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Di Liberto D, D’Anneo A, Carlisi D, Emanuele S, De Blasio A, Calvaruso G, Giuliano M, Lauricella M. Brain Opioid Activity and Oxidative Injury: Different Molecular Scenarios Connecting Celiac Disease and Autistic Spectrum Disorder. Brain Sci 2020; 10:E437. [PMID: 32659996 PMCID: PMC7407635 DOI: 10.3390/brainsci10070437] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022] Open
Abstract
Celiac Disease (CD) is an immune-mediated disease triggered by the ingestion of wheat gliadin and related prolamins from other cereals, such as barley and rye. Immunity against these cereal-derived proteins is mediated by pro-inflammatory cytokines produced by both innate and adaptive system response in individuals unable to adequately digest them. Peptides generated in this condition are absorbed across the gut barrier, which in these patients is characterized by the deregulation of its permeability. Here, we discuss a possible correlation between CD and Autistic Spectrum Disorder (ASD) pathogenesis. ASD can be induced by an excessive and inappropriate brain opioid activity during the neonatal period. Cereal-derived peptides produced in celiac patients cross the blood-brain barrier and bind to endogenous opioid receptors interfering with neurotransmission and generating deleterious effects on brain maturation, learning and social relations. Moreover, an increase in oxidative stress and a decrease in the antioxidant capacity, as well as an extended mitochondrial impairment in the brain, could represent a possible connection between ASD and CD. Therefore, we critically discuss the proposed relationship between ASD and CD and the possible usefulness of a gluten-free diet in ASD patients.
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Affiliation(s)
- Diana Di Liberto
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), University of Palermo, 90127 Palermo, Italy;
| | - Antonella D’Anneo
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), Laboratory of Biochemistry, University of Palermo, 90127 Palermo, Italy; (A.D.B.); (G.C.); (M.G.)
| | - Daniela Carlisi
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), Institute of Biochemistry, University of Palermo, 90127 Palermo, Italy; (D.C.); (S.E.)
| | - Sonia Emanuele
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), Institute of Biochemistry, University of Palermo, 90127 Palermo, Italy; (D.C.); (S.E.)
| | - Anna De Blasio
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), Laboratory of Biochemistry, University of Palermo, 90127 Palermo, Italy; (A.D.B.); (G.C.); (M.G.)
| | - Giuseppe Calvaruso
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), Laboratory of Biochemistry, University of Palermo, 90127 Palermo, Italy; (A.D.B.); (G.C.); (M.G.)
| | - Michela Giuliano
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), Laboratory of Biochemistry, University of Palermo, 90127 Palermo, Italy; (A.D.B.); (G.C.); (M.G.)
| | - Marianna Lauricella
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), Institute of Biochemistry, University of Palermo, 90127 Palermo, Italy; (D.C.); (S.E.)
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Castillo MA, Urdaneta KE, Semprún-Hernández N, Brigida AL, Antonucci N, Schultz S, Siniscalco D. Speech-Stimulating Substances in Autism Spectrum Disorders. Behav Sci (Basel) 2019; 9:E60. [PMID: 31212856 PMCID: PMC6616660 DOI: 10.3390/bs9060060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 12/23/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterized by the core domains of persistent deficits in social communication and restricted-repetitive patterns of behaviors, interests, or activities. A heterogeneous and complex set of neurodevelopmental conditions are grouped in the spectrum. Pro-inflammatory events and immune system dysfunctions are cellular and molecular events associated with ASD. Several conditions co-occur with ASD: seizures, gastro-intestinal problems, attention deficit, anxiety and depression, and sleep problems. However, language and speech issues are key components of ASD symptoms current therapies find difficult to face. Several speech-stimulating substances have been shown to be effective in increasing speech ability in ASD subjects. The need for large clinical trials to determine safety and efficacy is recommended.
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Affiliation(s)
| | - Kendy Eduardo Urdaneta
- Research Division, Autism Immunology Unit of Maracaibo, Maracaibo 4001, Venezuela.
- Department of Biology, Faculty of Sciences, University of Zulia, Maracaibo 4001, Venezuela.
| | - Neomar Semprún-Hernández
- Research Division, Autism Immunology Unit of Maracaibo, Maracaibo 4001, Venezuela.
- Catedra libre de Autismo, Universidad del Zulia, Maracaibo 4001, Venezuela.
| | | | - Nicola Antonucci
- Biomedical Centre for Autism Research and Treatment, 70126 Bari, Italy.
| | - Stephen Schultz
- Department of Cellular and Integrative Physiology, School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA.
| | - Dario Siniscalco
- Department of Experimental Medicine, University of Campania, 80138 Napoli, Italy.
- Centre for Autism-La Forza del Silenzio, 81036 Caserta, Italy.
