From Dr. Marco Ruggiero:
Shortly after the AutismOne meeting in Chicago on May 18-25, 2015, Dr. Jeff Bradstreet, myself and my wife, Dr. Stefania Pacini, begun working on a scientific project that, in our opinion, could have elucidated the underlying cause of autism and opened the way for a definitive cure of the disease. As a matter of fact, in his last lecture at AutismOne, Dr. Bradstreet explicitly stated, using a rhetorical question, how close we were to a cure for autism.
We begun working at this project very intensively and our goal was to identify the pathogenesis of autism and then to merge our respective protocols into a single one that addressed such ultimate pathogenesis of autism.
About one year earlier, we had observed that the brains of autistic children showed peculiar lesions that could be identified and classified using transcranial ultrasonography. These observations were published in a peer-reviewed journal, Frontiers in Human Neuroscience that can be retrieved in PubMed.
It is worth noticing that Frontiers in Human Neuroscience, is a Journal that is associated with the Nature Publishing Group, the most prestigious in the world. Frontiers in Human Neuroscience has become the #1 most-cited journal in psychology, the #1 most-cited open access journal dedicated to neuroscience and the 10th most-cited journal in all of neuroscience. It is also the 2nd and 3rd largest journal in all of psychology and neuroscience, respectively.
The presence of these lesions has been confirmed, using other methods of imaging such as MRI, by other research groups, and there is almost unanimous consensus that there are anatomical alterations in the brains of autistic children. It is also generally accepted that such anatomical alterations are correlated with the severity of the symptoms.
The key missing point, however, was the cause of such anatomical alterations and, without knowing such a cause, any type of therapeutic approach was, at best, empirical.
In the first two weeks of June, we had been able to hypothesize the cause of these brain alterations in autism and we worked day and night to write a scientific paper reporting the results of our observations. We worked so frantically because we knew that such a paper would have been a milestone in autism research because it solved the most basic question regarding autism that, in lay term, is: “what is the cause of autism?”
As soon as the paper was ready, Dr. Bradstreet submitted it to the same prestigious journal where we had published one year earlier, that is Frontiers in Human Neuroscience.
Fortunately, considering what happened immediately thereafter, the publisher is located in Switzerland, notoriously a neutral country.
A few days after the submission of the paper, Dr. Bradstreet tragically died.
The paper, however, had already been submitted and, therefore, I was able to revise it and to make all the changes that were necessary for its publication. It took about 5 months of intense work to complete the paper and to render our hypothesis acceptable by the mainstream medical scientific community.
This fundamental paper can be considered a posthumous homage to the scientific figure of Dr. Bradstreet and it is now published in Frontiers in Human Neuroscience from where it can be freely downloaded.
In this paper we write that infection or inflammation of the deep cervical nodes that drain lymph from the brain and from the mouth and throat may lead to impaired lymph drainage with consequent accumulation of extra-axial fluid in the brain that leads to disruption of the connections between neurons and glial cells.
Therefore, impaired lymphatic drainage would result in the accumulation of metabolites (toxins) in the brain and in constant inflammation of the brain and the meninges with consequent alterations of brain development and function.
Although the following speculation is not included in the paper, it can be hypothesized that impaired lymphatic drainage would decrease the immunological defenses of the brain and its capability to fight pathogenic microbes that penetrate into the brain, mainly from the intestine.
In fact, it was recently demonstrated that in the brain there are microbes that are commonly found in soil and water and the cells of the immune system (macrophages) carry these microbes to the brain (PLoS One. 2013;8(1):e54673. doi: 10.1371/journal.pone.0054673).
After the publication of our paper, we hypothesize that the brain lymphatic system, as described in our paper, through which the immune cells travel, is instrumental in carrying the good or the bad microbes to the brain and influence its function.
Although the interconnections between gut microbes, the immune system and brain development and function were well known, following the publication of our paper, we are now confronting a radical paradigm shift.
Microbes in the gut DO NOT INFLUENCE the development and the function of the brain: THEY ARE CELLS of the brain just like neurons and glial cells. Microbes are AS IMPORTANT as neurons and glial cells for brain function and the microbes that you have in the intestine are the microbes that you have in the brain.
Now that the pathogenesis of autism is clearly hypothesized in this paper of ours, it is foreseeable that it will open the way for a definitive and successful therapeutic approach.