Possible First Physical Marker of Autism Discovered in Airway

According to one researcher, autistic children may bear a physical marker of the neurodevelopmental disorder; if proven correct, this researcher will have discovered the first anatomical marker for autism.

Dr. Barbara Stewart, a pediatric pulmonologist at Nemours Children’s Clinic in Pensacola, Florida, was examining autistic children who had all come into her practice suffering from a persistent cough. When she examined their windpipes, however, she noticed the airways leading to the lungs of her autistic patients were different from those of children without autism.

Typically, the trachea divides into two main routes and the airways usually continue to branch off from that point in disorganized, asymmetrical patterns. In the autistic children, though, Stewart saw that the branches were bunched together and symmetrical. Further, where one large branch may protrude in a normal lung, Stewart observed two smaller branches in the autistic patients.

After this discovery, Stewart examined the bronchoscopy results of 49 children with autism spectrum disorder and more than 300 children without autism. The reports showed that every autistic child had what she has named symmetrical "doublets" in their airways. None of the un-autistic children had these doublets.

Stewart reported that she did not understand "what the significance of that is ... but it looks like they have more of everything.” She continued to say that all of the autistic patients displayed normal lung function, and this anatomical difference may or may not explain their shared complaint of a persistent cough.

Stewart acknowledged that it is difficult to notice such a difference in the autistic children at first. "When I was talking to my partner about this, he said, 'What are you talking about?' Then I pointed it out to him ... He started seeing it and now he can't miss it," Stewart said.

Stewart’s research will be presented Monday at CHEST 2011, the annual meeting of the American College of Chest Physicians, in Honolulu. Although Dr Daniel Coury, medical director for the Autism Treatment Network of Autism Speaks, said he wasn't sure what to make of the findings, he believes they warrant more research. "I've never heard of anything like this before and certainly, your first thought is, 'If autism is a neurodevelopmental disorder, why would we be finding problems in the lungs?'" Coury said.

"The fact is,” continued Coury, “we are thinking more and more that autism is a whole-body disorder. We are seeing some people with autism that have lower gastrointestinal problems and immune problems. So, once you toss aside the idea that this is strictly a brain problem and think of it as a whole-body problem, this becomes possible."