Home-made Liposomal EGCG — a cost effective therapy for Autism, Parkinson’s, and Alzheimer’s? Plus alternative antioxidants — Whey protein and Liposomal vitamin C

A $30 ultrasonic jewellery cleaner can be repurposed to make inexpensive liposomal supplements

 

Today’s post is really one for those who prefer not to use prescription drugs to treat autism, or those that are just unable to access them. It is also one our longtime reader Ling might regard as MacGyver-esque (from the TV series following the adventures of Angus MacGyver, a secret agent armed with remarkable scientific resourcefulness to solve any problem out in the field using any materials at hand).

It is about increasing the bioavailability of OTC supplements (EGCG in today’s case, but applicable to many others) to get closer to achieving their often elusive health benefits in autism.

There are some effective OTC autism therapies, but most are not. This is why repurposing existing prescription drugs is likely necessary.

 

Liposomal

One of the big things in the supplement world at the moment is to call products “liposomal” and triple the price. The theory is that a preparation contains the active drug/supplement inside very tiny, fat-like particles. This form is easier for the body to absorb and allows more drug/supplement to get to the target area of the body, such as the brain. Liposomal drugs may have fewer side effects and should, in theory, work better than other forms of the drug.

This fatty encapsulation helps protect the active compound from degradation in the digestive system and improves its absorption through the gut. It can also enhance delivery to target tissues (like the brain) because liposomes can sometimes cross biological barriers more easily.

This should mean higher effectiveness with lower doses and potentially fewer side effects compared to non-encapsulated forms.

 

If you are interested in the details:

https://en.wikipedia.org/wiki/Liposome

“A liposome is a small artificial vesicle, spherical in shape, having at least one lipid bilayer. Due to their hydrophobicity and/or hydrophilicity, biocompatibility, particle size and many other properties, liposomes can be used as drug delivery vehicles for administration of pharmaceutical drugs and nutrients, such as lipid nanoparticles in mRNA vaccines, and DNA vaccines. Liposomes can be prepared by disrupting biological membranes (such as by sonication).

Liposomes are most often composed of phospholipids, especially phosphatidylcholine, and cholesterol, but may also include other lipids, such as those found in egg and phosphatidylethanolamine, as long as they are compatible with lipid bilayer structure. A liposome design may employ surface ligands for attaching to desired cells or tissues.”

 

 

  

By making your own liposomal supplements you will save a lot of money, compared to commercial ones and have access to an undegraded product. If you customize the recipe/ingredients thoughtfully, and carefully control the processing, the result might replicate some of the benefits seen in university studies. You might wonder why compounding pharmacies are not already doing this - maybe some are.

You can pretty much buy everything you need on Amazon. Once you have figured out your ingredients and decided how big a batch to make, it is no more complex than baking a cake.

 

Liposomal vitamin C and whey protein as therapies for oxidative stress

Oxidative stress is a core feature of most autism, particularly in the early years, and a feature of aging for everyone. Vitamin C is a natural antioxidant, but it is a water soluble vitamin that your body automatically regulates and excretes via urine. If you take mega-doses of a standard supplement it just goes down the toilet, it does not reach the bloodstream.

Intravenous vitamin C causes a large increase in levels in the blood. This can be used to treat sepsis and even mast cell activation syndrome (MCAS). It has potential in oncology (cancer treatment) because at high concentrations, vitamin C can act as a pro-oxidant, generating hydrogen peroxide that is selectively toxic to tumor cells.  

It has also been used for Ehlers-Danlos syndrome, fibromyalgia and other conditions

Some practitioners consider IV vitamin C for autism because of its: 

• Antioxidant effects – reducing oxidative stress, which is elevated in many children with autism.
• Anti-inflammatory properties – calming neuroinflammation and microglial activation.
• Support for neurotransmitter synthesis – vitamin C is a cofactor in dopamine and norepinephrine production.
• Possible mast cell stabilization – relevant in children with autism and comorbid mast cell activation syndrome (MCAS).
• Histamine degradation support – helps recycle tetrahydrobiopterin (BH4), indirectly involved in histamine metabolism.

 

It has been found that liposomal vitamin C can achieve levels in the blood somewhere in between IV-vitamin C and regular vitamin C by food or supplements. 

High levels of vitamin C can cause side effects such as kidney stones.

Liposomal vitamin C is better tolerated than very high doses of standard vitamin C. It looks like things are likely to start going wrong above 3,000mg a day of liposomal.

Healthy people just need a good diet. If they have a poor diet then take a multivitamin.

Liposomal or IV therapy is only for people with real health issues.

People with MCAS plus autism certainly do have health issues.

Ehlers–Danlos syndrome (and milder subclinical versions) is linked to MCAS, ADHD, autism and Tourette’s. So that is another group to consider.

Fibromyalgia was put forward (by me) as a step towards autism in some females, in subsequent levels of their family tree.

So overall the idea of liposomal vitamin C has much more merit than a natural sceptic would have first thought. (There are loads of YouTube videos of people doing this, and likely many did not really need it.)

 

Whey protein as an antioxidant 

This topic was recently highlighted by our reader Stephen and it naturally fits into this post.

Back in 2013 when I was developing my son’s therapy I had to choose between NAC and whey protein to boost glutathione (GSH), the body’s key antioxidant. I chose NAC.

Here is a great paper to support the use of whey protein.

