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Rosenauer V, Schwarz MI, Vlasak T, Barth A. Childhood lead exposure increases the risk of attention-deficit-hyperactivity disorder: A meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 951:175574. [PMID: 39153625 DOI: 10.1016/j.scitotenv.2024.175574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/23/2024] [Accepted: 08/14/2024] [Indexed: 08/19/2024]
Abstract
Environmental lead exposure has been a much-discussed risk factor for the development of ADHD for decades. However, due to methodological shortcomings, the existing research on this topic is highly inconsistent. We will attempt to clarify this question by performing a meta-analysis based on a systematic literature search until February 2024 including different databases such as Pubmed and Google Scholar. The effects of environmental lead exposure were synthesized by odds ratios. A random effects model was deployed with a Paule-Mandel estimator using Hedges' invariance weighting. In addition, we carried out sensitivity analyses to examine the robustness of effects, including the detection of outliers, publication bias, p-hacking and moderating variables. In total, 14 studies with 14 effect sizes were included which had investigated the effects of lead exposure on the development of ADHD. The analyses were based on a final sample size of N = 7618 with n = 2554 ADHD cases (33,53 %) and n = 5064 healthy controls (66.47 %). Our results show that lead exposure was significantly associated with a higher risk of ADHD development. Regression analyses demonstrated that increased age of participants and increased lead significantly enhanced the risk of ADHD. Summing up we present novel results concerning the relationship between environmental lead exposure and the development of ADHD, while discussing underlying pathomechanisms as well as limitations. Finally, we provide recommendations for future studies and public health policies.
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Affiliation(s)
- Victoria Rosenauer
- Department of Psychology, Sigmund Freud Private University Linz, Adalbert-Stifter-Platz 2, 4020 Linz, Austria.
| | - Magdalena Isabell Schwarz
- Department of Psychology, Sigmund Freud Private University Linz, Adalbert-Stifter-Platz 2, 4020 Linz, Austria.
| | - Thomas Vlasak
- Department of Psychology, Sigmund Freud Private University Linz, Adalbert-Stifter-Platz 2, 4020 Linz, Austria.
| | - Alfred Barth
- Department of Psychology, Sigmund Freud Private University Linz, Adalbert-Stifter-Platz 2, 4020 Linz, Austria.
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Gu Q, Liu J, Zhang X, Huang A, Yu X, Wu K, Huang Y. Association between heavy metals exposure and risk of attention deficit hyperactivity disorder (ADHD) in children: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02546-z. [PMID: 39126497 DOI: 10.1007/s00787-024-02546-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
Heavy metals can negatively affect children's neurodevelopment, yet the relationship between heavy metals exposure and attention deficit hyperactivity disorder (ADHD) in children remains unclear. We aimed to examine associations between exposure to five common heavy metals (lead, arsenic, mercury, cadmium, and manganese) with neurodevelopmental toxicity and the risk of ADHD in children. Online databases of PubMed, Web of Science, and Embase were searched before February 29, 2024. A total of 31 studies involving 25,258 children were included in the final analysis. Our findings revealed that lead exposure was positively associated with ADHD risk in children (OR = 1.95, 95% CI: 1.57-2.41) overall, while the associations varied among different WHO regions, with the strongest in the Americas. Sensitivity analyses revealed significant associations between arsenic (OR = 1.53, 95% CI: 1.01-2.32) and manganese (OR = 1.79, 95% CI: 1.28-2.49) exposure and ADHD risk after omitting one study. Arsenic exposure was positively associated with ADHD risk in studies conducted in the Americas and adjusted for environmental smoke exposure. Positive associations between manganese exposure and ADHD risk were also found in several subgroup analyses. No significant associations were found for mercury and cadmium exposure. Dose-response meta-analysis suggested that children with higher blood lead levels exhibited a higher probability of ADHD diagnosis. Lead exposure consistently increases the risk of ADHD in children, while arsenic and manganese exposure may be associated with ADHD under different occasions. More research is required to understand heavy metals' impact on ADHD across varying exposure levels, particularly in less contaminated regions.
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Affiliation(s)
- Qianfei Gu
- School of Public Health, Shantou University, Shantou, Guangdong Province, China
- Mental Health Center of Shantou University, Shantou, Guangdong Province, China
| | - Jiayu Liu
- Mental Health Center of Shantou University, Shantou, Guangdong Province, China
- Shantou University Medical College-Faculty of Medicine of University of Manitoba Joint Laboratory of Biological Psychiatry, Shantou, Guangdong Province, China
| | - Xuanzhi Zhang
- Mental Health Center of Shantou University, Shantou, Guangdong Province, China
- Shantou University Medical College-Faculty of Medicine of University of Manitoba Joint Laboratory of Biological Psychiatry, Shantou, Guangdong Province, China
| | - Anyan Huang
- Shantou Maternity & Child Healthcare Hospital, Shantou, Guangdong Province, China
| | - Xinle Yu
- Mental Health Center of Shantou University, Shantou, Guangdong Province, China
- Shantou University Medical College-Faculty of Medicine of University of Manitoba Joint Laboratory of Biological Psychiatry, Shantou, Guangdong Province, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong Province, China.
| | - Yanhong Huang
- Mental Health Center of Shantou University, Shantou, Guangdong Province, China.
- Shantou University Medical College-Faculty of Medicine of University of Manitoba Joint Laboratory of Biological Psychiatry, Shantou, Guangdong Province, China.