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Fluegge K, Fluegge K. Environmental factors influencing the link between childhood ADHD and risk of adult coronary artery disease. Med Hypotheses 2017; 110:83-85. [PMID: 29317076 DOI: 10.1016/j.mehy.2017.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/14/2017] [Indexed: 01/09/2023]
Abstract
Yorbik et al. reported novel findings regarding a hypothesized relationship between childhood attention-deficit hyperactivity disorder (ADHD) and later risk for coronary heart disease in adulthood. The authors found that mean platelet volume (MPV), a marker of platelet reactivity and a presumable biomarker in patients with cardiovascular disease, was significantly elevated in children with ADHD compared to healthy controls. The mechanistic importance of this novel discovery remains unknown and warrants clarification. We have made the novel proposition that environmental exposure to the agricultural and combustion air pollutant, nitrous oxide (N2O), may be an etiological contributor to neurodevelopmental disorders. Clinical studies suggest that N2O may enhance platelet hyperaggregation, possibly via its biphasic role as an MAO inhibitor especially at trace levels of exposure or via the generation of oxidative stress. Therefore, this correspondence briefly details the hypothesis that altered biochemical profiles in neurodevelopmental disorders, derived from chronic environmental exposure to the agricultural and combustion air pollutant, N2O, may promote coronary artery disease in adulthood.
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Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
| | - Kyle Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA; New York City Department of Health and Mental Hygiene, New York 11101-4132 USA
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Fluegge K. Perinatal Hypoxic-Ischemic Conditions, Attention-Deficit Hyperactivity Disorder (ADHD), and Environmental Exposure to Nitrous Oxide. J Child Neurol 2017; 32:684-685. [PMID: 28381097 DOI: 10.1177/0883073817700493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH
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Fluegge K. Levels of peripheral neopterin in neurodevelopmental disorders. J Neuroimmunol 2017; 306:53-54. [PMID: 28385188 DOI: 10.1016/j.jneuroim.2017.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 03/10/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, P.O. Box 18442, Cleveland, OH 44118, USA.
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FLUEGGE BA K. Zinc and Copper Metabolism and Risk of Autism: a reply to Sayehmiri et al. IRANIAN JOURNAL OF CHILD NEUROLOGY 2017; 11:66-69. [PMID: 28883881 PMCID: PMC5582364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 03/06/2017] [Accepted: 06/12/2017] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Sayehmiri et al. recently conducted a meta-analysis to explore the relationship between zinc and copper metabolism and autism spectrum disorders (ASD). Recent reports have elucidated a full behavioral profile of mice exposed to prenatal zinc deficiency and documented a phenotype similar to that found in autism spectrum disorders (ASD). These studies suggest that significant alterations in Zn metabolism may be an important nutritional component in the development of ASD. MATERIALS & METHODS The idea that prenatal zinc deficiency may be to blame is cursorily challenged. Epidemiological studies show that high-income countries with a low estimated prevalence of inadequate zinc intake report the highest prevalence of ASD. Consistent with other reports indicating a link between air pollution and ASD, it has recently been proposed that use of the herbicide, glyphosate, in agriculture may serve as an instrumental variable in predicting later neurodevelopmental impairment via emissions of the agricultural air pollutant, nitrous oxide (N2O). RESULTS Work in anesthesiology has demonstrated the neurological effects from subanesthetic doses of N2O, including its inhibition of the alpha 7 nicotinic acetylcholine receptor (α7), a receptor coupled to both central nitric oxide (NO) metabolism and peripheral anti-inflammation. CONCLUSION This correspondence explores how the aforementioned nutritional phenotypes found by Sayehmiri et al. in their systematic review may be a compensatory mechanism to counter the effects (namely, α7 inhibition) of air pollutant exposures occurring during the most critical stages of fetal development.
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The BTBR mouse model, cholinergic transmission, and environmental exposure to nitrous oxide. Psychopharmacology (Berl) 2017; 234:319-321. [PMID: 27722774 DOI: 10.1007/s00213-016-4456-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/11/2016] [Indexed: 12/20/2022]
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Fluegge K. Environmental factors in the development of autism spectrum disorders: A reply to Sealey et al. (2016). ENVIRONMENT INTERNATIONAL 2016; 97:256-257. [PMID: 26926711 DOI: 10.1016/j.envint.2016.02.024] [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: 02/09/2016] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
Sealey et al. have reviewed the available evidence on environmental factors that may predispose the development of autism spectrum disorders (ASD) in vulnerable populations. The authors identify exposure to vaccines, pesticides, and air pollutants as potential contributors. The author of this correspondence has previously proposed elsewhere that exposure to increasing levels of the agricultural and environmental pollutant, nitrous oxide (N2O), may be the dominant etiology of ASD and other neurodevelopmental disorders. N2O is thought to target the opioidergic system, including the Ƙ-opioid receptor (KOR). Exposure to thimerosal-containing vaccines may disrupt the activity of several endogenous targets as has been shown, principally including μ-opioid receptor (MOR). Given the antagonistic actions of the MOR and KOR, dysregulation of MOR may leave the heightened dynorphin/KOR system unchecked, possibly inducing a negative emotional state that is characteristic of ASD. Future attention may need to be focused on understanding on how early-life mercury exposures, such as in vaccines, may or may not reveal a gestational opiate dependence induced from other ASD-implicated environmental factors.
