"CYCLE OF HEALTH." >> TONIGHT'S TOPIC, AUTISM, INCLUDING THE HOPEFUL NEW SCIENCE OF SALIVA TESTING. AUTISM IS A COMPLEX DISORDER THAT AFFECTS MILLIONS OF KIDS AND ADULTS WORLDWIDE. TONIGHT WE ARE JOINED BY THREE EXPERTS IN THE FIELD WHO WILL HELP US UNDERSTAND AUTISM. IT'S DIAGNOSIS, TREATMENT AND HOW THE NEW SALIVA TESTING PROCESS FITS IN. ♪ ♪ >> HELLO AND WELCOME TO CYCLE OF HEALTH; I'M DR. RICH O'NEILL. IN HONOR OF AUTISM AWARENESS MONTH, TONIGHT'S TOPIC: AUTISM, INCLUDING THE HOPEFUL NEW SCIENCE OF SALIVA TESTING. AUTISM IS A COMPLEX DISORDER THAT AFFECTS MILLIONS OF KIDS AND ADULTS WORLDWIDE. TONIGHT WE'RE JOINED BY THREE EXPERTS IN THE FIELD WHO CAN HELP US UNDERSTAND AUTISM, ITS DIAGNOSIS AND TREATMENT, AND HOW THE NEW SALIVA TESTING PROCESS FITS IN. LET'S MEET OUR GUESTS: DR. STEVE HICKS, PEDIATRIC PHYSICIAN SCIENTIST AND CHIEF MEDICAL OFFICER OF AS YOU ARE MR. BRYAN GREENE, CO-CEO OF QUADRANT LABORATORIES AND DR. FRANK MIDDLETON, PROFESSOR OF NEUROSCIENCE AND BIOCHEMISTRY AT SUNY UPSTATE MEDICAL UNIVERSITY CLOSE SO, Dr. HICKS, START US OFF WITH WHAT IS AUTISM? >> AUTISM IS A NEURO-DEVELOPMENTAL DIAGNOSIS THAT IS CHARACTERIZED BY DIFFICULTIES WITH SOCIAL INTERACTION AND COMMUNICATION, AND ALSO RESTRICTED AND REPETITIVE THOUGHTS OR BEHAVIORS. WE REFER TO AUTISM AS A SPECTRUM AND WE DEFINE IT IN TERMS OF ITS SEVERITY ON THREE LEVELS WHERE 1 REQUIRES THE LEAST AMOUNT OF SUPPORTS AND INDIVIDUALS WITH LEVEL 3 AUTISM TYPICALLY REQUIRE THE MOST SUPPORTS. >> SO HOW DO YOU GO FROM THAT DEFINITION TO A CLINICAL DIAGNOSIS? >> SO CLINICAL DIAGNOSIS TYPICALLY IS MADE BY A PHYSICIAN OR A PEDIATRIC PSYCHOLOGIST. IT INVOLVES REVIEWING THE CHILD'S DEVELOPMENTAL HISTORY, COLLECTING INFORMATION ABOUT THE CHILD'S BEHAVIOR FROM THE FAMILY, AND THEN OBSERVING THE CHILD WITH A STANDARDIZED SET OF PLAY ACTIVITIES. OFTEN TIMES THIS IS DONE IN A DOCTOR'S OFFICE, BUT AS A RESULT OF PANDEMIC-RELATED BARRIERS, WE'VE LEARNED CREATIVE AND EFFICIENT NEW WAYS TO SOMETIMES DO IT OVER TELEHEALTH. >> THAT'S WHERE YOUR COMPANY, AS YOU ARE, COMES IN. WE'LL TALK A LITTLE BIT MORE ABOUT THAT LATER. BUT SO YOU ARE REALLY MAKING THIS DIAGNOSIS BEHAVIORALLY, OBSERVATIONS AND FROM PARENTS AND TEACHERS AND PEDIATRICIANS, ET CETERA. AND THERE IS A GENETIC COMPONENT, WHICH I UNDERSTAND IS WHERE BRYAN'S LAB COMES IN. >> QUAD QUADRANT LABORATORIES IN