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Farmani R, Mehrpour O, Kooshki A, Nakhaee S. Exploring the link between toxic metal exposure and ADHD: a systematic review of pb and hg. J Neurodev Disord 2024; 16:44. [PMID: 39090571 PMCID: PMC11292919 DOI: 10.1186/s11689-024-09555-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 07/02/2024] [Indexed: 08/04/2024] Open
Abstract
INTRODUCTION Attention-Deficit/Hyperactivity Disorder (ADHD) is a recognized neurodevelopmental disorder with a complex, multifactorial origin. Lead (Pb) and mercury (Hg) are highly toxic substances that can potentially impair brain development and have been implicated in the development of ADHD. This systematic review aims to analyze the epidemiological literature regarding the association between Pb and Hg exposure and the diagnosis of ADHD. METHODS From November 1983 to June 2, 2023, a comprehensive search was conducted in multiple databases and search engines, including PubMed, Web of Science, Scopus, and Google Scholar. Observational studies (case-control, cohort, and cross-sectional) measuring Pb and Hg levels in various biological samples (blood, hair, urine, nail, saliva, teeth, and bone) of children with ADHD or their parents and their association with ADHD symptoms were included. RESULTS Out of 2059 studies, 87 met the inclusion criteria and were included in this systematic review. Approximately two-thirds of the 74 studies investigating Pb levels in different biological samples reported associations with at least one subtype of ADHD. However, most studies examining Hg levels in various biological samples found no significant association with any ADHD subtype, although there were variations in exposure periods and diagnostic criteria. CONCLUSION The evidence gathered from the included studies supports an association between Pb exposure and the diagnosis of ADHD, while no significant association was found with Hg exposure. Importantly, even low levels of Pb were found to elevate the risk of ADHD. Further research is needed to explore the comprehensive range of risk factors for ADHD in children, considering its significance as a neurodevelopmental disorder.
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Affiliation(s)
- Reyhane Farmani
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Omid Mehrpour
- Michigan Poison & Drug Information Center, Wayne State University School of Medicine, Detroit, MI, USA
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Alireza Kooshki
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.
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Xie YH, Song HX, Peng JC, Li SJ, Ou SY, Aschner M, Jiang YM. Treatment of manganese and lead poisoning with sodium para-aminosalicylic acid: A contemporary update. Toxicol Lett 2024; 398:69-81. [PMID: 38909920 DOI: 10.1016/j.toxlet.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/08/2024] [Accepted: 06/17/2024] [Indexed: 06/25/2024]
Abstract
Sodium para-aminosalicylic acid (PAS-Na) treatment for manganese (Mn) intoxication has shown efficacy in experimental and clinical studies, giving rise to additional studies on its efficacy for lead (Pb) neurotoxicity and its associated mechanisms of neuroprotection. The difference between PAS-Na and other metal complexing agents, such as edetate calcium sodium (CaNa2-EDTA), is firstly that PAS-Na can readily pass through the blood-brain barrier (BBB), and complex and facilitate the excretion of manganese and lead. Secondly, PAS-Na has anti-inflammatory effects. Recent studies have broadened the understanding on the mechanisms associated with efficacy of PAS-Na. The latter has been shown to modulate multifarious manganese- and lead- induced neurotoxicity, via its anti-apoptotic and anti-inflammatory effects, as well as its ability to inhibit pyroptosis, and regulate abnormal autophagic processes. These observations provide novel scientific bases and new concepts for the treatment of lead, mercury, copper, thallium, as well as other toxic encephalopathies, and implicate PAS-Na as a compound with greater prospects for clinical medical application.
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Affiliation(s)
- Yu-Han Xie
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning 530021, China
| | - Han-Xiao Song
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning 530021, China
| | - Jian-Chao Peng
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning 530021, China
| | - Shao-Jun Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning 530021, China
| | - Shi-Yan Ou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning 530021, China
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Yue-Ming Jiang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning 530021, China.
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Aschner M, Martins AC, Oliveira-Paula GH, Skalny AV, Zaitseva IP, Bowman AB, Kirichuk AA, Santamaria A, Tizabi Y, Tinkov AA. Manganese in autism spectrum disorder and attention deficit hyperactivity disorder: The state of the art. Curr Res Toxicol 2024; 6:100170. [PMID: 38737010 PMCID: PMC11088232 DOI: 10.1016/j.crtox.2024.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/27/2024] [Accepted: 04/23/2024] [Indexed: 05/14/2024] Open
Abstract
The objective of the present narrative review was to synthesize existing clinical and epidemiological findings linking manganese (Mn) exposure biomarkers to autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), and to discuss key pathophysiological mechanisms of neurodevelopmental disorders that may be affected by this metal. Existing epidemiological data demonstrated both direct and inverse association between Mn body burden and ASD, or lack of any relationship. In contrast, the majority of studies revealed significantly higher Mn levels in subjects with ADHD, as well as direct relationship between Mn body burden with hyperactivity and inattention scores in children, although several studies reported contradictory results. Existing laboratory studies demonstrated that impaired attention and hyperactivity in animals following Mn exposure was associated with dopaminergic dysfunction and neuroinflammation. Despite lack of direct evidence on Mn-induced neurobiological alterations in patients with ASD and ADHD, a plethora of studies demonstrated that neurotoxic effects of Mn overexposure may interfere with key mechanisms of pathogenesis inherent to these neurodevelopmental disorders. Specifically, Mn overload was shown to impair not only dopaminergic neurotransmission, but also affect metabolism of glutamine/glutamate, GABA, serotonin, noradrenaline, thus affecting neuronal signaling. In turn, neurotoxic effects of Mn may be associated with its ability to induce oxidative stress, apoptosis, and neuroinflammation, and/or impair neurogenesis. Nonetheless, additional detailed studies are required to evaluate the association between environmental Mn exposure and/or Mn body burden and neurodevelopmental disorders at a wide range of concentrations to estimate the potential dose-dependent effects, as well as environmental and genetic factors affecting this association.
