Su2078 Concomitant use of Adalimumab and Immunomodulators Compared With Adalimumab Alone: Pooled Malignancy Safety Analysis

Background: Autism and autism spectrum disorders (ASDs) are enigmatic conditions that have their origins in the interaction between genes and environmental factors. Several studies suggest that increased gut-blood-brain-barrier permeability might be involved in the pathogenesis of these conditions. Recently, we have reported an increased intestinal permeability (IPT) “leaky gut” in a large percentage of not celiac autistic subjects that seemed be influenced by gluten-free diet. We can hypothesize that autistic patients(pts) are gluten sensitive, as well as it happens in other recently described conditions such as individuals with Schizophrenia. Aim: it was to evaluate antibody prevalence to gliadin (AGA), transglutaminase (tTG), deamidated gliadin peptides (DPG), endomysium (EMA) in a group of autistic pts with gastro-intestinal symptoms (GI) and/or altered IPT being on regular alimentary regimen (RAR) or on gluten-casein free diet (GCFD). Patients and methods: in 70 ASD children (54 RAR, 16 GFD) were performed serologic test combination representing Celiac Disease (CD): total serum IgA (sIgA), AGA, DGP, tTG, EMA IgA-IgG by ELISA and HLA haplotype by Eurospital Eu-DQ kit. Results: All pts had normal sIgA values and were negative for tTG, EMA (IgA and IgG); a low number of pts, 1/69 (1.40%) showed positive AGA-IgA in contrast to 22/70 (31.40%) with positive AGA IgG; out of 5 (7.10%) of these pts had also positive DGP IgG. Moreover, of the 22 AGA IgG positive pts, 50% (11) were HLA negative. Among the RAR pts, we found 38.90%( 21/54) AGA IgG positive, compared to only 6.30% (1/16) that were on GCFD. Interestingly, a large percentage of pts (90.5%) on RAR have impaired intestinal barrier function, while implementation of a GCFD normalizes intestinal barrier function in approximately 1/3 ( 38.7%) of ASD pts. Conclusions: Our preliminary results suggest that a sub-group of autistic children could have Gluten Sensitivity. The findings may have potential implications for the treatment of these subjects given that a GFD could contribute to the improvement of their symptoms.