SYRACUSE PERFORMS GENETIC TESTING WITH SALIVA SPECIMENS FOR KIDS WITH AUTISM. THAT GENETIC TEST CAN HELP IDENTIFY SYNDROMIC CAUSES OF AUTISM. >> SYNDROMIC MEANS? >> SYNDROME IN TERMS OF GENETIC TESTING MEANS THAT THERE IS A KNOWN CHANGE IN DNA SEQUENCE THAT PRODUCES A CHARACTERISTIC SET OF CHANGES IN THE BEHAVIOR OR THE PHYSICAL APPEARANCE OF AN INDIVIDUAL. SO THERE ARE MANY EXAMPLES OF THIS. BUT IT IS SOMETHING THAT THEY CAN TEST FOR IN THE LAB THAT THEY KNOW WOULD ALMOST CERTAINLY BE THE CAUSE FOR THIS CHANGE IN APPEARANCE AND BEHAVIOR IN A PARTICULAR INDIVIDUAL. >> SO BACK TO YOU, BRYAN. HOW DOES YOUR LAB FIT INTO THAT? >> SO IN ADDITION TO LOOKING AT THE SYNDROMIC CAUSES OF AUTISM THROUGH YOWR AUTISM I.D. PANEL, WE ARE ABLE TO IDENTIFY ANY CO-MORBID CONDITIONS THAT EXIST WITHIN THAT CHILD AS WELL. >> CO-MORBID MEANS IT COMES ALONG WITH AUTISM? >> COMMONLY OCCURRING WITHIN THE SAME POPULATION. SO THOSE CO-MORBID CONDITIONS CAN BE VERY IMPORTANT AS IT HELPS PEDIATRICIANS LIKE STEVE IDENTIFY POTENTIAL MEDICATIONS THAT COULD WORK, HOW TO DOSE CERTAIN MEDICATIONS AND REALLY HOW TO DO EFFECTIVE PRESCRIPTIONS FOR THOSE CHILDREN. >> SO YOU ARE TESTING-- HOW SOON DO YOU DO THE TESTING NOW THAT THE GENETIC TESTING? THE GENETIC TEST CAN BE DONE FOLLOWING-- IT IS DONE FOLLOWING A DIAGNOSIS FOR THAT CHILD. SO ONCE A PEDIATRICIAN HAS DETERMINED THAT THAT CHILD IS ON THE AUTISM SPECTRUM, THEY WILL OFTEN ORDER GENETIC TESTING. IT'S RECOMMENDED BY BOTH THE AMERICAN ACADEMY OF PEDIATRICS AND THE AMERICAN COLLEGE OF MEDICAL GENETICISTS. THEY WILL PRESCRIBE THAT. THEY WILL DELIVER THAT PRESCRIPTION TO THE LAB. THE LAB WILL WORK WITH THE FAMILY TO MAKE SURE THEY HAVE ADEQUATE INSURANCE COVERAGE, TO SHIP THE SALIVA TEST TO THEIR HOUSE. THEY FACILITATE COLLECTION OF THAT SALIVA FROM THE CHILD BY THE PARENT. SO THE PARENT NEVER HAS TO LEAVE THEIR HOUSE, GO TO A LAB. DOESN'T HAVE TO GET A BLOOD DRAW. A LOT OF THE GENETIC TESTS THAT EXIST TODAY ARE BLOOD BASED. WHICH DOESN'T REALLY WORK WELL IN THE PEDIATRIC POPULATION, SPECIFICALLY THE POPULATION THAT HAS SENSORY ISSUES. SO THAT'S WHY IT'S VERY IMPORTANT THIS TEST THAT WE HAVE RIGHT HERE IN SYRACUSE IS ABLE TO OPERATE ON SALIVA. >> BASICALLY YOU ARE SAYING LIKE A PARENT DOESN'T HAVE TO HAVE GRUELING EXPERIENCE OF HAVING THEIR CHILD HAVING A NEEDLE STUCK IN THEIR ARM. THAT MAKES IT A