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Affiliation(s)
- Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Airton C. Martins
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA
| | | | - Anatoly V. Skalny
- Department of Medical Elementology, and Department of Human Ecology and Bioelementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119435, Russia
| | - Irina P. Zaitseva
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Yaroslavl 150003, Russia
| | - Aaron B. Bowman
- School of Health Sciences, Purdue University, West Lafayette, IN 47907-2051, USA
| | - Anatoly A. Kirichuk
- Department of Medical Elementology, and Department of Human Ecology and Bioelementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
| | - Abel Santamaria
- Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Laboratorio de Nanotecnología y Nanomedicina, Departamento de Cuidado de la Salud, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 04960, Mexico
| | - Yousef Tizabi
- Department of Pharmacology, Howard University College of Medicine, Washington, DC 20059, USA
| | - Alexey A. Tinkov
- Department of Medical Elementology, and Department of Human Ecology and Bioelementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119435, Russia
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Yaroslavl 150003, Russia
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Johnstone JM, Arnold LE, Villagomez A, Robinette LM, Gracious BL, Ast HK, Bruton AM, Hatsu IE. Dr. Johnstone et al. Reply to Dr. Elmrayed. J Am Acad Child Adolesc Psychiatry 2023; 62:1171-1175. [PMID: 37543077 PMCID: PMC11342338 DOI: 10.1016/j.jaac.2023.07.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
We thank Dr. Elmrayed and colleagues1 for highlighting clinical cautions in using broad-spectrum micronutrients to treat attention-deficit/hyperactivity disorder (ADHD) in children, in particular manganese (Mn) levels. We appreciate the opportunity to provide additional information and rationale for the vitamin and mineral doses contained in the studied formula.
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Affiliation(s)
- Jeanette M Johnstone
- Oregon Health & Science University, Portland, Oregon; National University of Natural Medicine, Helfgott Research Institute, Portland, Oregon.
| | | | | | | | - Barbara L Gracious
- HCA Florida Orange Park Hospital, Orange Park, Florida; Edward Via College of Osteopathic Medicine, Spartanburg, South Carolina
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Stojsavljević A, Lakićević N, Pavlović S. Does Lead Have a Connection to Autism? A Systematic Review and Meta-Analysis. TOXICS 2023; 11:753. [PMID: 37755763 PMCID: PMC10536388 DOI: 10.3390/toxics11090753] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/20/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
Environmental pollutants, particularly toxic trace metals with neurotoxic potential, have been related to the genesis of autism. One of these metals that stands out, in particular, is lead (Pb). We conducted an in-depth systematic review and meta-analysis of peer-reviewed studies on Pb levels in biological materials retrieved from autistic children (cases) and neurotypical children (controls) in this work. A systematic review was conducted after the careful selection of published studies according to established criteria to gain a broad insight into the higher or lower levels of Pb in the biological materials of cases and controls, and the findings were then strengthened by a meta-analysis. The meta-analysis included 17 studies (hair), 13 studies (whole blood), and 8 studies (urine). The overall number of controls/cases was 869/915 (hair), 670/755 (whole blood), and 344/373 (urine). This meta-analysis showed significantly higher Pb levels in all three types of biological material in cases than in controls, suggesting a higher body Pb burden in autistic children. Thus, environmental Pb exposure could be related to the genesis of autism. Since no level of Pb can be considered safe, the data from this study undoubtedly point to the importance of regularly monitoring Pb levels in autistic children.
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Affiliation(s)
- Aleksandar Stojsavljević
- Innovative Centre, Faculty of Chemistry, University of Belgrade, Studentski Trg 12–16, 11000 Belgrade, Serbia
| | - Novak Lakićević
- Clinical Centre of Montenegro, Clinic for Neurosurgery, Ljubljanska bb, 81000 Podgorica, Montenegro;
| | - Slađan Pavlović
- Institute for Biological Research “Siniša Stanković”—National Institute of the Republic of Serbia, University of Belgrade, Bulevar Despota Stefana 142, 11060 Belgrade, Serbia;
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do Nascimento PKDSB, Oliveira Silva DF, de Morais TLSA, de Rezende AA. Zinc Status and Autism Spectrum Disorder in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:3663. [PMID: 37630853 PMCID: PMC10459732 DOI: 10.3390/nu15163663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/14/2023] [Accepted: 01/27/2023] [Indexed: 08/27/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder, the prevalence of which has increased in children and adolescents over the years. Studies point to deficiency of trace elements as one of the factors involved in the etiology of the disorder, with zinc being one of the main trace elements investigated in individuals with ASD. The aim of this review is to summarize scientific evidence about the relationship between zinc status and ASD in children and adolescents. This review has been registered in the International Prospective Register of Systematic Reviews (registration number CRD42020157907). The methodological guidelines adopted were in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were selected from an active investigation of the PubMed, Scopus, LILACS, and Google databases to search for observational studies. Fifty-two studies from twenty-two countries were included. The sample sizes ranged from 20 to 2635, and the participants ranged from 2 to 18 years old. Nine types of biological matrices were used, with hair, serum, and plasma being the most frequently used in the evaluation of zinc concentrations. Significant differences in zinc concentrations between the ASD and control groups were observed in 23 studies, of which 19 (36%) showed lower zinc concentrations in the ASD group. The classification of studies according to methodological quality resulted in high, moderate, and low quality in 10, 21, and 21 studies, respectively. In general, we did not observe a significant difference between zinc concentrations of children and adolescents with ASD compared to controls; however, studies point to an occurrence of lower concentrations of Zn in individuals with ASD. This review reveals that more prospective studies with greater methodological rigor should be conducted in order to further characterize this relation.