 

Improving Antioxidant Capacity in Children With Autism: A Randomized, Double-Blind Controlled Study With Cysteine-Rich Whey Protein 

Previous studies indicate that children with autism spectrum disorder (ASD) have lower levels of glutathione. Nutritional interventions aim to increase glutathione levels suggest a positive effect on ASD behaviors, but findings are mixed or non-significant. A commercially available nutritional supplement comprising a cysteine-rich whey protein isolate (CRWP), a potent precursor of glutathione, was previously found to be safe and effective at raising glutathione in several conditions associated with low antioxidant capacity. Therefore, we investigated the effectiveness of a 90-day CRWP intervention in children with ASD and examined whether intracellular reduced and oxidized glutathione improvements correlated with behavioral changes. We enrolled 46 (of 81 screened) 3-5-year-old preschool children with confirmed ASD. Using a double-blind, randomized, placebo-controlled design, we evaluated the effectiveness of daily CRWP (powder form: 0.5 g/kg for children <20 kg or a 10-g dose for those >20 kg), compared with placebo (rice protein mimicking the protein load in the intervention group), on glutathione levels and ASD behaviors assessed using different behavioral scales such as Childhood Autism Rated Scale, Preschool Language Scale, Social Communication Questionnaire, Childhood Behavioral Checklist and the parent-rated Vineland Adaptive Behavior Scale, 2nd edition (VABS-II). Forty children (CRWP, 21; placebo, 19) completed the 90-day treatment period. Improvements observed in some behavioral scales were comparable. However, the VABS-II behavioral assessment, demonstrated significant changes only in children receiving CRWP compared to those observed in the placebo group in the composite score (effect size 0.98; 95% confidence intervals 1.42-4.02; p = 0.03). Further, several VABS-II domain scores such as adaptive behavior (p = 0.03), socialization (p = 0.03), maladaptive behavior (p = 0.04) and internalizing behavior (p = 0.02) also indicated significant changes. Children assigned to the CRWP group showed significant increases in glutathione levels (p = 0.04) compared to those in the placebo group. A subanalysis of the VABS-II scale results comparing responders (>1 SD change from baseline to follow up) and non-responders in the CRWP group identified older age and higher levels of total and reduced glutathione as factors associated with a response. CRWP nutritional intervention in children with ASD significantly improved both glutathione levels and some behaviors associated with ASD. Further studies are needed to confirm these results.

 

This study used a special commercial product called Immunocal, a cysteine-rich whey protein isolate (CRWP) that serves as a potent glutathione precursor.

There are less expensive alternatives to Immunocal that still offer high-quality, undenatured, cysteine-rich whey protein, especially if your goal is to support glutathione production without paying premium prices. These products are typically marketed as cold-processed, non-denatured whey protein concentrates or isolates, and some are even made from the same raw material sources as Immunocal.

If you want to further increase absorption you can even make a liposomal version of a cysteine-rich whey protein!! 

Regular body builders’ whey protein is great to help build muscles and to maintain muscle mass in seniors, but it is not the ideal source of cysteine. It has degraded during the production process, that why there are fancy ones available.

I think Stephen would indeed be well advised to add a scoop of cysteine-rich whey protein isolate (CRWP) to his sons’ diets. It should have a more prolonged effect than NAC. For young children with autism NAC really needs to be given 3-4 times a day.

You can have too much cysteine. You do not need high dose of both NAC and CRWP.

 

Back to liposomal EGCG

If you read the reviews many people find commercial liposomal supplements no more effective than the much cheaper, regular ones. I wonder why. Most likely they were not well formulated, or they degraded by the time they were used. These products are not heat or light stable.

Many manufactured products like fish oil supplements no longer maintain the health benefit of the genuine article (fish, in this case). This is because the product degraded and sometimes can even have a negative behavioral effect. 

 

Many healthy natural products like catechins or curcuma have very low bioavailability

There is a long list of healthy products that should be therapeutic in autism including:

·        Green tea catechins like EGCG

·        Turmeric/Curcuma

·        Resveratrol

·        Cocoa

·        Many herbs (sage, oregano, rosemary, Bacopa monnieri, ginseng, lions mane, etc)

They generally have very low bioavailability and so they work great in the lab, but much less so in humans; unless you consume very large amounts, for example turmeric in an Indian diet.

 

EGCG

I have written about EGCG in the past and have highlighted the research from Spain, more specifically from the beautiful city of Barcelona (just avoid visiting during the peak summer months). The research showed a benefit in Fragile X and Rett syndrome. As usual, no customized intervention has yet been brought to the market.

https://www.epiphanyasd.com/search/label/EGCG?max-results=20

Yet another study showing the potential benefit of EGCG, was published recently, this time in Pakistan.

 

Cross-linking catechins with neuro-regulatory model for autism spectrum disorder: A management in rats’ experiment 

We found that BDNF levels returned to normal levels within the groups who received Catechins treatment at III, IV, and V concentrations (compared to Group II), showing Catechins could potentially treat autism-like symptoms. The BDNF values measured in nano-grams per millilitre were Group I (13.1±0.3), followed by Group II (5.1±0.2) and Group III (9.8±0.3), Group IV (8.0±0.3), and then Group V (10.1±0.3). The BDNF concentration measured in Groups III, IV and V surpassed the BDNF level of Group II (PPA-induced) per results from a post-hoc Tukey's test at p 

Catechins successfully decreased neuroinflammatory markers throughout the brain and establish protective brain mechanisms that potentially improve ASD-associated behavioral symptoms. Rats given 100, 200, and 400 mg/kg of various catechins showed increases in BDNF levels of up to 75%, 61%, and 77%, respectively, as opposed to only 39% for rats that received no treatment. The findings of a study suggested a continuous and expandable neuroprotective effect based on dose strength. The experimental results demonstrated that in ASD models, catechins offer a potent and dosage-dependent defense against neuroinflammatory injuries.

  

This study confirms that epigallocatechin gallate (EGCG), among catechins, shows great promise for managing neuroinflammation in ASD patients. The results indicate that catechins deliver substantial reductions in neuroinflammatory markers, as they serve as protective element that improves behavioral and cognitive manifestations of ASD. Future investigations must explore mechanisms of effect and find best-use dosages for catechins while establishing their safety and lasting effect durations.

 

Then I came across this paper where the university made their own liposomal version of EGCG and tried it on their model of Parkinsons’ disease. It also worked very well. Autism is not Parkinsons’ but both conditions feature activated microglia, the brain’s immune cells that are also tasked with synaptic pruning housekeeping duties.