WHOLE LOT EASIER TO JUST DO A SALIVA SWAB. >> CORRECT. >> SO RATHER THAN HAVING TO GO SEE A PHLEBOTOMIST TO GET A BLOOD DRAW AND PUTTING THAT CHILD THROUGH THOSE SENSORY PAINS WHICH THEY'RE NOT GOING TO ENJOY, THAT SALIVA COLLECTION TAKES ABOUT 15 SECONDS, ALL PT COMPONENTS THE PARENT NEEDS ARE IN THE KIT THAT WE SEND TO THEIR HOUSE. THEY ADMINISTER THE SWAB, PACKAGE IT UP. DROP IT IN THEIR MAIL BOX AND IT SHOWS UP AT OUR LAB. >> THIS TYPICALLY OCCURS AFTER A BEHAVIORALLY BASED DIAGNOSIS IS AT LEAST SUSPECTED. >> CORRECT. >> AND THAT'S AROUND AGE 3? TYPICALLY? >> THE EARLIEST THAT AUTISM WOULD TYPICALLY BE DIAGNOSED COULD GO AS YOUNG AROUND AGE 2, BUT CURRENTLY THERE IS AN EXTREMELY LONG WAIT TIME FOR EVALUATION AND ISSUING OF A FORMAL DIAGNOSIS. AND THAT WAS ONE OF THE THINGS THAT WE WANTED TO ADDRESS BY BRINGING SALIVA TO THE FOREFRONT OF THE TOOLS THAT PEDIATRICIANS CAN USE TO ACCELERATE THE PACE OF DIAGNOSIS BY BRINGING IT-- BY REALLY SHORTENING THAT INTERVAL. AND THAT IS SOMETHING THAT HAS MEANT WE WILL BE ABLE TO SEE DIAGNOSIS OCCURRING EARLIER. >> SO I UNDERSTAND YOU AND STEVE, YOU WERE HIS MENTOR WHEN HE GOT HIS Ph.D., IF I REMEMBER CORRECTLY. AND YOU STARTED TO DO THE RESEARCH ON SALIVA TESTING OF AUTISM MAYBE 10 YEARS AGO? AM I REMEMBERING RIGHT? >> THAT'S CORRECT. APPROXIMATELY 10 YEARS AGO WHEN Dr. HICKS WAS A PEDIATRIC RESIDENT, WE RECOGNIZED THAT GENETIC TESTING WAS NOT SUFFICIENT TO IDENTIFY ALL OF THE CHILDREN WITH AUTISM. AND, IN FACT, THE VAST MAJORITY OF CHILDREN WITH AUTISM WON'T HAVE A DETECTABLE GENETIC CHANGE THAT YOU WOULD BE ABLE TO ASSOCIATE WITH ANY CERTAINTY WITH THE CONDITION. SO... >> SO WHAT YOU ARE SAYING IS PARENTS WHO ARE CONCERNED ABOUT THEIR CHILD DEVELOPING AUTISM, YOU CAN'T HAVE THAT AS PART OF YOUR PRENATAL SCREENING TO RULE THAT OUT. >> EXCEPT FOR CASES OF SYNDROMIC AUTISM, WHICH BRYAN REFERRED TO EARLIER. THERE ARE SOME EXAMPLES OF THAT. AND I'M SURE STEVE COULD ALSO PINPOINT SOME OF THOSE OR POINT OUT SOME OF THOSE FOR US AS WELL. BUT OUR GOAL WAS TO HAVE A SALIVA-BASED AID TO DIAGNOSIS THAT COULD BE USED ON ANY CHILD BEGINNING AS EARLY AS POSSIBLE, 18 MONTHS, IS WHERE WE SET OUR GOALS. AND THAT THIS WOULD ENABLE, THROUGH STUDYING WHAT WAS IN SALIVA, A MORE ACCURATE POTENTIAL DIAGNOSIS OF THIS CONDITION. >> SO I WANT TO-- THAT'S WONDERFUL. I WANT TO GO BACK TO STEVE FOR A