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Affiliation(s)
| | | | | | - Adriana Augusto de Rezende
- Department of Clinical and Toxicological Analyses; Federal University of Rio Grande do Norte—UFRN, Natal 59012-570, Brazil
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Ding M, Shi S, Qie S, Li J, Xi X. Association between heavy metals exposure (cadmium, lead, arsenic, mercury) and child autistic disorder: a systematic review and meta-analysis. Front Pediatr 2023; 11:1169733. [PMID: 37469682 PMCID: PMC10353844 DOI: 10.3389/fped.2023.1169733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/23/2023] [Indexed: 07/21/2023] Open
Abstract
Background Studies have found that toxic heavy metals exposure could induce the generation of reactive oxygen species (ROS), and is of epigenetic effect, which might be associated with the occurrence of Autistic Disorder (ASD). This systematic review and meta-analysis aims to elucidate the association between exposure to 4 heavy metals, cadmium (Cd), lead (Pb), arsenic(As), and mercury (Hg), and the occurrence of ASD in children. Methods We searched PubMed, Web of Science, Embase, and Cochrane Library, from their inception to October 2022, for epidemiological investigations that explore the association between exposure to Cd, Pb, As, or Hg and the occurrence of child ASD. Results A total of 53 studies were included, involving 5,054 individuals aged less than 18 (2,533 ASD patients and 2,521 healthy controls). Compared with the healthy controls, in hair and blood tests, concentrations of the 4 heavy metals were significantly higher in the ASD group than in the healthy control group, and the differences in Pb, arsenic and Hg were statistically significant (P < 0.05). In the urine test, concentrations of arsenic and Hg were significantly higher in the ASD group than in the healthy control group (P < 0.05), while the results of Cd and Pb were opposite to those of arsenic and Hg (P > 0.05). Subgroup analysis for geographic regions showed that ASD patients in Asia and Europe had higher concentrations of the 4 heavy metals, compared with the healthy controls, in which the differences in Pb, arsenic, and Hg were statistically significant (P < 0.05), while in North America, the healthy controls had higher Cd, arsenic, and Hg concentrations (P > 0.05). Conclusion Compared with the healthy control group, the ASD group had higher concentrations of Cd, Pb, arsenic, and Hg. These 4 heavy metals play different roles in the occurrence and progression of ASD. Moreover, there is significant heterogeneity among the included studies due to controversies about the study results among different countries and regions and different sources of detection materials. The results of this study firmly support the policies to limit heavy metals exposure, especially among pregnant women and young children, so as to help reduce the incidence of ASD.
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Affiliation(s)
- Mengmeng Ding
- Correspondence: Mengmeng Ding Shanshan Shi Shuyan Qie
| | - Shanshan Shi
- Correspondence: Mengmeng Ding Shanshan Shi Shuyan Qie
| | - Shuyan Qie
- Correspondence: Mengmeng Ding Shanshan Shi Shuyan Qie
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Ouisselsat M, Maidoumi S, Elmaouaki A, Lekouch N, Pineau A, Sedki A. Hair Trace Elements and Mineral Content in Moroccan Children with Autism Spectrum Disorder: a Case-Control Study. Biol Trace Elem Res 2023; 201:2701-2710. [PMID: 35896886 DOI: 10.1007/s12011-022-03365-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/16/2022] [Indexed: 11/02/2022]
Abstract
The prevalence of autism spectrum disorder (ASD) around the world continues to increase while the pathophysiology remains insufficiently elucidated. Genetics, environment, and epigenetic changes are often implicated. Abnormal level in trace elements and minerals is among environmental factors assumed to be involved. The purpose of this article is to assess hair concentrations of toxic and essential elements in children with ASD and children with neurotypical development in the city of Marrakech. Two hundred and twenty-seven children (107 with ASD and 120 controls) aged 3 to 14 years old were recruited. The results of analysis by ICP-MS showed a significant decrease in hair levels of copper, zinc, iron, and selenium (25%, 13%, 17%, 11%) of children with ASD. The most significantly reduced concentrations in children with ASD are that of manganese by 34%. Hair aluminum level was significantly elevated by 29% in ASD compared to controls. Multiple linear regression analysis revealed that copper, selenium, and iron content in hair were significantly inversely associated with ASD, similarly, hair aluminum content was significantly associated with ASD. Adjusted model for demographic parameters increased the predictive ability of the model, father's age was a significant predictor. In addition, ASD and gender were significant predictors of hair levels of aluminum, selenium, and manganese.These results support the hypothesis of the disparity of trace elements and minerals levels in children with ASD and highlight the potential interest of micronutrient supplementation in the eventual improvement of ASD symptoms. Future research should explore the pathophysiology of these micronutrient deficiencies.
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Affiliation(s)
- Mariam Ouisselsat
- Laboratory of Water, Biodiversity and Climate Change, Department of Biology, Faculty of Sciences - Semlalia, Cadi Ayyad University, Bd Moulay Abdellah BP, 2390-40001, Marrakech, Morocco.
| | - Sana Maidoumi
- Laboratory of Water, Biodiversity and Climate Change, Department of Biology, Faculty of Sciences - Semlalia, Cadi Ayyad University, Bd Moulay Abdellah BP, 2390-40001, Marrakech, Morocco
| | - Amal Elmaouaki
- Laboratory of Water, Biodiversity and Climate Change, Department of Biology, Faculty of Sciences - Semlalia, Cadi Ayyad University, Bd Moulay Abdellah BP, 2390-40001, Marrakech, Morocco
| | - Nadra Lekouch
- Laboratory of Water, Biodiversity and Climate Change, Department of Biology, Faculty of Sciences - Semlalia, Cadi Ayyad University, Bd Moulay Abdellah BP, 2390-40001, Marrakech, Morocco
| | - Alain Pineau
- Mineral Element Dosing Centre, UFR of Pharmaceutical and Biological Sciences, University of Nantes, 9, rue Bias, 44035 - 44000, Nantes Cedex 1, France
| | - Azeddine Sedki
- Laboratory of Water, Biodiversity and Climate Change, Department of Biology, Faculty of Sciences - Semlalia, Cadi Ayyad University, Bd Moulay Abdellah BP, 2390-40001, Marrakech, Morocco
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Nakhaee S, Amirabadizadeh A, Farnia V, Ali Azadi N, Mansouri B, Radmehr F. Association Between Biological Lead Concentrations and Autism Spectrum Disorder (ASD) in Children: a Systematic Review and Meta-Analysis. Biol Trace Elem Res 2023; 201:1567-1581. [PMID: 35499802 DOI: 10.1007/s12011-022-03265-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022]
Abstract
Studies have been conducted in different countries of the world to illustrate a link between autism spectrum disorder (ASD) and lead (Pb) in different specimens such as hair, blood, and urine. Therefore, we carried out a systematic review and meta-analysis to determine the association between Pb concentration in biological samples (blood, urine, and hair) and ASD in children through case-control and cross-sectional studies. In this systematic review, PubMed, Web of Sciences, Scopus, and Google Scholar were searched for relevant studies from January 2000 to February 2022. A random-effects model was used to pool the results. The effect sizes were standardized mean differences (proxied by Hedges' g) followed by a 95% confidence interval. Pooling data under the random effect model from blood and hair studies showed a significant difference between the children in the ASD group and the control group in blood lead level (Hedges' g: 1.21, 95% CI: 0.33-2.09, P = 0.01) and hair level (Hedges' g: 2.20, 95% CI: 0.56-3.85, P = 0.01). For urine studies, pooling data under the random effect model from eight studies indicated no significant difference between the children in the ASD group and control group in urinary lead level (Hedges' g: - 0.34, 95% CI: - 1.14,0.45, P = 0.40). Moreover, the funnel plot and the results of the Egger test for the blood and urine samples showed no publication bias, while, for the hair samples, the funnel plot illustrated the existence of publication bias.
