Overview
Behavioral testing is the gold standard for diagnosing ASD. These tests, including ADOS and ADI-R, are subjective, require trained staff to administer, are time-consuming, and can only be administered at a later age. Blood-, urine- or stool-based diagnostic biomarker test for ASD would enable objective early diagnosis, potentially even before clinical symptoms are present, eliminate the need for trained staff and enable early intervention. Such a test would not only conserve money and time but would also provide clues to ASD pathogenesis.
Description
There is accumulating evidence that at least a subset of children diagnosed with ASD also have aberrant immune functions. This study will attempt to identify more specifically the nature of the potential immune abnormalities in children.
The study will follow a case-control design, involving the following cohorts:
- young children diagnosed with ASD
- young children diagnosed with ASD and scheduled to undergo stem cell transplantation therapy (SCT)
- age- and sex-matched typically developing children
- high-risk infants (10-18 months) with at least one sibling with diagnosed ASD
- mothers of these high-risk infants
Parents will be asked to complete several questionnaires relating to demographic and anamnestic details and to the child's development.
A single blood draw will be performed in the clinic and single stool and urine samples will be collected at home. For children scheduled to undergo SCT, the blood, stool and urine samples must be collected before therapy. For participating mothers, only a single blood sample will be collected (no stools or urine samples).
- Parents of high-risk infants will be contacted by phone or email when the child reaches diagnosable age (3.5 years) and again at the age of 6 years, to obtain an update on the child's ASD status. If the child has been diagnosed with ASD, an additional blood and stool sample may be collected.
- Children who underwent SCT will be contacted 2±1 months and 6±1 months after the first treatment session, for collection of additional blood samples. Stool and urine samples will be collected at the 6±1 month post-treatment visit as well. Should the child undergo additional SCT within two years of the first treatment, additional blood, stool and urine samples may be collected. At each subsequent visit, a parent/legal guardian will be asked to complete several short questionnaires.
Adverse events to blood drawing will be reported to the Data Coordinating Center using the appropriate Case Report Form (CRF).
In cases of adverse effects (AE) related to the drawing of blood or performance of examination of patients in the course of standard examination procedures, the investigating team will proceed in accordance with local guidelines (to be inserted by the PI), reporting the incidents which occurred during the course of a clinical trial.
Clinical data will be collected by the investigator, or a person appointed and appropriately trained by the investigator, and shall be entered into standardized CRFs and shared online with the sponsor. Source data will be retained for all data entered in the CRFs. Progress reports and the Final Report at the conclusion of the trial will be submitted to the regulatory authority and the Ethics Committee, as required.
Eligibility
Inclusion Criteria:
- Male and female children
- Child aged 2-12 with diagnosed autism spectrum disorder (ASD) according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV (299.00) or DSM-V (299.00) ± ADOS OR Child aged 2-12 diagnosed autism spectrum disorder (ASD) according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV (299.00) or DSM-V (299.00) ± ADOS AND scheduled to undergo stem cell transplantation OR Child aged 10-18 months not diagnosed with ASD but with a sibling diagnosed with ASD according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV (299.00) or DSM-V (299.00) ± ADOS (herein termed "high-risk infants") OR Mothers of high-risk infants OR A typically developing child aged 2 to 12 years with no signs of ASD or history of ASD in the immediate family
- Informed consent signed by the parents
Exclusion Criteria:
- Child and/or mother that have been treated with systemic steroids or have undergone immune suppression treatment within the last 6 months
- Child and/or mother diagnosed with severe infectious diseases or sepsis over the last 6 months
- Child with ASD treated for a severe convulsive disorder
- Child and/or mother with hematological or malignant disorder
- For children in the SCT cohort: No new planned treatment (other than SCT) for at least 6 months from planned stem cell transplantation date and no new treatments (other than SCT) started within 6 months before planned transplantation date.