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Your Environment. Your Health.

Staci Bilbo, Ph.D. — Bridging Basic Research and Clinical Care to Better Understand Autism

Staci Bilbo
Staci Bilbo, Ph.D., explores how interactions between environment and immune system affect healthy brain development.

March 20, 2019

Staci Bilbo, Ph.D., studies how environmental exposures and the immune system interact in early life to impact brain development. Her research focuses on autism spectrum disorder (ASD), which affects about 1 in 59 children. As a basic scientist, Bilbo and her research team work in a lab using mouse models, but they also partner with clinicians to explore how their basic research may be relevant to understanding and treating ASD.

“I became interested in autism because of the community of parents and clinicians who were recognizing autism in their children and patients and trying to grapple with this disorder that was on the rise,” said Bilbo, who is an associate professor of pediatrics and neuroscience at Harvard Medical School and director of research for the Lurie Center for Autism at Mass General Hospital for Children. In July 2019, she will be returning to Duke University, where she was an assistant professor for nine years, as the Haley Family professor of psychology and neuroscience.

Research Path Leads to Autism and the Environment

The Immune System and the Brain

Immune molecules are critical for normal brain development. Exposure to infection, stress, or environmental chemicals during pregnancy can disrupt normal production of immune molecules during critical stages of brain development, potentially increasing the risk for ASD and other developmental disorders.

Bilbo’s path to ASD research began when she was a graduate student, curious about how the immune system interacts with other important biological systems and functions in the body. She found that factors known to impact the immune system, such as an infection or stress during pregnancy, affected brain development and behavior in offspring.

When Bilbo was an assistant professor at Duke University, she began to explore how prenatal exposure to environmental chemicals, like air pollution, and social factors, like stress, interact to influence health outcomes. “There is pretty striking evidence in the literature showing that stress makes individuals more vulnerable to the effects of air pollution,” she explained. She credits Marie Lynn Miranda, Ph.D., who at the time was director of the Duke University Southern Center on Environmentally Driven Disparities in Birth Outcomes, for encouraging her to pursue a research path in environmental health.

Bilbo and colleagues found that mice exposed to both prenatal diesel exhaust and maternal stress had worse ASD-related outcomes compared to mice exposed to stress or diesel exhaust alone. "We see a true synergy in terms of the impact on offspring if we look at outcomes like social behavior deficits or immune system abnormalities. We don't see much with just diesel exposure or stress alone, but we see a lot with the two combined,” explained Bilbo. “This finding has implications for mothers and children living in poorer neighborhoods, where both air pollution and stress levels may be high.”

With a grant from NIEHS, Bilbo and her research team continue to investigate how combined exposure to maternal stress and diesel exhaust during pregnancy may contribute to autism risk by disrupting immune molecules that are critical for normal brain development.

Moving Research Beyond the Lab

Bilbo also partners with clinicians who work with ASD patients at the Lurie Center for Autism, a treatment center for individuals with ASD and other developmental disorders. She was named director of research for the Lurie Center in 2016.

Students sit around a conference room table looking at a presentation on a projector

Students from the Bilbo lab present their research to Lurie Center clinicians at a monthly research exchange.
(Photo courtesy of Staci Bilbo)

Bilbo teamed up with Lurie Center Director, Christopher McDougle, M.D., to create a unique program that brings together the postdocs and trainees working in her lab with Lurie Center clinicians. The clinical and lab groups meet once a month for a “research exchange” in which the clinicians talk about their specialty and how they care for patients, and lab students present their basic research.

This exchange helps the clinicians contribute to and stay current with the latest research around the biology underlying autism. It also encourages basic scientists to consider how the research they are doing is relevant to ASD patients. Bilbo’s postdocs and trainees also shadow clinicians to meet some of the patients and their families. “For many of my students, this is the first time they have met ASD patients and their families and grasped the clinical relevance of their research.”

Through virtual meetings and travel, Bilbo will maintain her connection with the Lurie Center when she moves to Duke University in July. She also hopes to establish a research exchange program with ASD clinicians and researchers at Duke and will continue working with her research team in Boston through a small satellite lab. “I'm feeling very optimistic because I think this type of collaboration is the way science should be – there's no way we're going to solve a problem like autism by confining it to a single city, place, or lab.”

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