MOMENT THOUGH BECAUSE WE WERE TALKING ABOUT CO-MORBID CONDITIONS AND SO ONE OF THE THINGS THAT HAPPENS WHEN YOU DO YOUR TESTING AT THE LAB IS YOU ARE ABLE TO IDENTIFY POSSIBLE CO-MORBID CONDITIONS. HOW IS THAT OF A POTENTIAL BENEFIT TO A PEDIATRICIAN, STEVE? AND PARENTS, OBVIOUSLY. >> SURE. SO ONE SPECIFIC EXAMPLE IS A CONDITION CALLED McDERMOTT SYNDROME WHICH INVOLVES DELETION OF A PORTION OF THE 22nd CHROMOSOME. IF THAT IS IDENTIFIED ON BRYAN'S TEST, THAT IS HELPFUL TO CLINICIANS BECAUSE IT TELLS THEM THAT CHILD HAS AN INCREASED RISK FOR SEIZURES AND COULD LEAD TO CHANGES IN THE WAY WE PRESCRIBE MEDICATIONS TO PREVENT FUTURE SEIZURES. >> YOU GET THIS GENETIC INFORMATION FROM THE LAB AND THEN YOU HAVE ADDITIONAL INFORMATION THAT WOULD BE USEFUL TO YOU HOW TO TREAT A CHILD WHO HAS AUTISM. IS THAT-- AM I GETTING IT RIGHT? >> YES. IN ADDITION TO THAT, I WOULD SAY EVEN IF THERE IS NOT ANY MEDICAL ACTION TO BE TAKEN OR MEDICATIONS TO BE PRESCRIBED, I THINK IT'S JUST EXTREMELY HELP HELPFUL FOR FAMILIES TO UNDERSTAND THE BIOLOGY THAT MIGHT BE LEADING TO THEIR CHILD'S SYMPTOMS. BECAUSE THERE ARE SOME FAMILIES THAT, UNFORTUNATELY, FEEL GUILT AROUND THE DIAGNOSIS AT TIMES AND IT'S HELPFUL FOR THEM TO KNOW THAT THIS IS SOMETHING THAT IS COMING FROM THEIR CHILD'S DNA. >> RATHER THAN LIKE YOU DID SOMETHING TO THIS CHILD TO CAUSE THIS OR WHATEVER OR SOME OTHER MYTHICAL DESTRUCTIVE BELIEF. >> EXACTLY. AUTISM IS NOT EVER-- THE CAUSE IS NEVER A PARENT'S BEHAVIOR, THE WAY THEY RAISED THEIR CHILD. SCH SO THERE HAS BEEN THIS GENETIC TESTING AND THEN THERE WAS SOMETHING NEW YOU DEVELOPED AS REALLY THE THREE OF YOU WORKING AS A TEAM IT SOUNDS LIKE. SO TELL US ABOUT THAT DISPL. THAT'S WHAT WE BEGAN 10 YEARS AGO. WE RECOGNIZED THAT CHANGESES IN DNA SEQUENCE WEREN'T GOING TO ACCOUNT FOR THE VAST MAJORITY OF THE NEW CASES COMING OUT. >> LET ME INTERRUPT SOMETHING. WHEN I READ ABOUT AUTISM, I SEE THAT THERE IS MORE AND MORE-- THE NUMBERS KEEP GOING UP AND UP, LIKE THE LATEST FIGURE I SAW WAS LIKE ONE IN CASE KIDS IS DIAGNOSED WITH AUTISM. IS THAT ACCURATE? >> IT'S EVEN HIGHER THAN THAT NOW. WE BELIEVE THE LATEST ESTIMATES, ONE IN 36 AND IN SOME STATES, SUCH AS CALIFORNIA, AS HIGH AS ONE IN 22. >> WOW. >> AND THAT WAS A MAJOR CONCERN OF OURS. WE THOUGHT THERE MUST BE SOME PROCESS GOING ON THAT WE NEED TO GET A BETTER HANDLE ON. AND THAT WAS