Folate-centric concept of pathogenesis and GBINC personalized multidisciplinary

Solving the problem of childhood neuropsychiatric diseases is a priority task of modern medicine. Recent scientific achievements in the field of genetics, molecular biology and immunology, demonstrating biochemical and immune-dependent pathways for the formation of human neuropsychiatric disorders, shed light on the mechanisms of brain damage in children with ASD, which allows to look with restrained optimism at the prospect of overcoming this severe psychiatric pathology in the near future through the implementation of genetic, biochemical and immunodiagnostic approaches, as well as metabolic and immunotherapeutic interventions with neuroprotective effects. The folate-centric concept of polygenic inheritance of a tendency to develop neuropsychiatric syndromes in children with multisystem damage to the body has been established. Biochemical and immunodependent (infectious, autoimmune, immunoinflammatory and allergic) pathways for the formation of microbe-induced autoimmune inflammatory encephalopathy with neuropsychiatric clinical manifestations are discussed in the context of the folate-centric concept. Taking into account the new data, two personalized multidisciplinary approaches to the management of children with ASD and other neuropsychiatric syndromes are proposed James Jeffrey Bradstreet et al. first approach 2010 is based on an empirical analysis of a large group of laboratory biomarkers, the relevance of which has been demonstrated in clinical trials, and subsequent targeted correction of the identified disorders that these biomarkers describe (the so-called biomarker-guided interventions). Richard E. Frye in 2022 developed a multidisciplinary personalized approach called Bas-BISTOR (collect Baseline data, search by symptoms, measure Biomarkers, Select Treatment, Observe for Response), which systematizes and stratifies diagnostic and therapeutic interventions based on diagnostic and therapeutic biomarker-based interventions. In order to improve existing recommendations regarding specific subtypes of neuropsychiatric syndromes in children, this article puts forward an improved personalized multidisciplinary approach to the clinical management of patients with ASD and neuropsychiatric manifestations associated with genetic folate cycle deficiency.