 

Epigallocatechin-3-Gallate-Loaded Liposomes Favor Anti-Inflammation of Microglia Cells and Promote Neuroprotection

Microglia-mediated neuroinflammation is recognized to mainly contribute to the progression of neurodegenerative diseases. Epigallocatechin-3-gallate (EGCG), known as a natural antioxidant in green tea, can inhibit microglia-mediated inflammation and protect neurons but has disadvantages such as high instability and low bioavailability. We developed an EGCG liposomal formulation to improve its bioavailability and evaluated the neuroprotective activity in in vitro and in vivo neuroinflammation models. EGCG-loaded liposomes have been prepared from phosphatidylcholine (PC) or phosphatidylserine (PS) coated with or without vitamin E (VE) by hydration and membrane extrusion method. The anti-inflammatory effect has been evaluated against lipopolysaccharide (LPS)-induced BV-2 microglial cells activation and the inflammation in the substantia nigra of Sprague Dawley rats. In the cellular inflammation model, murine BV-2 microglial cells changed their morphology from normal spheroid to activated spindle shape after 24 h of induction of LPS. In the in vitro free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, EGCG scavenged 80% of DPPH within 3 min. EGCG-loaded liposomes could be phagocytized by BV-2 cells after 1 h of cell culture from cell uptake experiments. EGCG-loaded liposomes improved the production of BV-2 microglia-derived nitric oxide and TNF-α following LPS. In the in vivo Parkinsonian syndrome rat model, simultaneous intra-nigral injection of EGCG-loaded liposomes attenuated LPS-induced pro-inflammatory cytokines and restored motor impairment. We demonstrated that EGCG-loaded liposomes exert a neuroprotective effect by modulating microglia activation. EGCG extracted from green tea and loaded liposomes could be a valuable candidate for disease-modifying therapy for Parkinson’s disease (PD).

 

Looks great, but you cannot buy their product. It then appeared that people are already making liposomal supplements at home.

Dig a little deeper to see what other clever ideas exist in the university research world that might make DIY versions better. 

 

Liposomal Formulations for an Efficient Encapsulation of Epigallocatechin-3-Gallate: An In-Silico/Experimental Approach

As a part of research project aimed to optimize antioxidant delivery, here we studied the influence of both salts and lipid matrix composition on the interaction of epigallocatechin-3-gallate (EGCG) with bilayer leaflets. Thus, we combined in silico and experimental methods to study the ability of neutral and anionic vesicles to encapsulate EGCG in the presence of Ca2+ and Mg2+ divalent salts. Experimental and in silico results show a very high correlation, thus confirming the efficiency of the developed methodology. In particular, we found out that the presence of calcium ions hinders the insertion of EGCG in the liposome bilayer in both neutral and anionic systems. On the contrary, the presence of MgCl2 improves the insertion degree of EGCG molecules respect to the liposomes without divalent salts. The best and most efficient salt concentration is that corresponding to a 5:1 molar ratio between Mg2+ and EGCG, in both neutral and anionic vesicles. Concerning the lipid matrix composition, the anionic one results in better promotion of the catechin insertion within the bilayer since experimentally we achieved 100% EGCG encapsulation in the lipid carrier in the presence of a 5:1 molar ratio of magnesium. Thus, the combination of this anionic liposomal formulation with magnesium chloride, avoids time-consuming separation steps of unentrapped active principle and appears particularly suitable for EGCG delivery applications.

 

The Mozafari method for Liposomal delivery

The latest methods used in universities to make liposomal products cannot be entirely replicated at home, but there is a well-known method developed by Dr Mohammad Mozafari that has been proved to increase bioavailability 2 to 8 times. The Mozafari method is used today by biohackers at home. Often they seem to skip some important steps.

We can fine tune his method, for example by noting the research showing that magnesium ions can help stabilize the liposomes and improve encapsulation of EGCG. Calcium ions have a very negative effect and so make sure no calcium (for example, from hard water) enters the process. YouTubers just use tap water. So use high-quality deionized (DI) water and add Magnesium Chloride (MgCl₂).

Anionic liposomes (negatively charged phospholipids) promote better EGCG insertion compared to neutral liposomes. With Mg²⁺, anionic liposomes reached 100% encapsulation efficiency experimentally. So it was actually perfect.

Magnesium chloride (MgCl₂) at about a 5:1 molar ratio relative to EGCG

(Example: for 500 mg EGCG ≈ 1.1 mmol, add ~5.5 mmol MgCl₂ — roughly 670 mg MgCl₂·6H₂O)

Both pH and temperature control are important and seem to get ignored by YouTubers.

Choose the right lipid. Here are the choices:

Most DIYers are using Lecithin (sunflower or soy), which contains phosphatidylcholine (PC), plus other substances you do not want. It is cheaper than pure PC.

If you are making liposomal vitamin C, glutathione, DHA or EGCG for therapeutic use (e.g., autism, MCAS, oxidative stress), pure PC gives superior performance.

Lecithin is zwitterionic, meaning it contains both positive and negative charges, but is overall electrically neutral. This dual nature is what makes lecithin perfect for encapsulating both water-soluble (like vitamin C) and fat-soluble (like curcumin) compounds in liposomes.

For closer to University-grade work we need to look at pure chemicals.

·        Phosphatidylcholine (PC) — neutral

·        Phosphatidylserine (PS) — anionic (negative charged)

·        CHEMS (Cholesteryl Hemisuccinate), a negatively charged cholesterol derivative.

·        Cholesterol

 

Component             Role  

PC                               Bilayer structure & fluidity         

PS                               Anionic charge, Mg²⁺ interaction          

Cholesterol               Stabilization (optional)    

CHEMS                      Additional anionic charge (optional)

 

Phosphatidylserine (PS) is itself therapeutic

PS naturally concentrates in the brain, especially in neuronal membranes.

It is known to support memory, attention, synaptic function, and neuroplasticity — ideal for neurodegenerative and developmental conditions.

PS is negatively charged (anionic), which helps form stable liposomes and can improve encapsulation of positively charged or hydrophilic molecules like EGCG.

PS has functional activity, beyond just being a carrier, PS itself may synergize with EGCG and other cognitive-enhancing compounds.

Adding cholesterol makes the liposome less leaky and more resistant to degradation. Without cholesterol, liposomes are more prone to oxidation, fusion, or breakdown over time

  

Example for 2 g Total Lipids:

Lipid Component	Weight (grams)	Percentage
PC	1.2 g	60%
PS	0.4 g	20%
Cholesterol	0.4 g	20%

 

• PC provides a stable bilayer and good liposome formation.
• PS introduces a negative charge that enhances electrostatic interaction with Mg²⁺ and EGCG.
• Cholesterol improves membrane rigidity and stability, helping prevent leakage.
• You can adjust cholesterol slightly depending on how rigid you want the membrane.
• Maintain MgCl₂ at ~5:1 molar ratio to EGCG in the aqueous buffer for optimal encapsulation, as per references.