PART OF THE REASON WE WERE VERY EXCITED AND MOTIVATED TO START DOING SALIVA-BASED COLLECTION, TO TRY TO GAIN SOME INSIGHT INTO POTENTIAL CAUSES, BUT ALSO THE PROCESS OF AUTISM. >> SINCE IT'S NOT-- LIKE ONLY IN, I THINK YOU SAID FIVE OR 10% IS THE GENETIC DNA BASED. >> THAT'S RIGHT. A CHANGE IN DNA SEQUENCE IS SOMETHING THAT'S FAIRLY EASY TO IDENTIFY. IT'S STRAIGHTFORWARD. BUT IT SIMPLY DOES NOT ACCOUNT FOR THIS LARGE INCREASE IN THE CASES THAT IS OCCURRING AROUND THE WORLD. >> SO AS SCIENTISTS, YOU ARE WORKING TO FIGURE OUT WHAT IS CAUSING THIS. >> THAT'S RIGHT. >> SO WHAT IS THE NEW PROCESS? WHAT ARE YOU LOOKING AT? >> SO A LOT OF PEOPLE WHO HAVE STUDIED AUTISM, WOULD TRY TO TAKE SAMPLES OF CHILDREN'S BLOOD AND THINK THEY COULD LEARN SOMETHING ABOUT THE BRAIN. STEVE AND I, A DECADE AGO, DECIDED WE WERE GOING TO COLLECT SALIVA. THERE WERE A LOT OF REASONS WHY WE FELT THAT SALIVA MADE MORE SENSE THAN FOCUSING IN ON BLOOD. >> WHAT WERE YOU THINKING, STEVE, BACK 10 YEARS AGO? WHY ARE YOU THINKING SALIVA WOULD BE MORE INTERESTING THAN BLOOD? >> WELL, ONE OF THE REASONS IS BECAUSE YOUR MOUTH IS INNERVATED BY FIVE CRANIAL NERVES FROM YOUR BRAIN STEM INTO YOUR MOUTH. >> MEANING NERVES COPPING FROM THE BRAIN GO DOWN TO YOUR MOUTH? >> YES, THEY COME INTO YOUR TONGUE AND THE BACK OF YOUR THROAT. THEY CONTROL TASTE AND SENSATION AND HOW YOU MOVE YOUR LIPS AND YOUR TONGUE. AND THEY'RE CONSTANTLY SIGNALING TO ONE ANOTHER USING EPI GENETIC MOLECULES WE KNEW WE WOULD BE ABLE TO MEASURE. >> EPIGENETIC MEANS WHAT? >> YOU CAN THINK OF SIMPLY AS SORT OF ON AND OFF SWITCHES THAT CONTROL HOW YOUR DNA OR YOUR GENES GET EXPRESSED. >> SO YOU'VE GOT THIS DNA, AND THERE ARE EPIGENETIC FACTORS THAT INFLUENCE HOW THOSE GENES WORK. IS THAT-- TURN THEM ON AND OFF. >> THAT'S RIGHT. WE WERE ABLE TO MEASURE SPECIFICALLY THOSE FACTORS, WHICH MOST OF WHICH ARE IN THE FORM OF RNA MOLECULES. >> RNA. >> WE ARE HEARING A LOT ABOUT THAT DURING COVID TESTING. >> WE ARE. MOST RNA THAT PEOPLE THINK OF IS THE TYPE OF RNA THAT CODES FAIRWAY A PROTEIN PRODUCT LIKE RNA VACCINES. THEY CODE FOR THE SPIKE PROTEIN OF THE SARS COV-2 VIRUS. BUT THE RNA THAT STEVE AND I BEGAN TO MEASURE AND REALIZE WAS PRESENT AT SUCH HIGH LEVELS IN THE MOUTH, THESE TYPES OF RNA ARE REGULATORY IN NATURE. SO THEY CONTROL WHETHER GENES ARE TURNED ON OR TURNED OFF, BUT THEY DON'T THEMSELVES