Translating Evidence Into Practice.
Running head: LITERATURE REVIEW 1
LITERATURE REVIEW 2
Project Part 2
September 24, 2018
Autism spectrum disorder (ASD) is a condition which is usually developmental and tends to affect the behavior and communication of a person. (National Institute of Mental Health [NIMH], 2017). The reason as to why this kind of disorder is considered as being developmental is because its symptoms usually appear during the first two years of life. People who have autism spectrum disorder typically have behaviors that are restricted and repetitive as well as symptoms that affect the ability of the person to properly function while at school, work or even in other areas of life. (NIMH, 2017). Autism spectrum disorder can affect any person regardless of their racial, ethnic or economic group. Despite autism spectrum being considered as a lifelong disorder treatment and services can assist in improving the symptoms associated with this particular disorder as well as the ability of a person to function. (Myers & Johnson, 2007). This review synthesizes information in some of the articles whereby the authors of those particular articles tried to evaluate whether the use of stem cell treatment is a more appropriate method to use while treating children suffering from autism spectrum disorder as compared to the administration of food and drugs to help in preventing the adverse effects associated with the autism spectrum disorder.
Synthesis of the Studies
Current investigative therapies which are aimed at reversing the abnormalities which are associated with spectrum autism disorder mainly aim at administering antibiotics, hyperbaric oxygen, and anti-inflammatory oxygen. The therapeutic approaches for autism can be largely classified under educational, medical, allied health, behavioral and complementary as well as alternative medicine interventions. Presently, there is no defined mechanism of pathogenesis and consequently treatment is limited to behavioral interventions. Use of stem cells is being considered as better diagnosis method compared to food and drug administration in the prevention of adverse effects of autism. The main reason as to why the use of stem cells from the umbilical cord tissue is that it has shown to reduce inflammation in the autistic patient which in turn alleviates symptoms of autism. Transplantation of stem cells may offer an exceptional treatment strategy for spectrum autism disorder due to the neural dysregulation and immune which are observed in this condition. The degree of severity of the autism symptoms has been associated or correlated with inflammatory and neuroinflammatory cytokines which include macrophage-derived chemokine as well as thymus and activation-regulated chemokine. There are several immune disorders which are associated with autism such as autoimmunity, immune deficiencies, overactivation of certain immune populations and allergy. This helps improve the health outcomes of the patient. The stem cells are being used by the health providers to help in the creation of new models of autism with an aim of testing the effects that new drugs could possibly be having (Sharma et al., 2013).
Conforming to precedent pre-clinical studies that have been carried out it is evident that the mesenchymal stem cells have a tendency to represent immune regulatory properties that are significant through suppression of proliferation as well as function of several major immune cells which includes B cells, natural killer cells, T cells, inducing regulatory T cells and modulating the activities of dendritic cells. Therapies that employ the use of stem cells are usually in a better position of inhibiting the release of pro-inflammatory cytokines and also have strong immune suppressive activities. This does not only help in the autologous transplantation but also help in heterologous transplantation without the requirement of pharmacological immune suppression (Lv et al., 2013). Translating Evidence Into Practice.
According to the studies analyzed stem cell treatment is a more appropriate diagnosis method as compared to the administration of food and drug because stem cells are cells which are undifferentiated and they are usually defined by their ability to self-renew as well as differentiate into cells that are mature. The stem cells are also preferable because they are highly proliferative which implies that there are several numbers of mature cells which can be generated from a given stem cell source. The cell replacement therapy hypothesizes that new retinal cells could be generated from stem cells to help ion substituting the cells that have already been damaged by the disorder (Siniscalco, Bradstreet, Sych & Antonucci, 2014). The stem cells also have a protective effect which is usually referred to as the paracrine effect. The protective effect of the stem cells assists in modulating the microenvironment of the tissues that have been affected by the disorder to help in protecting the cells that have been injured, promote the survival rate as well as activate any endogenous repair mechanism that is available. The stem cells in the treatment of autism spectrum disorder usually trigger the development of the brain and after that, the body of the child proceeds in doing their work (Ng, Fortino, Pelaez, & Cheung, 2014).
Inconsistencies and Contradictions in the Literature
One of the inconsistencies and contradictions found in the literature is the fact that there is only one registered human trial that has used MSCs to treat autism in children whereby there were two components that were involved to have a better health outcome. In this one study combined transplantation of MSCs and mononuclear cells had therapeutic effects that were better as compared to using transplantation of mononuclear cells alone. Another controversy as per the studies used is that the administration of the stem cells needs to be administered in a given manner to achieve quality results. Although the outcome after using the stem cell in treating autism in children can be positive or negative the risk-benefit ratio of stem cell therapy in autistic children appears to be favorable.
In conclusion, the evidence in the researched literature and journals provides a strong support for a change in practice whereby health providers should start using stem cell treatment to diagnose children suffering from Austin spectrum disorder as compared to the use of food and drug administration. This method helps in replacing the cells that have been damaged by the disorder. From the literature it is evident that the applied behavior analysis is a mode of treatment that is mainly based on theories of learning and operant conditioning yet the disorder could be as a result of an inborn disorder or because of the genes of a person and therefore in such a case the stem cell treatment is the most appropriate. Despite the literature providing a strong support as to why health providers should implement the use stem cells in the treatment of autism spectrum disorder in children further research still need to be carried out to help guide the health providers on the particular symptoms of autism in children that can be addressed using this mode of treatment. This is significant taking into account that stem cells typically differentiate into different cell types needed by the body such as oligodendrocytes, neurons, and blood cells.
Lv, Y. T., Zhang, Y., Liu, M., Ashwood, P., Cho, S. C., Huan, Y., … & Hu, X. (2013). Transplantation of human cord blood mononuclear cells and umbilical cord-derived mesenchymal stem cells in autism. Journal of translational medicine, 11(1), 196.
Myers, S. M., & Johnson, C. P. (2007). Management of children with Autism Spectrum Disorder. Retrieved September 24, 2018 from http://pediatrics.aappublications.org/content/120/5/1162
National Institute of Mental Health (2017). Autism spectrum disorder. Retrieved September 24, 2018 from https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders- asd/index.shtml
Ng, T. K., Fortino, V. R., Pelaez, D., & Cheung, H. S. (2014). Progress of mesenchymal stem cell therapy for neural and retinal diseases. World journal of stem cells, 6(2), 111.
Sharma, A., Gokulchandran, N., Sane, H., Nagrajan, A., Paranjape, A., Kulkarni, P., … & Badhe, P. (2013). Autologous bone marrow mononuclear cell therapy for autism: an open label proof of concept study. Stem cells international, 2013.
Siniscalco, D., Bradstreet, J. J., Sych, N., & Antonucci, N. (2014). Mesenchymal stem cells in treating autism: Novel insights. World journal of stem cells, 6(2), 173.
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