EGCG is highly oxidation-sensitive.

Both vitamin C (ascorbic acid) and vitamin E (tocopherol) protect:

·        the lipids in the liposome from peroxidation,

·        the EGCG itself from degradation.

So it is wise to add both vitamin C and E.

• Vitamin E is lipid-soluble and embeds in the bilayer.
• Vitamin C is water-soluble and protects the aqueous core.

 

Here is the home version.

 

 

Equipment

• Glass beaker or jar
• Ultrasonic cleaner (sold to clean jewellery)
• Stirring rod
• pH strips or meter
• Dark glass storage bottle

 

Method

1.     Mix Vitamin E with PS

o    Combine PS powder and vitamin E oil or powder thoroughly in a small container.

2.     Prepare aqueous phase

o    Dissolve EGCG powder and magnesium chloride in ~20 mL PBS or distilled water with buffer salts.

o    Add vitamin C to this aqueous solution last and stir gently until dissolved.

3.     Hydrate lipids

o    Slowly add the aqueous phase (EGCG + MgCl₂ + vitamin C) to the PS + vitamin E mix.

o    Stir or vortex gently to disperse.

4.     Sonicate

o    Place the mixture in an ultrasonic cleaner bath for 20–30 minutes, stirring occasionally.

o    Solution should become milky/opalescent, indicating liposome formation.

 

How to Use Ultrasonic Cleaner for Liposomal EGCG

1.     Prepare your liposome suspension in a suitable sealed container—usually a small glass vial or bottle with a tight lid (e.g., amber glass bottle or glass vial).

2.     Fill the ultrasonic cleaner tank with clean water—enough so that when you place your container in it, the water level reaches just below the lid or about 2/3 up the container’s height. The water must not overflow into your liposome container

3.     Place your sealed bottle/vial into the ultrasonic bath, making sure it sits upright and stable.

4.     Turn on the ultrasonic cleaner for the recommended at medium power.

5.     During the process, keep an eye on the temperature—if the water or sample gets too warm (>40°C), pause and let it cool, since heat will degrade EGCG.

6.     After sonication, remove the bottle and store the liposomal EGCG in a dark, refrigerated place.

 

Important Tips

• Use sealed containers to avoid contamination or water ingress.
• Never put the liposomal suspension directly into the ultrasonic cleaner’s water bath.
• If your ultrasonic cleaner has a temperature control or timer, use those settings to protect the sample.
• Clean the ultrasonic tank well before and after use.

The final product will be stable for 7 days in the fridge.

You can freeze portion sized doses in a silicone ice cube tray. Later store in the freezer in a zip lock bag for 2-3 months. Defrost in the fridge, one by one, as you need it.

Keeping the temperature below 40°C is essential when sonifying delicate compounds like EGCG, vitamin C, and phospholipids (especially phosphatidylserine). They degrade or oxidize easily when exposed to excessive heat.

 

 1. Use a Cold Water Bath

• Fill the ultrasonic cleaner with cold water (4–10°C).
• Add ice cubes to keep it cold.
• Replenish ice as needed during sonication.

 

2. Monitor Temperature

• Use a probe thermometer or an infrared laser thermometer.
• Check the temperature of your sample, not just the water bath.

 

Ultrasonic waves create cavitation — rapid formation and collapse of microbubbles — which:

• Generates localized heat (tiny hot spots in the solution)
• Transfers energy into the liquid, raising the overall temperature gradually
• Can increase your solution temperature from room temp to 50–60°C in 10–15 minutes if not managed

Even if the water bath feels lukewarm, the inside of your beaker can be much hotter, especially in the center.

 

 Sensitive Ingredients at Risk

• EGCG starts to degrade above ~40°C
• Phospholipids can oxidize or become unstable
• Vitamin C rapidly degrades in heat and light

 

Best Practices to Avoid Overheating

Tip	Why
Use an ice-cold bath	Keeps temp under control during sonication
Sonicate in short bursts (30s ON, 30s OFF)	Prevents buildup of heat
Stir gently before and after sonication	Helps distribute heat and emulsify
Monitor temperature regularly	Keeps you in the safe zone (under 40°C)
Work with small batches (≤100 mL)	Easier to cool and control

 

Sonication is the process of using high-frequency sound waves—usually ultrasound—to agitate particles in a liquid. In making liposomes, sonication helps break down large lipid aggregates into smaller, uniform liposomes by creating tiny bubbles that collapse and generate energy, mixing and dispersing the components more thoroughly.

In simpler terms, sonication is like using sound waves to gently shake and break up the mixture so that the fat-like particles (liposomes) form smaller, more consistent droplets, which can improve how well the active ingredient (like EGCG) gets absorbed by your body.

  

Conclusion

Immunocal, a cysteine-rich whey protein isolate (CRWP) does show a benefit in autism. It is an OTC product that is sold online.

EGCG is the most abundant catechin in green tea.  When taken orally, EGCG has poor absorption even at daily intake equivalent to 12 cups of green tea.

EGCG does show merit in autism research studies, but to be effective in humans the bioavailability needs to be improved. Using liposomes to encase the EGCG is a promising approach.

Will the method proposed in this post be effective?

I asked Gemini AI to comment on the method and it replied: 

"The EGCG method you described is a fantastic example of a DIY approach that is grounded in sound scientific principles. By using specific lipids, optimizing the formulation with magnesium, and strictly controlling the process, it goes far beyond the simplistic and often ineffective methods seen online.

While it won't produce a pharmaceutical-grade product, it is highly likely to create a solution that contains a significant number of genuine, stable, and correctly sized liposomes. This makes it far more likely to be an effective delivery system than the typical DIY liposomal vitamin C, which is often just an unverified emulsion."