CODE FOR ANY PROTEIN PRODUCT. WE DIDN'T KNOW THIS CLASS OF RNA EVEN EXISTED 30 YEARS AGO. THIS IS ALL NEW INFORMATION. AND WHAT WE'VE LEARNED NOW IS THAT THESE REGULATORY RNA MOLECULES THAT WE CAN MEASURE IN SALIVA. ACTUALLY WE CAN MEASURE IN ANY BODY FLUID, THE ONES WE MEASURE IN SALIVA APPEAR TO GIVE US NEW INSIGHT INTO NOT ONLY THE BIOLOGY OF AN INDIVIDUAL SUCH AS CIRCADIAN RHYTHMS. >> LIKE THE SHIFT ACROSS TIME, ACROSS THE DAY THAT INFLUENCES HOW THINGS WORK LIKE SLEEP. >> SLEEP/WAKE CYCLES. WE HAVE GAINED A LOT OF INSIGHT ABOUT THAT PROCESS FROM STUDYING THESE. WE'VE ALSO LEARNED THAT THERE ARE CHANGES IN THE LEVELS OF THESE REGULATORY RNA MOLECULES IN CHILDREN AND ADULTS WHO HAVE AUTISM. >> SO THERE IS A DIFFERENT CONCENTRATION OF THESE RNA MOLECULES IN PEOPLE WITH AUTISM THAN PEOPLE WITHOUT? >> THAT'S CORRECT. THERE IS A SHIFT. AND THIS SHIFT LIKELY IMPACTS THE EXPRESSION OF GENES THAT ARE INVOLVED IN BRAIN DEVELOPMENT AND BRAIN COMMUNICATION. THAT IS WHAT WE ARE SEEING THE CHANGES IN. THOSE PARTICULAR TYPES OF REGULATORY RNA THEY WOULD BE MASTER REGULATORS OF THOSE PROCESSES. >> SO, YEAH, GO. >> THIS WORK Dr. MIDDLETON IS DOING IS REALLY IMPORTANT. AND WE AT QUAD RABBIT LABORATORIES, WE HAVE AN AMAZING TEAM THAT HAS WORKED WITH BOTH Dr. MIDDLETON AND Dr. HICKS TO COMMERCIALIZE THIS. LATER THIS YEAR WE WILL BE COMMERCIALIZING CLARIFY ASD. THE SAME COLLECTION PROCESS AS THE GENERAL ETDIC TESTING. >> THE SAME SWABBING. >> SAME KIT. BUT THAT TEST WILL BE DONE PRE-DIAGNOSIS. SO FRANK REFERENCED EARLIER SOME OF THE WAIT TIMES ASSOCIATED WITH AUTISM AND THE IMPORTANCE OF MOVING THAT DIAGNOSTIC AGE... >> WHY THIS IS IMPORTANT, Dr. HICKS, GETTING IT SOONER? THE DIAGNOSIS? >> WE KNOW THE SOONER WE CAN MAKE THE DIAGNOSE AND PROVIDE A CHILD WITH THE SUPPORTS THAT THEY NEED, THE GREATER IMPACT WE CAN HAVE ON THEIR DEVELOPMENTAL TRAJECTORY AND HELP THEM LEARN SKILLS LIKE LANGUAGE AND COMMUNICATION THAT THEY MIGHT OTHERWISE STRUGGLE WITH. >> SO YOU ARE GETTING THEM REALLY THE TREATMENT, THE EARLIER THE TREATMENT COMES IN, THE MORE INFLUENCE IT CAN HAVE ON HOW THEIR BRAIN DEVELOPS. >> THAT'S EXACTLY RIGHT. >> YEAH, SO THESE SALIVA SWABS COME BACK TO OUR LAB. THEY GO THROUGH A STATE-OF-THE-ART SEQUENCING FACILITY WE HAVE SET UP ON THE UPSTATE CAMPUS AT QUADRANT LABORATORIES. WE HAVE A REALLY AMAZING TEAM THAT HAS