson says.