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Open AccessArticle

A Cohort Study Comparing Women with Autism Spectrum Disorder with and without Generalized Joint Hypermobility

1
Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
2
Department of Pediatrics, Greenville Health System Children’s Hospital, Greenville, SC 29605, USA
3
Department of Statistics, Colorado State University, Fort Collins, CO 80523, USA
4
Autism Research Institute (ARI), San Diego, CA 92116, USA
*
Author to whom correspondence should be addressed.
Behav. Sci. 2018, 8(3), 35; https://doi.org/10.3390/bs8030035
Received: 23 November 2017 / Revised: 26 February 2018 / Accepted: 15 March 2018 / Published: 17 March 2018
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Abstract

Reports suggest comorbidity between autism spectrum disorder (ASD) and the connective tissue disorder, Ehlers-Danlos syndrome (EDS). People with EDS and the broader spectrum of Generalized Joint Hypermobility (GJH) often present with immune- and endocrine-mediated conditions. Meanwhile, immune/endocrine dysregulation is a popular theme in autism research. We surveyed a group of ASD women with/without GJH to determine differences in immune/endocrine exophenotypes. ASD women 25 years or older were invited to participate in an online survey. Respondents completed a questionnaire concerning diagnoses, immune/endocrine symptom history, experiences with pain, and seizure history. ASD women with GJH (ASD/GJH) reported more immune- and endocrine-mediated conditions than their non-GJH counterparts (p = 0.001). Autoimmune conditions were especially prominent in the ASD/GJH group (p = 0.027). Presence of immune-mediated symptoms often co-occurred with one another (p < 0.001–0.020), as did endocrine-mediated symptoms (p < 0.001–0.045), irrespective of the group. Finally, the numbers of immune- and endocrine-mediated symptoms shared a strong inter-relationship (p < 0.001), suggesting potential system crosstalk. While our results cannot estimate comorbidity, they reinforce concepts of an etiological relationship between ASD and GJH. Meanwhile, women with ASD/GJH have complex immune/endocrine exophenotypes compared to their non-GJH counterparts. Further, we discuss how connective tissue regulates the immune system and how the immune/endocrine systems in turn may modulate collagen synthesis, potentially leading to higher rates of GJH in this subpopulation. View Full-Text
Keywords: connective tissue diseases; autoimmunity; mast cells; immunity; humoral; endocrine system diseases; neurodevelopmental disorders connective tissue diseases; autoimmunity; mast cells; immunity; humoral; endocrine system diseases; neurodevelopmental disorders
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Casanova, E.L.; Sharp, J.L.; Edelson, S.M.; Kelly, D.P.; Casanova, M.F. A Cohort Study Comparing Women with Autism Spectrum Disorder with and without Generalized Joint Hypermobility. Behav. Sci. 2018, 8, 35.

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