VALIDATED THAT TEST WITH Dr. MIDDLETON, AND BROUGHT AND WILL BE BRINGING THAT TO MARKET. IT'S VERY IMPORTANT BECAUSE IT LOWERS THAT DIAGNOSIS AGE TO AS LOW AS 1 MONTHS TO GET-- 18 MONTHS TO GET THE KIDS THE SERVICES SOONER. >> WOW. THAT'S REALLY HOPEFUL NEWS FOR PARENTS AND THAT'S GOING TO BE AVAILABLE STIMULATER THIS YEAR. >> YEAH LAUNCHED RIGHT HERE OUT OF SYRACUSE. >> CONGRATULATIONS. >> AND TELL ME, WE JUST HAVE A FEW MINUTES LEFT, BUT TELL ME ABOUT HOW THE MICROBIOME, YOU WERE TELLING ME ABOUT, HOW IS THAT RELATED TO THIS? >> SO ONE OF THE THINGS THAT STEVE AND I LEARNED EARLY ON IN THIS PROCESS OF DOING ALL OF THIS INVESTIGATION OF WHAT IS IN SALIVA THROUGH THIS SWAB COLLECTION WAS THAT, IN FACT, A LOT OF THE MATERIAL THAT WE WERE QUANTIFYING AND MEASURING WASN'T HUMAN AT ALL, BUT ACTUALLY BELONGED TO THE BACTERIA. AND SO THAT-- >> ARE YOU TELLING ME THE BACTERIA IN ME THAT DOESN'T BELONG-- THAT'S NOT ME? >> THAT'S EXACTLY WHAT THE MICROBIOME IS. EVERYTHING THAT IS GROWING IN YOU OR ON YOU THAT'S NOT YOU. >> EVERYTHING GROWING IN ME AND ON ME THAT'S NOT ME. THAT SOUNDS LIKE A LITTLE YUCK FACTOR HERE. HOW MUCH OF ME IS NOT ME? >> WELL, IN FACT, IF YOU TOOK YOUR PERSON AND YOU COUNTED ALL THE CELLS OCCUPYING YOUR PERSON SPACE, YOUR HUMAN CONTRIBUTION TO THAT IS ONLY ABOUT 10%. >> WHAT? >> 90% OF THE CELLS THAT OCCUPY YOUR SPACE BELONG TO THE MICROBIOME. >> YOU MEASURE THAT. HOW IS THAT RELATED TO AUTISM? >> SO THE MICROBIOME, BEING BACTERIA, COLONIZES THE WHOLE INTERNAL SURFACE OF YOUR GASTROINTESTINAL TRACK, YOUR GUT, BEGINNING WITH YOUR MOUTH. SO WE ARE ABLE TO MEASURE SALIVA AND WE CAN UNDERSTAND THE BACTERIA THAT IS ON THE INPUT SIDE OF THE WHOLE G.I. TRACT. EVERY DAY AN INDIVIDUAL SWALLOWS MORE THAN A TRILLION BACTERIA. AND THESE COL COLORADO ONIZE YOUR GUT. ALMOST ALL THE TIME THEY'RE HELPING YOU, CONTRIBUTING IMPORTANT BYPRODUCTS, HELPING YOU DIGEST FOOD AND HELPING TO SEND SIGNALS. SOMETIMES THIS PROCESS GOES AWRY. IF THERE IS AN INJURY INSIDE THE CELL LINING OF SOMEBODY'S STOMACH OR THEIR INTESTINES, THE BACTERIA CAN DEVELOP AN INFECTION INTERNALLY OR YOU COULD HAVE AN ABSCESS. CHILDREN WITH AUTISM HAVE AN UNUSUALLY HIGH FREQUENCY OF G.I. PROBLEMS. THEY HAVE DIFFICULTIES WITH DIGESTION. >> SO THERE MAY BE A LINK BETWEEN THEIR MICROBIOME AND THE DEVELOPMENT OF AUTISM, YOU ARE THINKING? >> THAT WAS ONE OF