The MARAbio Test
What is MARA, and how we test for it
The MARAbio test is based on a proprietary set of autoantibodies that are present in the blood of a significant percentage of mothers with autistic children. Dr. Judy Van de Water, a Professor in the Division of Rheumatology/Allergy and Clinical Immunology at UC Davis and the UC Davis MIND Institute, has discovered a new immune system-mediated subtype of autism, now known as Maternal Antibody Related Autism (MARA). The MARAbio test identifies the presence of the MARA antibodies in mothers who are at increased likelihood and enables the earliest detection of autism in her child.
Dr. Van de Water has conducted extensive clinical studies that, to date, have demonstrated > 97% specificity for an autism diagnosis. Through numerous peer-reviewed scientific manuscripts, the MARA subtype is estimated to account for approximately 20% of autism diagnoses. Further, the data show that certain patterns of MARA autoantibodies present in the mother may be predictive of the severity of autism in her child, including significantly increased odds of an ”Autism with Intellectual Disability” diagnosis (ASD+ID). Ultimately, knowing if a child has MARA may help therapists begin interventions earlier and tailor approaches for improved outcomes.
Maternal immunity during gestation
In humans, immunoglobulin G (IgG) antibodies transfer at high concentrations beginning around mid-gestation as a mechanism to protect the fetus against pathogens. Under normal conditions, antibodies are unable to cross the blood-brain barrier (BBB) to access the brain. However, the BBB is more permissive during early brain development and thus permits maternal antibodies access to the fetal brain. Prenatal exposure to maternal antibodies that bind to fetal brain has been suggested as a mechanism for altering typical brain development.
Maternal autoantibodies
in autism
Several studies have led to the identification of eight Maternal Autoantibody Related Autism (MARA) antigens and their pathogenic antigenic determinants. The proteins were identified as collapsin response mediator proteins 1 and 2 (CRMP1, CRMP2), guanine deaminase or cypin (GDA), lactate dehydrogenase A and B (LDHA, LDHB), neuron-specific enolase (NSE), stress-induced phosphoprotein-1 (STIP1), and Y-box binding protein 1 (YBX1). Preclinical animal models have demonstrated these antibodies cause behavioral and structural brain changes in exposed offspring.
Prenatal exposure to maternal antibodies that bind to fetal brain proteins has been suggested as a mechanism for altering typical brain development
The MARAbio Test
The MARAbio test is a simple blood test in women that will identify their likelihood of having a child with autism. The assay will measure up to eight (8) specific autoantibodies, and combinations thereof, that have been linked to a form of autism that represents nearly 1 in 5 of all diagnosed cases. This test can be used to detect the MARA subtype of autism in a child, even before symptoms exist. The test can also help accelerate the diagnosis of MARA in a child with signs of developmental delay. Additionally, the test can be used by women at elevated risk before they get pregnant to determine their likelihood of having a child with the MARA subtype of autism.
Who should be tested?
The MARAbio test is in development for biological mothers:
of an autistic child and who is contemplating a subsequent pregnancy and/or
of a child who is at a high likelihood of an autism diagnosis (pre-symptomatic), thereby enabling interventions such as earlier intensive behavioral therapy.
of a child who fails to meet developmental milestones
The test is not intended or validated for use during pregnancy until treatment is available. The MARAbio test detects the MARA type of autism, which is estimated to be 20% of all autism diagnoses.