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Affiliation(s)
- Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Alireza Amirabadizadeh
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, 9717113163, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nemam Ali Azadi
- Biostatistics Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Farnaz Radmehr
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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12
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Nutritional Status and Feeding Behavior of Children with Autism Spectrum Disorder in the Middle East and North Africa Region: A Systematic Review. Nutrients 2023; 15:nu15030711. [PMID: 36771417 PMCID: PMC9920501 DOI: 10.3390/nu15030711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/23/2023] [Indexed: 02/01/2023] Open
Abstract
Autism spectrum disorder (ASD) in children is associated with increased risks of overweight/obesity and underweight, altered nutrient profile, and abnormal feeding behaviors. This systematic review aimed to elucidate the literature on the nutritional status of children with ASD in the Middle East North Africa (MENA) region, by providing a summary and assessment of the body of evidence. A systematic review of English and Arabic publications up to November 2020 was conducted of five databases in addition to the grey literature, which include a nutrition-related parameter, from both experimental and observational study designs. Children with ASD (ASD-C) between 2 and 19 years in the MENA Region were the target population. For risk of bias, the Academy of Nutrition and Dietetics' Quality Criteria Checklist (QCC) was adopted. The number of published articles was grossly limited. Forty-three articles were included, of which only four articles reported a low risk of bias; therefore, the results were interpreted in light of methodological limitations. Both overweight and underweight were common in ASD-C, although not consistently different than typically developing children. Nutrient inadequacies of energy, protein, omega-3, and others; deficiencies in serum iron indicators and calcium, as well as vitamins B12, B9, and D levels; and higher levels of homocysteine and omega-6/omega-3 ratios were reported. Feeding behavior problems were also common in ASD-C. Understanding nutritional requirements and food preferences can guide the planning of the appropriate comprehensive interventions for ASD-C. Various nutritional and behavioral concerns were identified in the included studies; however, they were subject to methodological weaknesses, which limited the generalizability of these results. Future research is warranted that must be directed to finding strong evidence using robust study designs on nutritional status and feeding behaviors of ASD-C, with a particular emphasis on the MENA Region.
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13
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Nasrallah O, Alzeer S. Measuring Some Oxidative Stress Biomarkers in Autistic Syrian Children and Their Siblings: A Case-Control Study. Biomark Insights 2022; 17:11772719221123913. [PMID: 36120384 PMCID: PMC9476242 DOI: 10.1177/11772719221123913] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/10/2022] [Indexed: 12/05/2022] Open
Abstract
Objective: Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder whose cause remains unknown. Oxidative stress is one of the possible causes of many disorders, including neurological ones. This study aims to measure some oxidative stress biomarkers (Malondialdehyde “MDA,” Advanced Oxidation Protein Product “AOPP,” Glutathione “GSH”) within Syrian children with ASD. Methods: MDA, AOPP & GSH were measured in the plasma of a total of 60 children. The ages of the children ranged from 1 to 13 years old. Thirty children had ASD and were compared with 30 controls that don’t have ASD. Fifteen of the controls were siblings of an ASD child, while the remaining 15 had no relations with ASD. Results: MDA and AOPP plasma levels were higher in ASD children compared with non-related controls (P = .0001). However, there were no significant differences between MDA and AOPP plasma levels in ASD children in comparison with related controls (P > .05). Alternatively, GSH plasma levels were lower in ASD children compared with both related and non-related controls (P = .0001). Conclusion: Further studies are needed to investigate more regarding the diagnostic use of oxidative stress biomarkers, and the therapeutic use of antioxidants in children affected with the autism spectrum disorder.
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Affiliation(s)
- Oula Nasrallah
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Damascus University, Damascus, Syria
| | - Samar Alzeer
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Damascus University, Damascus, Syria.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Kalamoon, Deir Atiyah, Syria
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14
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Kim H, Harrison FE, Aschner M, Bowman AB. Exposing the role of metals in neurological disorders: a focus on manganese. Trends Mol Med 2022; 28:555-568. [PMID: 35610122 PMCID: PMC9233117 DOI: 10.1016/j.molmed.2022.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/14/2022] [Accepted: 04/25/2022] [Indexed: 02/06/2023]
Abstract
Metals are ubiquitous chemical entities involved in a myriad of biological processes. Despite their integral role in sustaining life, overexposure can lead to deleterious neurological outcomes posing a public health concern. Excess exposure to metals has been associated with aberrant neurodevelopmental and neurodegenerative diseases and prominently contributes to environmental risk for neurological disorders. Here, we use manganese (Mn) to exemplify the gap in our understanding of the mechanisms behind acute metal toxicity and their relationship to chronic toxicity and disease. This challenge frustrates understanding of how individual exposure histories translate into preventing and treating brain diseases from childhood through old age. We discuss ways to enhance the predictive value of preclinical models and define mechanisms of chronic, persistent, and latent neurotoxicity.