Some people do grow their own broccoli sprouts to make sulforaphane, others grow wheat sprouts for spermidine. Some people grow their own probiotic bacteria. Making tumeric balls is a simple way to get the benefits of tumeric. There are many home-made options, and I think the parent almost certainly benefits. 

You would think that some enterprising pharmacist in Barcelona would start producing small batches of liposomal EGCG, using research grade equipment. I think Rett syndrome and Fragile X syndrome parents would buy it. Not to mention those who have parents diagnosed with Parkinson's or Alzheimer's.

   

  

HDAC Inhibitors for which Cancer/Autism?

Most types of autism can be viewed as the miss-expression of a few hundred genes, in some cases this has been caused by an initial defect in just one gene.  These single gene autisms are the ones that are usually studied.

Epigenetics has been covered previously in this blog and can either be made to look ultra-complex, which is the reality, or quite simple. The simple view is that in some people genes are miss-expressed because they have been tagged with heritable and removable markers; these can be wiped away. One type of epigenetic marker can be modified by an HDAC inhibitor or HDI.  

Some medical conditions featured genes turned off when they should be on. For example tumor suppressor gene (and autism gene) PTEN is turned off in the prostate of many males with prostate cancer; a neat therapy would be to switch it back on.  Deacetylation of PTEN by SIRT1 deacetylase and, by HDAC1, can stimulate its activity, so probably a good thing for people with this kind of common cancer.

In some types of autism there is a deficiency of a single protein because one of the two copies of the gene that encodes it does not work (Haploinsufficiency) and a neat therapy would be to make the remaining copy of that gene work harder. When I originally looked at epigenetics I thought it would not be possible to epigenetically tag the good copy of the specific gene, to switch it on. However it seems that we do not need to tag a specific gene, just provide the “post-it” notes and let the body do the tagging.

All this leads to the use of HDIs to treat cancer, leaving the body to figure out the hard part of which genes.  In reality an HDI will change the expression of numerous genes, not just the one(s) you wanted.

Different Colours of Tags

Just as those useful Post-It notes come in multiple colours, epigenetic markers come in different varieties.  This has been well studied in the cancer research.

HDAC1 inhibitors only affect part of the epigenome; there are other modifiers that are required to affect other genes.

In autism, as in cancer, you need to know which genes are miss-expressed and then you can see if an epigenetic therapy exists that covers them.  Put more simply if HDAC1 inhibitors affect only yellow post-its, which cancers/autisms would become treatable?

The more complex explanation regarding different colours of post-its:

“Important epigenetic modifications known to regulate gene expression. a DNA methylation of CpG islands in promoter regions by DNA methyltransferases (DNMT) represses gene activity. Posttranslational covalent histone modifications of lysine (K), arginine (R) or serine (S) residues in the “histone tail” also influence gene expression in different ways. b Histone acetylation (Ac) catalysed by histone acetyltransferases (HAT) is usually correlated to increased gene activity, whereas histone deacetylation caused by histone deacetylases (HDAC) is considered to decrease gene expression, even though histone hyperacetylation not always matches regions of increased gene activity. c Histone methylation (Me) and demethylation by histone methyltransferases (HMT) and histone demethylases (HDM) at lysine or arginine residues show different effects on gene activity depending on number and position of methyl groups. d Histone ubiquitinylation (Ub) at lysine residues alters histone structure and allows access of enzymes involved in transcription. e Histone phosphorylation (P) at distinct serine residues is known to be associated with increased gene expression, and it is also involved in DNA damage response and chromatin remodelling. Phosphorylation at linker histone (LH) H1 is considered to be a signal for the release of histone H1 from chromatin. In general, epigenetic regulation depends on the addition of epigenetic marks by writer enzymes (e.g. DNMT, HMT, HAT) and the removal of these marks by epigenetic eraser enzymes (e.g. HDAC and HDM) as well as epigenetic reader enzymes (not shown in this figure)”

https://clinicalepigeneticsjournal.biomedcentral.com/articles/10.1186/s13148-015-0095-z

Treating cancer is always going to be more difficult than treating autism because by the time it has been identified a whole cascade of changes is already underway and whereas autism is not degenerative, cancer by definition is. So even a very partially effective cancer drug might be potent enough for autism, or just a tiny dose of an effective cancer drug.

Source: https://www.sciencedirect.com/science/article/pii/S1044579X17300536

This post is about HDAC1&2 / yellow Post-its 

1.  The Grant Application 

Discovery of Novel Drugs for Autism

The goal of this study is to discover novel, mechanism-based pharmacological intervention for autism, a devastating neurodevelopmental disorder with no treatment currently. Genetic sequencing has revealed extensive overlap in risk genes for autism and for cancer, many of which are chromatin remodeling factors important for transcriptional regulation, suggesting the possibility of repurposing the anti-cancer drugs targeting epigenetic enzymes for autism treatment. ASDDR LLC and Yan Lab at SUNY-Buffalo propose to jointly investigate the hypothesis that histone deacetylase (HDAC) inhibitors are able to restore the expression of key autism risk factors and induce long-lasting rescue of autism-like behavioral and synaptic deficits. Combined behavioral, biochemical and electrophysiological approaches will be used to address two specific aims. 

Aim 1. To discover HDAC inhibitors that can alleviate autism-like behavioral deficits in autism mouse models. Yan lab screened a number of drugs and found that a brief treatment with the highly potent and class I-specific HDAC inhibitor, romidepsin (Istodax, an FDA-approved anti-cancer agent) at the very low dose, led to dramatic and prolonged rescue of the social deficits in the Shank3-deficient mouse model of autism. To determine whether this pharmacological agent can serve as a tool compound for autism drug development, its therapeutic efficacy and safety will be examined in two different models of autism, Shank3-deficient mice and BTBR mice.

Aim 2. To identify the molecular targets of HDAC inhibitors as benchmarks for the treatment of autism. For the discovery of effective drugs to treat autism, the molecular pathways on which HDAC inhibitors act to alleviate the autism-like behavioral deficits in Shank3-deficient mice need to be understood. We will reveal the potential benchmark, such as actin regulators and NMDARs, as molecular targets of romidepsin. This phase I preclinical study will provide great promise for the discovery of new and effective pharmacological agents to treat the social interaction deficits, a core symptom of autism.

