The Neuroimmunology of Autism

Alterations and maladaptations of the immune system remain some of the most controversial concepts in autism spectrum disorder (ASD). Nonetheless, intensifying evidence confirms that much of what ASD involves is related not to fixed ´autistic states of being´ but rather to the consequences of environmental insult and complex psychological and physiological processes along a neuro-immune-microbiota-axis. This paper focuses on clinical research and is written to specialists and non-specialists, to provide access to multi- and interdisciplinary perspectives with wide-ranging cutting-edge implications for all people with ASD. Beginning with an epidemiological and etiological underpinning, we elaborate on the current role of the immune system in the pathophysiology of ASD. Theoretical and scientific discourse on the relationship of the immune system with the nervous system and host microbiota in homeostasis/allostasis, neurodevelopment, and psychological and physiological health and disease is also provided. This gives us a platform for not only examining the role of the immune system in the etiology, pathogenesis, and pathophysiology of ASD but also understanding social and higher-level processes of consciousness for individuals on the spectrum. Finally, taking a neuroimmunological perspective, we highlight the need for a multi-scale, holistic, and ´middle-out´ approach to understanding and developing future therapeutic modalities to address the core symptoms of ASD that go beyond the current reductionist and ´magic-bullet´ medical paradigm.