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Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, USA.
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Maternal infection during pregnancy, risk of offspring autism, and the role of bacterial denitrification. Brain Behav Immun 2016; 57:371. [PMID: 27350210 DOI: 10.1016/j.bbi.2016.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 06/23/2016] [Indexed: 11/23/2022] Open
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Fluegge K. Does environmental exposure to the greenhouse gas, N 2O, contribute to etiological factors in neurodevelopmental disorders? A mini-review of the evidence. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2016; 47:6-18. [PMID: 27566494 DOI: 10.1016/j.etap.2016.08.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 08/11/2016] [Accepted: 08/13/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Neurodevelopmental disorders are increasing in prevalence worldwide. Previous work suggests that exposure to the environmental air pollutant and greenhouse gas - nitrous oxide (N2O) - may be an etiological factor in neurodevelopmental disorders through the targeting of several neural correlates. METHODOLOGY While a number of recent systematic reviews have addressed the role of general anesthesia in the surgical setting and neurodevelopmental outcomes, a narrative mini-review was conducted to first define and characterize the relevant variables (i.e., N2O, attention-deficit hyperactivity disorder [ADHD] and autism spectrum disorders [ASD]) and their potential interactions into a coherent, hypothesis-generating work. The narrative mini-review merges basic principles in environmental science, anesthesiology, and psychiatry to more fully develop the novel hypotheses that neurodevelopmental impairment found in conditions like ADHD and ASD may be due to exposure to the increasing air pollutant, N2O. RESULTS The results of the present mini-review indicate that exposure to N2O, even at non-toxic doses, may modulate central neurotransmission and target many neural substrates directly implicated in neurodevelopmental disorders, including the glutamatergic, opioidergic, cholinergic, and dopaminergic systems. Epidemiological studies also indicate that early and repeated exposure to general anesthesia, including N2O, may contribute to later adverse neurodevelopmental outcomes in children. CONCLUSIONS The current evidence and subsequent hypotheses suggest that a renewed interest be taken in the toxicological assessment of environmental N2O exposure using validated biomarkers and psychiatric endpoints. Given the relevance of N2O as a greenhouse gas, societies may also wish to engage in a more robust monitoring and reporting of N2O levels in the environment for climactic benefit as well.
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Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
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Fluegge K. Gluten Intolerance and Neurodevelopmental Disorders: Is Nitric Oxide the Common Biomarker Linking These Conditions? ANNALS OF NUTRITION AND METABOLISM 2016; 69:54-5. [PMID: 27498299 DOI: 10.1159/000448664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cruchet et al. attempt to tease out the myths and facts surrounding the growing popularity of certain dietary approaches in the management of neurodevelopmental disorders, like attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs). The authors identify a particular exclusionary-type approach that seeks to eliminate dietary gluten. Although the relationship between celiac disease (CD) and ADHD/ASD is not well established, a repeated clinical feature noted in CD is the elevated levels of nitric oxide in serum and urine. Elevated oxidative stress has also been observed in neurodevelopmental conditions, and the author of this correspondence has been the first to propose that chronic, environmental exposure to the air pollutant, nitrous oxide may contribute to these oxidative stress profiles through neural cholinergic perturbation. Therefore, the purpose of this correspondence is to highlight this biochemical connection between these conditions so as to identify the clinical populations who may realize the greatest benefit of these dietary approaches, while minimizing any potential risk of nutrient deficiencies.
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Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, Ohio, USA
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Fluegge K. Does MeCP2 deficiency in autism confer protection against later development of Alzheimer’s disease? A reply to Oberman and Pascual-Leone (2014). Med Hypotheses 2016; 92:18-20. [DOI: 10.1016/j.mehy.2016.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/11/2016] [Accepted: 04/13/2016] [Indexed: 02/08/2023]
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Fluegge K. In Regard to "Autism in the Son of a Woman with Mitochondrial Myopathy and Dysautonomia: A Case Report". INNOVATIONS IN CLINICAL NEUROSCIENCE 2016; 13:13-14. [PMID: 27800280 PMCID: PMC5077252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, Ohio
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