Public Health Relevance

This project is to discover novel, mechanism-based therapeutic strategies for autism. The corporate and academic partners propose to jointly investigate the hypothesis that histone deacetylase (HDAC) inhibitors are able to restore the expression of key autism risk factors and induce long-lasting rescue of autism-like behavioral and synaptic deficits.

2. Study Press Release 

Autism’s social deficits are reversed by an anti-cancer drug

Using an epigenetic mechanism, romidepsin restored gene expression and alleviated social deficits in animal model of autism 

 “The advantage of being able to adjust a set of genes identified as key autism risk factors may explain the strong and long-lasting efficacy of this therapeutic agent for autism.”

BUFFALO, N.Y. — Of all the challenges that come with a diagnosis of autism spectrum disorder (ASD), the social difficulties are among the most devastating. Currently, there is no treatment for this primary symptom of ASD. New research at the University at Buffalo reveals the first evidence that it may be possible to use a single compound to alleviate the behavioral symptoms by targeting sets of genes involved in the disease.

The research, published today in Nature Neuroscience, demonstrated that brief treatment with a very low dose of romidepsin, a Food and Drug Administration-approved anti-cancer drug, restored social deficits in animal models of autism in a sustained fashion.

The three-day treatment reversed social deficits in mice deficient in a gene called Shank 3, an important risk factor for ASD. This effect lasted for three weeks, spanning the juvenile to late adolescent period, a critical developmental stage for social and communication skills. That is equivalent to several years in humans, suggesting the effects of a similar treatment could potentially be long-lasting, the researchers say.

Profound, prolonged effect

“We have discovered a small molecule compound that shows a profound and prolonged effect on autism-like social deficits without obvious side effects, while many currently used compounds for treating a variety of psychiatric diseases have failed to exhibit the therapeutic efficacy for this core symptom of autism,” said Zhen Yan, PhD, professor in the Department of Physiology and Biophysics in the Jacobs School of Medicine and Biomedical Sciences at UB, and senior author on the paper.

The study builds on her previous research from 2015. That work revealed how the loss of Shank 3 disrupts neuronal communications by affecting the function of the NMDA (n-methyl-D-aspartate) receptor, a critical player in regulating cognition and emotion, leading to deficits in social preference that are common in ASD.

In the new research, the UB scientists found they could reverse those social deficits with a very low dose of romidepsin, which, they found, restores gene expression and function using an epigenetic mechanism, where gene changes are caused by influences other than DNA sequences. Yan noted that human genetics studies have suggested that epigenetic abnormalities likely play a major role in ASD.

To pursue these promising findings, Yan has founded a startup company called ASDDR, which was awarded a Small Business Technology Transfer grant from the National Institutes of Health last summer for more than $770,000.

Epigenetics in ASD

Many of the mutations in ASD, Yan explained, result from chromatin remodeling factors, which are involved in dynamically changing the structure of chromatin, the complex of genetic material in the cell nucleus that condenses into chromosomes.

“The extensive overlap in risk genes for autism and cancer, many of which are chromatin remodeling factors, supports the idea of repurposing epigenetic drugs used in cancer treatment as targeted treatments for autism,” said Yan.

She and her colleagues knew that chromatin regulators — which control how genetic material gains access to a cell’s transcriptional machinery — were key to treating the social deficits in ASD, but the challenge was to know how to affect key risk factors at once.

“Autism involves the loss of so many genes,” Yan explained. “To rescue the social deficits, a compound has to affect a number of genes that are involved in neuronal communication.”

To do so, the team turned to a type of chromatin remodeler called histone modifiers. They modify proteins called histones that help organize genetic material in the nucleus so gene expression can be regulated. Since many genes are altered in autism, the UB scientists knew a histone modifier might be effective.

Loosening up chromatin

In particular, they were interested in histone deacetylase (HDAC), a family of histone modifiers that are critically involved in the remodeling of chromatin structure and the transcriptional regulation of targeted genes.

“In the autism model, HDAC2 is abnormally high, which makes the chromatin in the nucleus very tight, preventing genetic material from accessing the transcriptional machinery it needs to be expressed,” said Yan. “Once HDAC2 is upregulated, it diminishes genes that should not be suppressed, and leads to behavioral changes, such as the autism-like social deficits.”

But the anti-cancer drug romidepsin, a highly potent HDAC inhibitor, turned down the effects of HDAC2, allowing genes involved in neuronal signaling to be expressed normally.

 “The HDAC inhibitor loosens up the densely packed chromatin so that the transcriptional machinery gains access to the promoter area of the genes; thus they can be expressed,” Yan said.

The rescue effect on gene expression was widespread. When Yan and her co-authors conducted genome-wide screening at the Genomics and Bioinformatics Core at UB’s New York State Center of Excellence in Bioinformatics and Life Sciences, they found that romidepsin restored the majority of the more than 200 genes that were suppressed in the autism animal model they used.

“The advantage of being able to adjust a set of genes identified as key autism risk factors may explain the strong and long-lasting efficacy of this therapeutic agent for autism,” Yan explained. She and her colleagues will continue their focus on discovering and developing better therapeutic agents for autism.  

Full study:-  

Social deficits in Shank3-deficientmouse models of autism are rescued by histone deacetylase (HDAC) inhibition

HDAC Inhibitors

HDIs have a long history of use in psychiatry and neurology as mood stabilizers and anti-epileptics. More recently they are being investigated as possible treatments for cancers, parasitic and inflammatory diseases. 

HDAC inhibitors have effects on non-histone proteins that are related to acetylation. HDIs can alter the degree of acetylation of these molecules and, therefore, increase or repress their activity.

“To carry out gene expression, a cell must control the coiling and uncoiling of DNA around histones. This is accomplished with the assistance of histone acetyl transferases (HAT), which acetylate the lysine residues in core histones leading to a less compact and more transcriptionally active chromatin, and, on the converse, the actions of histone deacetylases (HDAC), which remove the acetyl groups from the lysine residues leading to the formation of a condensed and transcriptionally silenced chromatin. Reversible modification of the terminal tails of core histones constitutes the major epigenetic mechanism for remodeling higher-order chromatin structure and controlling gene expression. HDAC inhibitors (HDI) block this action and can result in hyperacetylation of histones, thereby affecting gene expression.^[5][6][7] The open chromatin resulting from inhibition of histone deacetylases can result in either the up-regulation or the repression of genes.”