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Affiliation(s)
- Hyunjin Kim
- School of Health Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Fiona E Harrison
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Aaron B Bowman
- School of Health Sciences, Purdue University, West Lafayette, IN 47907, USA.
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15
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Alsufiani HM, Alkhanbashi AS, Laswad NAB, Bakhadher KK, Alghamdi SA, Tayeb HO, Tarazi FI. Zinc deficiency and supplementation in autism spectrum disorder and Phelan-McDermid syndrome. J Neurosci Res 2022; 100:970-978. [PMID: 35114017 DOI: 10.1002/jnr.25019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 12/02/2021] [Accepted: 01/07/2022] [Indexed: 01/05/2023]
Abstract
Approximately 1 in 36 children are diagnosed with autism spectrum disorder (ASD). The disorder is four times more common in males than in females. Zinc deficiency and mutations in SHANK2 and SHANK3 (members of a family of excitatory postsynaptic scaffolding proteins) are all risk factors that may contribute to the pathophysiology of the disease. The presence of shankopathies (loss of one copy of the SHANK3 gene) can lead to the development of Phelan-McDermid syndrome (PMDS)-a rare genetic disorder characterized by developmental delay, intellectual disability, poor motor tone, and ASD-like symptoms. We reviewed the relationship between zinc, ASD, and PMDS as well as the effect of zinc supplementation in improving symptoms of ASD and PMDS based on 22 studies published within 6 years (2015-2020). Zinc deficiency (assessed by either dietary intake, blood, hair, or tooth matrix) was shown to be highly prevalent in ASD and PMDS patients as well as in preclinical models of ASD and PMDS. Zinc supplements improved the behavioral deficits in animal models of ASD and PMDS. Clinical trials are still needed to validate the beneficial therapeutic effects of zinc supplements in ASD and PMDS patients.
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Affiliation(s)
- Hadeil M Alsufiani
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.,Experimental Biochemistry Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alaa S Alkhanbashi
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Norah A Bin Laswad
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khulood K Bakhadher
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shareefa A Alghamdi
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Haythum O Tayeb
- Division of Neurology, Department of Internal Medicine, The Neuroscience Research Unit, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Frank I Tarazi
- Department of Psychiatry and Neuroscience, Harvard Medical School and McLean Hospital, Belmont, Massachusetts, USA
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16
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Błażewicz A, Grywalska E, Macek P, Mertowska P, Mertowski S, Wojnicka J, Durante N, Makarewicz A. Research into the Association of Cadmium and Manganese Excretion with Thyroid Function and Behavioral Areas in Adolescents with Autism Spectrum Disorders. J Clin Med 2022; 11:jcm11030579. [PMID: 35160030 PMCID: PMC8837100 DOI: 10.3390/jcm11030579] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 02/06/2023] Open
Abstract
Thyroid dysfunction and toxic metal exposure have been linked to the increased risk of autism spectrum disorders (ASD); however, the relationship between those factors remains unclear. We aimed to evaluate the relationship between the serum level of hormones, namely thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and urinary cadmium (U-Cd) and urinary manganese (U-Mn), in patients with ASD. The study group consisted of 129 adolescents with ASD, and the control group consisted of 86 healthy persons. Ion chromatography with spectrophotometric detection (IC-UV/ViS) was used to quantitatively determine Cd and Mn in all 24-h urine samples. These results indicate that severity of certain symptoms in autism is associated with thyroid function. Correlation analysis between Childhood Autism Rating Scale (CARS) results and the content of both U-Mn and U-Cd as well as fT3, fT4 and TSH values in ASD patients showed significantly positive correlation of CARS7 (visual reaction) with fT3 and fT4 and a negative correlation with TSH for the whole study group. In the group of adolescents over 14 years of age, it was also observed that CARS10 (anxiety reaction) negatively correlates with serum TSH levels, and among younger individuals, CARS9 (near receptor responsiveness, taste, smell) positively correlates with TSH.
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Affiliation(s)
- Anna Błażewicz
- Department of Pathobiochemistry and Interdisciplinary Applications of Ion Chromatography, Medical University of Lublin, 1 Chodźki Street, 20-093 Lublin, Poland; (J.W.); (N.D.)
- Correspondence: ; Tel.: +48-81448-7300
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland; (E.G.); (P.M.); (S.M.)
| | - Paweł Macek
- Department of Oncology, Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-713 Kielce, Poland;
- Department of Epidemiology and Cancer Control, Holycross Cancer Centre, 25-734 Kielce, Poland
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland; (E.G.); (P.M.); (S.M.)
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland; (E.G.); (P.M.); (S.M.)
| | - Julia Wojnicka
- Department of Pathobiochemistry and Interdisciplinary Applications of Ion Chromatography, Medical University of Lublin, 1 Chodźki Street, 20-093 Lublin, Poland; (J.W.); (N.D.)
| | - Nicolo Durante
- Department of Pathobiochemistry and Interdisciplinary Applications of Ion Chromatography, Medical University of Lublin, 1 Chodźki Street, 20-093 Lublin, Poland; (J.W.); (N.D.)
