A blood test for prenatal autism? What could possibly go wrong?

(UPDATE 1-20-15: The reporter from the San Diego Union-Tribune has contacted us to point out that, “contrary to the original article, the reporter has corrected the story to reflect that the test is not being promoted for use during pregnancy” as was previously attributed to the CEO of the company, Ms. D’Alvise. See his comment below or click here.)

Back in 2013, the UC Davis MIND institute put out some research into maternal antibodies and their association with autism:

“UC Davis MIND Institute researchers have identified the specific antibodies that target fetal brain proteins in the blood of a subset of women whose children are diagnosed with autism. The finding is the first to pinpoint a specific risk factor for a significant subset of autism cases, as well as a biomarker for drug development and early diagnosis. The researchers have named autism related to these antibodies “Maternal Autoantibody-Related,” or MAR autism.

The study found that the mothers of children with autism were more than 21 times as likely to have the specific MAR antibodies in their systems that reacted with fetal brain proteins, or antigens, than were the mothers of children who did not have autism. In fact, specific combinations of MAR antibodies were not found in the blood of mothers whose children were typically developing.”

From that research — or some variation of it — comes word of a new blood test that expectant mothers can take to find out if they’re at an increased risk of having an autistic child:

“A blood test for one of the most common forms of autism is due to be launched in the third quarter of 2015, San Diego’s Pediatric Bioscience said Wednesday.

The test identifies maternal antibodies that interfere with prenatal brain development, the company says. These antibodies are implicated in a form of autism spectrum disorder representing 23 percent of all cases. The test can help with early diagnosis or steer potential mothers toward alternatives such as surrogate pregnancy.

The antibody test delivers a false positive response just 1.3 percent of the time, making it highly predictive, said Jan D’Alvise, president and chief executive of privately held Pediatric Bioscience. D’Alvise spoke at the Biotech Showcase conference in San Francisco, an annual meeting of biotech investors and companies held concurrently with the JP Morgan Healthcare Conference.”

If I were an unethical son of a bitch, I would invest heavily in this company because that test is going to sell like hotcakes at Pamela’s on a cold Pittsburgh morning.

I say unethical because the research looking into the maternal autoantibodies and autism didn’t come up with any causal association between the antibodies and the children’s autism. It’s an interesting theory that boils down to, “We found these antibodies in a lot of the women who had autistic children. Not all of them, but a lot of them. These antibodies seem to target the unborn fetus’ brain, so it stands to reason that they may cause some sort of damage that leads to autism.” It’s not their words, but it’s something that I’m hearing in my mind as I read their paper. It’s something I’m sure a reasonable person might interpret as a test that can predict autism. I feel it would be unethical for me to profit off of something so seemingly unnecessary.

This is troubling to me because autism is so often referred to as a “disease” or as “brain damage” by many people claiming to know more about autism than they do. It is also troubling because the research doesn’t seem to show any prediction for how “severe” or socially impairing the autism will be. The mother with the positive test has a higher-than-expected chance of having an autistic child, but the test will in no way predict the degree to which the child will be able to be part of society. There is the very real possibility that mothers (and fathers, but it’s the mother’s decision) will want to terminate the pregnancy out of fear of having a “brain damaged” child.

(I can feel my blood pressure rising at the thought of ignorant fools calling autistics “brain damaged.”)

The test only really tells a person that they have these antibodies. It doesn’t say whether or not the antibodies cause the autism. That’s why the researchers call them autism related antibodies, not autism causing antibodies. I don’t think from the research that they can make that claim. A similar argument could be made that autism is genetic, and that those genes are present in the mother and causing those autoantibodies to be produced by the mother. The genes are then passed on to the child and the child develops autism. In short, there is way too much that we don’t know about autism.

One thing we do know is that vaccines don’t cause autism, of course.

Here’s the weirdest part of it all: From Pediatric Bioscience, the makers of the test, we learn the recommended reasons for having the test done:

“The MAR antibody test should be ordered on three types of “at risk” women : 1) Women of child-bearing age who have already had a child with autism, 2) Mothers of young children in need of a diagnosis for their child’s perceived developmental delay, and 3) Women over the age of 30 who are at least 2 times more likely to give birth to an autistic child. Specifically, women in this group who are considering In Vitro Fertilization (IVF) to become pregnant may want to consider taking the test before they proceed with the procedure. The MAR test is not intended for pregnant women or women who think that they may be pregnant.”

Read that last sentence and marvel at the contradiction from what Jan D’Alvise, president of the company marketing the test, said to the San Diego Union-Tribune:

“If a pregnant women gets a positive diagnosis, preparations can begin before birth to get the child into therapy if needed, D’Alvise said. Or a baby showing delays in development can be diagnosed faster if the mother tests positive.”

Which is it? Either the test is not to be done on pregnant women or it is. It is very possible that Ms. D’Alvise didn’t know that their website states that the test is not intended for pregnant women or that the website is outdated and their test is now to be used on pregnant women who think their unborn child may be autistic. Either way, the message is fuzzy on whether or not this test will be able to tell with 100% certainty that the unborn child (or any future children) will be autistic.

(UPDATE 1-20-15: The reporter from the San Diego Union-Tribune has contacted us to point out that, “contrary to the original article, the reporter has corrected the story to reflect that the test is not being promoted for use during pregnancy” as was previously attributed to the CEO of the company, Ms. D’Alvise. See his comment below or click here.)

The test is said to cost $1,000. No word on whether or not health insurance will pay for it, or what additional steps should be taken for a positive test. There is also no word on what the FDA has to say about this test. We’ll be on the lookout for their opinion. In the meantime, there’s a little something we need to talk about next time.

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