Pitt Hopkins Research

We saw that transcription factor TCF4 (the Pitt Hopkins gene) is also lacking in some MR/ID and schizophrenia. We saw in an earlier post that TCF4 can be upregulated by PKA (protein kinase A) and that this can be achieved using a PDE4 inhibitor as used to treat asthma and COPD. So in theory Daxas should help.

The lack of the TCF4 protein in Pitt Hopkins causes a cascade of other genes to be miss-expressed. The logical thing to do is to correct that miss-expression. 

The Shank3 research is not the first to suggest that HDAC inhibition as a potentially viable therapy. In 2016 the same idea was suggested for Pitt Hopkins and while this is a rare condition, milder dysfunctions of the same TCF4 gene are seen as common in MR/ID and indeed in schizophrenia. So HDAC inhibition may be a viable therapy for many people.

HDACi meds may reverse effects of Pitt Hopkins

In a paper published this week by the journal Cell Reports, Sweatt and his colleagues at the University of Alabama at Birmingham (UAB) report that mice deficient in Tcf4 exhibit impairments in social interaction, vocalization, learning and memory characteristic of PTHS.

The impairments were “normalized” when the mice were given small-molecule drugs called HDAC inhibitors, which alter Tcf4-associated gene expression in the brain. The finding suggests that “broadly acting, epigenetically targeted therapeutics … might be particularly beneficial in PTHS patients,” the researchers concluded.

“We are quite excited by these findings, said Sweatt, a Vanderbilt University-trained pharmacologist who formerly chaired the Department of Neurobiology and directed the McKnight Brain Institute, both at UAB.

“Pitt-Hopkins Syndrome is an orphan disease that has not been extensively studied,” he said. “Having identified one potential avenue for possible therapeutics is an important step forward.”

http://www.cell.com/cell-reports/fulltext/S2211-1247(16)31036-1

“Nearly one-quarter of the genes dysregulated in the Tcf4(+/−) mice are also regulated by HDAC inhibition. The strong negative correlation between Tcf4(+/−) and CI-994 DEGs (R² = 0.72) suggests HDAC inhibition is a viable avenue for correcting a large percentage of transcriptional dysregulation associated with Tcf4 haploinsufficiency.”

Which HDAC Inhibitor?

It should be noted that Romidepsin inhibits both HDAC1 and HDAC2.

There are HDACs numbered 1 through 10.

HDAC inhibitors vary in potency. Below is a chart comparing different HDI drugs in the activation of HIV expression.

In vitro activation of HIV expression by HDAC inhibitors in an in vitro latency model.

  

The role of diet

I know that many readers of this blog like dietary interventions and do not like drugs.

In cancer I think diet can be preventative rather than therapeutic or curative. Once cancer takes hold you need very potent therapies.

In dementia it looks like diet can be preventative and therapeutic.

In mild ADHD and mild autism it looks like dietary intervention can be sufficient.  

Many flavonoids have mild epigenetic properties. They are unlikely to be potent enough to halt the cascade of changes seen in a runaway cancer, but they may well be chemoprotective, i.e. they prevent cancer developing in the first place.

Since in some autism we only need a relatively mild  effect perhaps flavonoids do have some potential, depending on which genes are miss expressed.

Epigenetic activities of flavonoids in the prevention and treatment of cancer

Food containing high amounts of epigenetically active flavonoids

Description	Class	Flavonoid	Ǿ mg/100 g	Sources of data
Grapefruit, raw (not specified as to colour) (Citrus paradisi)	Flavanones	Hesperetin	1.50	aUSDA Database for the Flavonoid Content of Selected Foods: e.g. [193]
		Naringenin	53.00
	Flavonols	Kaempferol	0.40
		Quercetin	0.50
Onions, red, raw	Flavones	Apigenin	0.24	aUSDA Database for the Flavonoid Content of Selected Foods: e.g. [193, 194, 195, 196]
		Luteolin	0.16
	Flavonols	Kaempferol	0.70
		Myricetin	2.16
		Quercetin	39.21
Soybeans, mature seeds, raw (all sources)	Isoflavones	Daidzein	62.07	bUSDA Database for the Isoflavone Content of Selected Foods: e.g. [197, 198, 199, 200, 201, 202]
		Genistein	80.99
Spices, parsley, dried (Petroselinum crispum)	Flavones	Apigenin	4503.50	aUSDA Database for the Flavonoid Content of Selected Foods: e.g. [196]
		Luteolin	19.75
Strawberries (including frozen unsweetened strawberries)	Flavonols	Fisetin	16	[203]
		Kaempferol	0.49	aUSDA Database for the Flavonoid Content of Selected Foods: e.g. [204, 205]
		Myricetin	0.35
		Quercetin	0.46
Cacao beans	Flavan-3-ols	(+)-Catechin	88.45	aUSDA Database for the aFlavonoid Content of Selected Foods: e.g. [206]
		(−)-Epicatechin	99.18
Tea, black, brewed, prepared with tap water	Flavan-3-ols	(+)-Catechin	1.51	aUSDA Database for the Flavonoid Content of Selected Foods: e.g. [196, 207, 208, 209]
		(−)-Epigallocatechin 3-gallate	9.36
	Flavonols	Kaempferol	1.41
		Myricetin	0.45
		Quercetin	2.19
Tea, green, brewed, decaffeinated	Flavan-3-ols	(−)-Epigallocatechin 3-gallate	26.05	aUSDA Database for the Flavonoid Content of Selected Foods:
	Flavonols	Kaempferol	1.00
		Myricetin	1.00
		Quercetin	2.77

A good example is EGCG 

In earlier posts on EGCG, being trialed in Spain on Down Syndrome and Fragile X; I was intrigued by the its long-lasting effects: 

Green tea extract 'boosts mental ability' in people with Down's

For most of the tests (21 of 24) there were no differences between the groups. 

However, in three tests people who'd taken EGCG did better. This improvement lasted for six months after the study ended. 

