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Autism Research Group

Background
In 2004, Professor McKinnon and Dr Manya Angley established the Autism Research Group (ARG) within the Sansom Institute in the School of Pharmacy and Medical Sciences, University of South Australia. Establishment of the ARG involved engaging a team of multidisciplinary players who are now currently involved in a range of autism-based projects that seek to apply critical analysis to autism and its treatments. The ARG has members from the following disciplines: clinical psychology, chemistry, pharmacy, occupational therapy, molecular biology, statistics and computer science.

Membership
ARG members include:
Prof Ross McKinnon
Dr Manya Angley
A/Prof Robyn Young (Psychology, Flinders University)
Dr Susan Semple
Dr Cobus Gerber
Dr Michael Sorich
Mr Damien Abarno
Mr David Ellis (Women’s and Children’s Hospital; Children, Youth and Women’s Health Service)
Dr Alison Lane (School of Health Sciences, UniSA)
Professor Andy Koronios (School of Computing and Information Science, UniSA)
Mr John Petkov (Statistics, Whyalla, UniSA)

Research activities
There are two key aspects of the ARG’s research activities.
1. Development of a metabonomics-based approach to diagnose and phenotype autism
Recently developed profiling technologies such as microarray technology, proteomics and metabonomics have the potential to improve the diagnosis and subsequent management of individuals with autism through increased insight into the pathophysiology of the disorder and physiological responses to existing interventions. Metabonomics has emerged recently as a particularly powerful technique involving the analysis of biofluids including urine and plasma in order to reflect whole organism biochemical profiles and regulation of function. In this project, metabonomic technology is applied to the diagnosis and classification of autism in an attempt to improve outcomes in this distressing condition. This project presents a novel opportunity for multidisciplinary approaches to be focussed towards the complex disorder of autism and combines expertise in Clinical Psychology with the most recent diagnostic molecular profiling techniques that have been developed within the pharmaceutical rigor of the Centre for Pharmaceutical Research (CPR) which is also housed within the Sansom Institute. The CPR offers a range of commercial pharmaceutical services to national and international clients including some of the world’s largest pharmaceutical companies. Over the last three years, the CPR has established this technology in house, applying a degree of pharmaceutical level rigor to the technology consistent with its role as a provider of analytical services to the international pharmaceutical industry. The potential significance of this work is the development of metabolic signatures for autism and subsequently, the development of clinically relevant subtyping of the disorder. Identification of subtypes will enable prediction and monitoring of responses to interventions and general progress of the condition, with the potential to guide treatment to optimise outcomes for the individual. Development of the autism ‘bioresource’ will form the backbone of future research in the area of autism with scope for applications in molecular determinants of drug response, drug target identification and autism-specific drug development.


2. Quality use of conventional and complementary medicines in autism
Both conventional and complementary and alternative medicines (CAMs) are widely used in autism. In particular, antipsychotic medications are increasingly used in people with autism and the importance of monitoring for adverse effects is paramount. Currently, evidence for antipsychotic use and awareness of adverse effects in young people with autism is limited. This aspect of ARG research has focussed upon examining: evidence for use; patterns of usage; and adverse effects experienced when young people with autism are prescribed antipsychotics. A printed and electronic chart has been developed for monitoring physical health and adverse effects in young people with autism to assist health care professionals (HCPs) achieve quality use of antipsychotic medicines.
In another Quality Use of Medicines (QUM) project, a systematic review of the literature has been conducted to determine the rationale, safety and efficacy of a range of CAMs used in autism. Specifically, the following interventions were investigated: olive leaf extract, vitamins A, B, C and E, dimethylglycine (DMG), calcium, iron, magnesium, selenium, zinc, essential fatty acids, melatonin, colostrum, secretin, probiotics, chelating agents, glutathione, glutamine and digestive enzymes. Factors influencing caregivers’ decisions to implement and maintain particular interventions have also been examined. For the majority of interventions investigated, evidence for use in autism was rated as being either unclear or conflicting. Most interventions were associated with only mild adverse effects, although there was a lack of long-term safety data. HCPs and caregivers need to be informed that the use of CAMs in autism is not risk-free and often lacks sound clinical evidence. The information needs of caregivers and HCPS regarding complementary medicines in autism is currently being developed with a view to developing a resource to guide HCPs and caregivers in evidence based selection of CAMs in autism.
The work investigating the evidence base for CAM in autism has identified that the use of CAMs in autism is not risk-free and often lacks sound clinical evidence. Supplementation with omega 3-fatty acids, melatonin and probiotics all hold promise as treatments for autism but are currently lacking an evidence base. The ARG is planning randomised placebo-controlled trials to investigate the efficacy of these agents in autism.

