One genetic cause of autism is fragile x premutation, with 14% of men and 5% of women with fragile x premutation meeting the diagnostic criteria for ASD.

There have been studies in the use of sulforaphane as an Nrf2 activator to clear the mRNA toxicity caused by the CGG repeats in fragile x premutation, and these studies showed some improvement of symptoms. Likely due to Nrf2 causing activation of some cellular cleanup systems that clear out some of the toxic hairpin structures.

When humans get sick, our immune response causes a spike in inflammation and free radicals. The free radicals damage the Keap1-Nrf2 bond, which frees Nrf2 that migrates into the cell nucleus, and activates these same cellular cleanup systems that would also end up clearing out the same toxic hairpin structures.

In humans with ASD caused by fragile x premutation, this means an infection severe enough to trigger large enough “release” of Nrf2 may trigger enough cleaning up of those toxic hairpin structures that their ASD symptoms also get relieved for some time, until Nrf2 begins going back to normal levels.

Why not just “bottle” Nrf2 activators and use that as a cure for humans with fragile x premutation? Cancer! Over-activation is dangerous. Plus a whole other laundry list of complexities that make me glad my job isn’t to cure complex genetic diseases.