Another example is Sulforaphane (sometimes)

It appears that some people taking sulforaphane experience disease changing results, which are likely caused by the epigenetic effects of inhibiting HDAC. 

Sulforaphane from Broccoli Reduces Symptoms of Autism: A Follow-up Case Series from a Randomized Double-blind Study

Summarized Case Reports

A.    Three participants who took SF did not appear to improve during the study. Their parents reported lack of a noticeable effect and were not aware whether their young adults had been taking SF or placebo.

B.     One participant no longer uses SF. However, he improved dramatically while taking it during the study and remained “improved” after the study, suggesting to the study team a possible “epigenetic switch” might have been triggered.

“W is doing fantastic. He really turned into the most relaxed and fantastic child (on sulforaphane). Definitely something great. Helped him a lot. His friends, family, and members at his home all noticed a wonderful change. He is off the sulforaphane and has been since the end of his study in 2012.”

  

Perhaps Butyrate?  

Butyrate, Neuroepigenetics and the Gut Microbiome: Cana High Fiber Diet Improve Brain Health?

As interest in the gut microbiome has grown in recent years, attention has turned to the impact of our diet on our brain. The benefits of a high fiber diet in the colon have been well documented in epidemiological studies, but its potential impact on the brain has largely been understudied. Here, we will review evidence that butyrate, a short-chain fatty acid (SCFA) produced by bacterial fermentation of fiber in the colon, can improve brain health. Butyrate has been extensively studied as a histone deacetylase (HDAC) inhibitor but also functions as a ligand for a subset of G protein-coupled receptors and as an energy metabolite. These diverse modes of action make it well suited for solving the wide array of imbalances frequently encountered in neurological disorders. In this review, we will integrate evidence from the disparate fields of gastroenterology and neuroscience to hypothesize that the metabolism of a high fiber diet in the gut can alter gene expression in the brain to prevent neurodegeneration and promote regeneration.

  

Butyrate enhances mitochondrial function during oxidative stress in cell lines from boys with autism

In general, these data suggest that BT can enhance mitochondrial function in the context of physiological stress and/or mitochondrial dysfunction, and may be an important metabolite that can help rescue energy metabolism during disease states. Thus, insight into this metabolic modulator may have wide applications for both health and disease since BT has been implicated in a wide variety of conditions including ASD. However, future clinical studies in humans are needed to help define the practical implications of these physiological findings.

Conclusion

Clearly HDAC inhibitors are beneficial in some cancer and some autism.

In cancer the dose required is so high there almost inevitably will be some side effects, particularly in people already in poor health.

Hopefully when Dr Yan moves on to trial Romidepsin in her second mouse model, the BTBR model, she will be as successful as with the Shank3 model.

Ultimately, I assume she will trial her low dose Romidepsin as a single dose in humans. I am sure plenty of people will be interested in that, including all the Pitt Hopkins families. Hopefully someone will trial Daxas in Pitt Hopkins (upregulate PKA which then upregulates TCF4).

Dietary HDAC inhibitors include butyrate and sulforaphane. They are much weaker than Romidepsin. Would a very large dose of sulforaphane/butyrate have the potency of a small dose of Romidepsin?

To be effective in autism the HDAC inhibitor would have to freely cross the blood barrier, clearly drugs used to treat brain cancer tick this box.

Vorinostat/Zolinza also looks interesting.

We should not overlook Valproic acid, another HDAC inhibitor. This epilepsy drug can cause autism when taken during pregnancy, but is taken by some children with autism. Unlike Romidepsin and Vorinostat, which are hugely expensive, Valproic acid is cheap.

Continued use of Valproic acid can cause side effects, as seen in the comments section of this blog. A short sharp shock with valproic acid might be different.

I am sure Dr Yan chose Romidepsin for its potency. A small dose of Romidepsin is likely much more effective than a bucket load of broccoli sprouts (sulforophane).  

Just how low a dose is Dr Yan talking about? Recall that Professor Catterall’s  low dose of clonazepam (to modulate alpha3 subunits of GABAa receptors) was so low in humans it has none of the well-known drawbacks of benzodiazepine use (addiction, tolerance etc).

Dr Naviaux’s use of Suramin was long thought to be impractical in humans due to side effects, but now this appears not to be the case.

Back to Dr Yan:- 

Social deficits in Shank3-deficient mouse models of autism are rescued by histone deacetylase (HDAC) inhibition

Treatment with the HDAC inhibitor romidepsin lastingly relieves autism-like social deficits in Shank3-deficient mice. The level of global H3 acetylation (Fig. 1a) in the frontal cortex of Shank3+/ΔC mice was significantly lower than that from wild-type (WT) mice. 

 A systemic administration of low-dose romidepsin (0.25 mg/kg, intraperitoneally (i.p.), once daily for 3 d), a highly potent and brainpermeable class I-specific HDAC inhibitor (with nanomolar in vitro potency25) approved by the US Food and Drug Administration (FDA) for cancer treatment26–28, significantly elevated the level of acetylated H3 in Shank3+/ΔC mice, while it had little effect in WT mice. These data suggest that Shank3-deficient mice have an abnormally low level of histone acetylation, which can be restored by romidepsin treatment. 

This dose looks like about one tenth of the used in mice in cancer trials.

In humans, Romidepsin is for intravenous infusion only. Each 10 mg single-use vial of Romidepsin/Istodax costs about $2,800.

Vorinostat/Zolinza costs about $3,800 for 30 capsules.

If the autism effects of a potent HDAC1/2 inhibitor can last for several years in humans, as suggested by Dr Yan, and if the dose is a tenth of the cancer dose, the cost would not seem to be such a barrier.

The open question is the safety profile of Romidepsin at a single low dose in otherwise physically healthy children.

Risk vs Reward

While nobody wants side effects, one has to consider the risk versus the reward. In some single gene types of severe autism it is clear what the outcome with no intervention will be; perhaps that looming outcome warrants taking a bigger risk than someone with mild autism struggling with social difficulties? But then again, perhaps an HDAC1/2 inhibitor might improve social functioning so someone with Asperger’s, or indeed schizophrenia, does not commit suicide?