Publications
1. Journal Articles - Refereed
Angley M, Semple S, Ellis D, Paterson P, Hewton C, Chan W, Young R, McKinnon R. Children and autism: What GPs need to know about medications and dietary interventions (in press accepted 14/03/07, Australian Family Physician)

2. Journal Articles - Non-Refereed
Angley M, McKinnon R, Young R & Evans A, (2006) ‘Autism and children: Can the pharmacist help?’ Australian Pharmacist vol. 25 no. 6 pp. 468-472.

Lim, Y.Z., Angley, M Tait, P., Young, R. & McKinnon, R. (2006). ‘Immunisation and autism: Sifting myth from reality?’ Australian Pharmacist vol. 25 no. 7 pp. 554-558.

3. Conference Publications - Edited Volume of Conference Proceedings
Wu A, Young R, Angley M., Petkov J, Johns C, Churches O & McKinnon R
(2005) ‘Establishing an autism database’. In proceedings of the joint
ASCEPT and APSA Meeting Melbourne.

Wu A, Chung WK, Young R, McKinnon R & Angley, M (2005). ‘Children and Autism: Can the Pharmacist Help?’ In proceedings of the joint
ASCEPT and APSA Meeting Melbourne.

Wong YC, Gerber JP, Berryman MJ, Angley MT, Abarno DV, Young RL & McKinnon RA (2005) ‘Discrimination of autistic children from healthy controls using LCMS-based metabonomics: A pilot study’. In proceedings of the joint
ASCEPT and APSA Meeting Melbourne.

Lim YZ, Tait PA, Young RL, Xia XA, Koronios A & Angley MT (2005) ‘Autism and Immunisation: Sifting myth from reality’. In proceedings of the joint
ASCEPT and APSA Meeting Melbourne.

Shirzadi K, Ellis D & Angley M (2005) ‘Monitoring Physical Health in Children and Adolescents using Antipsychotics’. In proceedings of the joint ASCEPT and APSA Meeting Melbourne.

Ellis D, Shirzadi K & Angley M (2006) ‘Development of a package to monitor physical health in children and adolescents using antipsychotics.’ In proceedings of the National Medicines Symposium Canberra.

Angley MT, Lim YZ, Tait PA, Young RL, Xia XA, Koronios A & McKinnon RA (2006)‘ Autism and immunisation: What’s the story?’ In proceedings of the National Medicines Symposium Canberra.

Hewton C, Paterson F, Semple S & Angley M (2006) Autism and complementary medicines: What is being used and why? In proceedings of the APSA Meeting Adelaide.

Paterson F, Hewton C, Angley M, Semple S (2006) Autism and complementary medicines: what is the evidence? In proceedings of the APSA Meeting Adelaide.

Chan W, Ellis D, Jureidini J & Angley M (2006) Auditing antipsychotic prescribing in young people at the Women’s and Children’s hospital; Children, Youth and Women’s Health Service In proceedings of the APSA Meeting Adelaide.

Grzeskowiak L, Ellis D, Phillips A & Angley M (2006) Implementation of a chart and guidelines for monitoring physical health in children and adolescents using antipsychotics. In proceedings of the APSA Meeting Adelaide.


Angley M, Hewton C, Paterson F, Semple S, Ellis D, Chan W, Grzeskowiak L, Shirzadi K, Phillips A, Stanek J (Aug/Sept 2007) ‘Quality use of conventional and complementary medicines in autism’ In proceedings of the 8th International Congress Autism - Europe

Invited presentations (with Conference Publications - Edited Volume of Conference Proceedings)
Angley MT, Ellis D and McKinnon RA (May, 2005). ‘Autism Research at the University of South Australia’ In Proceedings of the Inaugural Autism SA State Conference. Adelaide.

Angley M, Ellis D, Chan W, Grzeskowiak L, Shirzadi K, Phillips A, Stanek J
(Dec, 2006) ‘Quality use of antipsychotic medications in children and adolescents’ APSA New Investigator’s Symposia In proceedings of the APSA Meeting Adelaide. P.15


Angley M & Semple S, (May 2007) ‘Quality Use of Medicines in autism and developing a metabonomic based laboratory test to diagnose autism’ In proceedings of the Autism SA 2nd State Conference

4. Other Creative Works - Minor Written or Recorded Work
Lim YZ, Young, R, Tait, P, McKinnon R & Angley M (2005) ‘Autism and Immunisation: The story behind the controversy’ A guide for parents. A deliverable from the honours thesis prepared by Yun Zi Lim. ISBN 1920927468

 

 

 

 

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