| | - Agata Makarewicz
- Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439 Lublin, Poland;
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17
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Anashkina AA, Erlykina EI. Molecular Mechanisms of Aberrant Neuroplasticity in Autism Spectrum Disorders (Review). Sovrem Tekhnologii Med 2021; 13:78-91. [PMID: 34513070 PMCID: PMC8353687 DOI: 10.17691/stm2021.13.1.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Indexed: 01/03/2023] Open
Abstract
This review presents the analysis and systematization of modern data on the molecular mechanisms of autism spectrum disorders (ASD) development. Polyetiology and the multifactorial nature of ASD have been proved. The attempt has been made to jointly review and systematize current hypotheses of ASD pathogenesis at the molecular level from the standpoint of aberrant brain plasticity. The mechanism of glutamate excitotoxicity formation, the effect of imbalance of neuroactive amino acids and their derivatives, neurotransmitters, and hormones on the ASD formation have been considered in detail. The strengths and weaknesses of the proposed hypotheses have been analyzed from the standpoint of evidence-based medicine. The conclusion has been drawn on the leading role of glutamate excitotoxicity as a biochemical mechanism of aberrant neuroplasticity accompanied by oxidative stress and mitochondrial dysfunction. The mechanism of aberrant neuroplasticity has also been traced at the critical moments of the nervous system development taking into account the influence of various factors of the internal and external environment. New approaches to searching for ASD molecular markers have been considered.
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Affiliation(s)
- A A Anashkina
- Senior Teacher, Department of Biochemistry named after G.Y. Gorodisskaya; Senior Researcher, Central Scientific Research Laboratory, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - E I Erlykina
- Professor, Head of the Department of Biochemistry named after G.Y. Gorodisskaya, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
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18
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Rashaid AHB, Nusair SD, Alqhazo MT, Adams JB, Abu-Dalo MA, Bashtawi MA. Heavy metals and trace elements in scalp hair samples of children with severe autism spectrum disorder: A case-control study on Jordanian children. J Trace Elem Med Biol 2021; 67:126790. [PMID: 34022568 DOI: 10.1016/j.jtemb.2021.126790] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/28/2021] [Accepted: 05/13/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Elemental analysis has been increasingly used for biomonitoring heavy metals and trace elements. METHODS This study monitored the levels of two heavy metals (Al and Pb), and seven trace elements (Macroelements Mg, K, P and Ca; Microelements Zn, Cu, Fe) in scalp hair of 57 children with severe autism spectrum disorder (ASD) and 50 age-matched controls, using Inductively Coupled Plasma Atomic Emission Spectrophotometry (ICP-AES). RESULTS Compared to controls, significantly higher levels of Al (p = 0.001), Pb (p = 0.001) and K (p = 0.021), with lower levels of Mg and Zn (p = 0.038) were observed for the ASD group. ASD boys had higher levels of Al (p = 0.001), Pb (p = 0.001) and K (p = 0.017) than control boys, while ASD girls had higher Pb levels (p = 0.005) than control girls. The ASD subgroup exposed to passive smokers had higher levels of Al (p = 0.033) and Pb (p = 0.001, and the ASD subgroup not exposed to passive smoke had higher levels of Al (p = 0.011), Pb (p = 0.001), K (p = 0.003); and lower levels of Mg (p = 0.011) than their controls. Other confounding factors and the correlation between these elements were also investigated. CONCLUSION This data suggests that exposure to Al and Pb, increase intake of K, and decreased intake of magnesium and zinc, may contribute to ASD etiology.
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Affiliation(s)
- Ayat Hussein B Rashaid
- Department of Chemistry, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan.
| | - Shreen Deeb Nusair
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mazin Taha Alqhazo
- Department of Rehabilitation Sciences, Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Muna Ahmed Abu-Dalo
- Department of Chemistry, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
| | - Mahmoud Ahmad Bashtawi
- Department of Neuroscience, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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19
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Zinc status in attention-deficit/hyperactivity disorder: a systematic review and meta-analysis of observational studies. Sci Rep 2021; 11:14612. [PMID: 34272450 PMCID: PMC8285486 DOI: 10.1038/s41598-021-94124-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 07/05/2021] [Indexed: 12/18/2022] Open
Abstract
Previous studies regarding the zinc status in attention-deficit/hyperactivity disorder (ADHD) yielded inconsistent results. Thus, the present meta-analysis was aimed to estimate the association between hair and serum/plasma zinc levels and ADHD. Online databases of Medline, EMBASE, and Scopus were searched up to October 2020 with no limitation in time and language. Weighted mean differences (WMDs) of hair and serum/plasma zinc levels were calculated using a random-effects model. Overall, 22 articles with 1280 subjects with ADHD and 1200 controls were included. The pooled effect size indicated that serum/plasma zinc levels in subjects with ADHD were not statistically different than their controls (WMD = − 1.26 µmol/L; 95% CI − 3.72, 1.20). Interestingly, the exclusion of one study from the analysis showed that people with ADHD significantly have lower circulating levels of zinc compared to their controls (WMD: − 2.49 µmol/L; 95% CI − 4.29, − 0.69). Also, the pooled effect size indicated that hair zinc levels in cases with ADHD were not statistically different than their controls (WMD = − 24.19 μg/g; 95% CI − 61.80, 13.42). Present meta-analysis raises the possibility that subjects with ADHD are prone to have declined levels of zinc levels. Based on current findings, screening the zinc levels in subjects with ADHD could be reasonable. Further well-designed studies are needed to clarify the role of zinc in the etiology of ADHD.
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20
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Stanton JE, Malijauskaite S, McGourty K, Grabrucker AM. The Metallome as a Link Between the "Omes" in Autism Spectrum Disorders. Front Mol Neurosci 2021; 14:695873. [PMID: 34290588 PMCID: PMC8289253 DOI: 10.3389/fnmol.2021.695873] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/14/2021] [Indexed: 12/26/2022] Open
Abstract
Metal dyshomeostasis plays a significant role in various neurological diseases such as Alzheimer's disease, Parkinson's disease, Autism Spectrum Disorders (ASD), and many more. Like studies investigating the proteome, transcriptome, epigenome, microbiome, etc., for years, metallomics studies have focused on data from their domain, i.e., trace metal composition, only. Still, few have considered the links between other "omes," which may together result in an individual's specific pathologies. In particular, ASD have been reported to have multitudes of possible causal effects. Metallomics data focusing on metal deficiencies and dyshomeostasis can be linked to functions of metalloenzymes, metal transporters, and transcription factors, thus affecting the proteome and transcriptome. Furthermore, recent studies in ASD have emphasized the gut-brain axis, with alterations in the microbiome being linked to changes in the metabolome and inflammatory processes. However, the microbiome and other "omes" are heavily influenced by the metallome. Thus, here, we will summarize the known implications of a changed metallome for other "omes" in the body in the context of "omics" studies in ASD. We will highlight possible connections and propose a model that may explain the so far independently reported pathologies in ASD.