OUR INSPIRATIONS FOR ADDING THIS TO THE THINGS WE MEASURE. SO NOT JUST THE HUMAN REGULATORY RNA BUT ALSO THE MICROBIOME. WE BRING ALL THREE OF THOSE PIECES TOGETHER WITH BEHAVIOR... >> IN THE NEW TESTING? >> THAT'S RIGHT. >> AMAZING. STEVE, I'M GOING TO GIVE YOU THE SECOND TO LAST WORD. SUM IT ALL UP FOR US. YOU GOT 30 SECONDS, BELIEVE IT OR NOT. >> I THINK IT'S AN EXCITING TIME TO BE PROVIDING CARE TO CHILDREN AND FAMILIES WITH AUTISM. THERE IS JUST SO MANY NEW BREAKTHROUGHS ON THE HORIZON BETWEEN THE TELEHEALTH DIAGNOSIS THAT WE ARE ABLE TO PROVIDE AS YOU ARE TO THE NON INVASIVE SALIVA-BASED TESTING THAT BRYAN WAS SPEAKING ABOUT AND THIS NOVEL EPIGENETIC AND MICROBIOME IAL TO HELP DEVELOP NEW WAYS TO PROVIDE PERSONALIZED MEDICINE CARE. >> YOU GUYS ARE QUITE THE AMAZING TEAM I HAVE TO SAY AND I UNDERSTAND BRYAN, THERE IS AN AUTISM ACCEPTANCE WALK. TELL US ABOUT THAT DISPL. SO RIGHT HERE IN OUR LOCAL COMMUNITY, THE AUTISM SOCIETY OF AMERICA'S CENTRAL NEW YORK CHAPTER ON SATURDAY APRIL 29, AT 10 A.M. AT JAMESVILLE BEACH IS DOING THEIR ANNUAL ONE STEP AT A TIME AUTISM ACCEPTANCE WALK. SO I REALLY ENCOURAGE EVERYBODY TO JOIN US AT QUADRANT LABORATORIES THERE AT JAMESVILLE BEACH THIS SATURDAY, 10 A.M. >> TERRIFIC. GENTLEMEN, THANK YOU SO MUCH FOR COMING. EXCITING INFORMATION. SO HELP HOPEFUL FOR PARENTS AND ADULTS WITH AUTISM. AND THAT'S ALL THE TIME WE HAVE. I WANT TO THANK OUR GUESTS DR. STEVE HICKS, PEDIATRIC PHYSICIAN SCIENTIST AND CHIEF MEDICAL OFFICER OF AS YOU ARE MR. BRYAN GREENE, CO-CEO OF QUADRANT LABORATORIES AND DR. FRANK MIDDLETON, PROFESSOR OF NEUROSCIENCE AND BIOCHEMISTRY AT SUNY UPSTATE MEDICAL UNIVERSITY IF YOU'D LIKE TO SEE MORE OF OUR PROGRAM AND EXTRAS, VISIT OUR WEBSITE, WCNY.ORG/CYCLEOFHEALTH. TO HEAR OUR NEW COMPANION COMMUNITY FM RADIO SHOW, CHECK UP FROM THE NECK UP, VISIT WCNY.ORG/COMMUNITYFM. FOR CYCLE OF HEALTH, I'M PSYCHOLOGIST DR. RICH O'NEILL. THANKS FOR CHECKING IN. ♪ ♪ ♪ ♪ NEXT WEEK ON "CYCLE OF HEALTH..." >> WHILE THE MEDICAL PROFESSION HAS MADE STRIDES IN RECENT YEARS TO INCREASE DIVERSITY, THERE IS A LONG WAY TO GO. TONIGHT, OUR FOUR PANELISTS WILL EXPLORE WHY DIVERSITY IN THE MEDICAL FIELD IS SO IMPORTANT. >> IT'S CRUCIAL TO LEARN THE HISTORY OF THE CULTURE OF MEDICINE. I THINK THAT'S THE FOUNDATIONAL BASIS OF UNDERSTANDING, YOU KNOW, WHY WE HAVE IN SOME OF THESE DISPARITIES EXIST.