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Affiliation(s)
- Janelle E Stanton
- Department of Biological Sciences, University of Limerick, Limerick, Ireland.,Bernal Institute, University of Limerick, Limerick, Ireland
| | - Sigita Malijauskaite
- Bernal Institute, University of Limerick, Limerick, Ireland.,Department of Chemical Sciences, University of Limerick, Limerick, Ireland
| | - Kieran McGourty
- Bernal Institute, University of Limerick, Limerick, Ireland.,Department of Chemical Sciences, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Andreas M Grabrucker
- Department of Biological Sciences, University of Limerick, Limerick, Ireland.,Bernal Institute, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
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21
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Zhou Q, Huang D, Xu C, Wang J, Jin Y. Hair levels of heavy metals and essential elements in Chinese children with autism spectrum disorder. J Trace Elem Med Biol 2021; 66:126748. [PMID: 33756185 DOI: 10.1016/j.jtemb.2021.126748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/11/2021] [Accepted: 03/15/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Disproportional heavy metals and essential elements were reported in children with autism spectrum disorder (ASD) that is obscure in etiology. Inevitably, the association is biased by diet and environmental factors. METHODS Fifty pairs, one with ASD and the other living together from the same special school with cerebral palsy (CP), were recruited in Hangzhou (China), aged from 2 to 11 years old (74.0 % male). All samples were divided into two subgroups: preschool-aged (2-5 years old) and school-aged (6-10 years old). Heavy metals (As, Hg, Pb) and essential elements (Al, Ca, Cu, Mg, Mn, Zn) in hair were quantified by inductively coupled plasma mass spectrometry analysis and flame atomic absorption spectroscopy. RESULTS The children with ASD generally had lower hair levels of Mn (ASD 0.124 μg/g, CP 0.332 μg/g, P = 0.001) compared to the children with CP. After stratification for age, there were no significant differences detected in preschool-aged group. In school-aged group, the results exhibited the children with ASD had higher hair Pb (1.485 μg/g, 0.690 μg/g, P = 0.007) and Cu/Zn ratio (0.092, 0.060, P = 0.003), while hair Hg (0.254 μg/g, 0.353 μg/g, P = 0.016)、Mn (0.089 μg/g, 0.385 μg/g, P = 0.002)、Mg (17.81 μg/g, 24.53 μg/g, P = 0.014) and Zn (100.15 μg/g, 135.83 μg/g, P = 0.007) showed an opposite pattern. CONCLUSIONS These results suggest an imbalance of Mn in Chinese children with ASD.
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Affiliation(s)
- Qinfeng Zhou
- Environmental Epigenetics Laboratory, Department of Environmental Medicine, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Danni Huang
- Environmental Epigenetics Laboratory, Department of Environmental Medicine, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chenlu Xu
- Environmental Epigenetics Laboratory, Department of Environmental Medicine, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Juling Wang
- Environmental Epigenetics Laboratory, Department of Environmental Medicine, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yongtang Jin
- Environmental Epigenetics Laboratory, Department of Environmental Medicine, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China; Department of General Practice, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China.
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22
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Brimo Alsaman MZ, Sallah H, Badawi R, Ghawi A, Shashaa MN, Kassem LH, Ghazal A. Syrian medical, dental and pharmaceutical publication in the last decade: A bibliometric analysis. Ann Med Surg (Lond) 2021; 66:102441. [PMID: 34123378 PMCID: PMC8173265 DOI: 10.1016/j.amsu.2021.102441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/22/2021] [Accepted: 05/23/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Scientific research has an essential role in building up the basics of public health and clinical care. As a developing country, Syria has a limited contribution to scientific research. Besides, the current Syrian crisis has inflicted severe damage to the infrastructure of the country, which, in turn, negatively affected the scientific sphere. This study examines the scientific publishing in Syria from 2011 until 2020. It aims to define the real and deep reasons for the slow-down in publication to get over them, push Syria to keep track of the latest updates, and take its place in scientific research. METHODS We conducted a bibliometric analysis of articles published in (PubMed and Scopus) Databases from 1/1/2011 until 26/12/2020, using the following search terms (("Syrian Arab Republic") OR (Syria) OR (Syrian)) limiting the search to (Affiliation) fields. RESULTS Syrian medical, dental and pharmaceutical institutions published 1403 papers from 2011 until 2020. There were only 55 papers in 2011, and a peak with 180 papers in 2018. Besides, publications in the last 4 years were 1.135 times more than publications in the last 6 years. CONCLUSION We noticed a peak in quantity of Syrian medical, dental and pharmaceutical publications in the last decade. Accordingly, we recommend enhancing research skills, paying more attention to the quality of researches, and holding research workshops and Evidence Based conferences to enhance the scientific endeavor.
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Affiliation(s)
| | - Hala Sallah
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Rayan Badawi
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Anas Ghawi
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | - Luma Haj Kassem
- Department of Otolaryngology, Faculty of Medicine, University of Aleppo, Aleppo, Syria
- CME Office, Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Ahmad Ghazal
- Department of Surgery, Aleppo University Hospital, Aleppo, Syria
- CME Office, Faculty of Medicine, University of Aleppo, Aleppo, Syria
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