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Önal S, Sachadyn-Król M, Kostecka M. A Review of the Nutritional Approach and the Role of Dietary Components in Children with Autism Spectrum Disorders in Light of the Latest Scientific Research. Nutrients 2023; 15:4852. [PMID: 38068711 PMCID: PMC10708497 DOI: 10.3390/nu15234852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects several areas of mental development. The onset of ASD occurs in the first few years of life, usually before the age of 3 years. Proper nutrition is important to ensure that an individual's nutrient and energy requirements are met, and it can also have a moderating effect on the progression of the disorder. A systematic database search was conducted as a narrative review to determine whether nutrition and specific diets can potentially alter gastrointestinal symptoms and neurobehavioral disorders. Databases such as Science Direct, PubMed, Scopus, Web of Science (WoS), and Google Scholar were searched to find studies published between 2000 and September 2023 on the relationship between ASD, dietary approaches, and the role of dietary components. The review may indicate that despite extensive research into dietary interventions, there is a general lack of conclusive scientific data about the effect of therapeutic diets on ASD; therefore, no definitive recommendation can be made for any specific nutritional therapy as a standard treatment for ASD. An individualized dietary approach and the dietician's role in the therapeutic team are very important elements of every therapy. Parents and caregivers should work with nutrition specialists, such as registered dietitians or healthcare providers, to design meal plans for autistic individuals, especially those who would like to implement an elimination diet.
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Affiliation(s)
- Seda Önal
- Department of Nutrition and Dietetics, Health Sciences Institute, Ankara University, 06110 Ankara, Turkey;
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Fırat University, 23200 Elazığ, Turkey
| | - Monika Sachadyn-Król
- Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
| | - Małgorzata Kostecka
- Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
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2
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Rabaya S, Nairat S, Bader K, Herzallah MM, Darwish HM. Iron metabolism in autism spectrum disorder; inference through single nucleotide polymorphisms in key iron metabolism genes. J Neurol Sci 2023; 453:120817. [PMID: 37813049 DOI: 10.1016/j.jns.2023.120817] [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: 04/24/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/11/2023]
Abstract
Autism spectrum disorder (ASD) is a heterogeneous group of neurodevelopmental problems with various genetic and environmental components. The ASD diagnosis is based on symptom expression without reliance on any biomarkers. The genetic contributions in ASD remain elusive. Various studies have linked ASD with iron. Since iron plays a crucial role in brain development, neurotransmitter synthesis, neuronal myelination and mitochondrial function, we hypothesized that iron dysregulation in the brain could play a role and contribute to the pathogenesis of ASD. In this study, we investigated single nucleotide polymorphisms in ASD in various iron metabolism genes, including the Transferrin Receptor (TFRC) gene (rs11915082), the Solute Carrier Family 11 Member 2 (SLC11A2) gene (rs1048230 and rs224589), the Solute Carrier Family 40 Member 1 (SLC40A1) gene (rs1439816), and hepcidin antimicrobial peptide (HAMP) gene (rs10421768). We recruited 48 patients with ASD and 88 matched non-ASD controls. Our results revealed a significant difference between ASD and controls in the G allele of the TFRC gene rs11915082, and in the C allele of the SLC40A1 gene rs1439816. In silico analysis demonstrated potential positive role of the indicated genetic variations in ASD development and pathogenesis. These results suggest that specific genetic variations in iron metabolism genes may represent part of early genetic markers for early diagnosis of ASD. A significant effect of SNPs, groups (ASD/control) as well as interaction between SNPs and groups was revealed. Follow-up post hoc tests showed a significant difference between the ASD and control groups in rs11915082 (TFRC gene) and rs1439816 (SLC40A1 gene). Backward conditional logistic regression using both the genotype and allele data showed similar ability in detecting ASD using allel model (Nagelkerke R2 = 0.350 p = 0.967; Variables: rs1439816, rs11915082) compared to genotype model (Nagelkerke R2 = 0.347, p = 0.430; Variables: rs1439816 G, rs1439816 C, rs10421768 A). ROC curve showed 54% sensitivity in detecting ASD compared to 47% for the genotype model. Both models differentiated controls with high accuracy; the allele model had a specificity of 91% compared to 92% for the genotype model. In conclusion, our findings suggest that specific genetic variations in iron metabolism may represent early biomarkers for a diagnosis of ASD. Further research is needed to correlate these markers with specific blood iron indicators and their contribution to brain development and behavior.
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Affiliation(s)
- Sabha Rabaya
- Department of Health Sciences, Molecular Genetics and Genetic Toxicology Program, Arab American University, Ramallah,Palestine
| | - Sameera Nairat
- Palestinian Neuroscience Initiative, Al-Quds University, Abu Dis, Jerusalem, Palestine
| | - Khaldoun Bader
- Faculty of Public Health, Al-Quds University, Abu Dis, Jerusalem, Palestine
| | - Mohammad M Herzallah
- Palestinian Neuroscience Initiative, Al-Quds University, Abu Dis, Jerusalem, Palestine; Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA.
| | - Hisham M Darwish
- Department of Health Sciences, Molecular Genetics and Genetic Toxicology Program, Arab American University, Ramallah,Palestine; Department of Medical Laboratory Sciences, Faculty ofAllied Medical Sciences, Arab American University, Jenin, Palestine.
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3
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Arcot A, Xing X, Gao X, Font SA, Murray-Kolb LE. Iron status, development, and behavior in young children in the Pennsylvania foster care system. PLoS One 2023; 18:e0289951. [PMID: 37590213 PMCID: PMC10434919 DOI: 10.1371/journal.pone.0289951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 07/28/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Children in foster care are classified as a highly vulnerable population and struggle with both physical and mental health problems. Medical conditions, like poor nutritional status, remain understudied in children in foster care. To our knowledge, few studies in children in U.S. foster care have quantified the prevalence of anemia, and no studies have examined the association between anemia status and relevant developmental and behavioral outcomes. OBJECTIVE/AIMS (1) To determine the prevalence of anemia among children in or adopted from Pennsylvania foster care, between the ages of six months to ten years and (2) To examine if a child's anemia status is associated with greater odds of relevant developmental and behavioral diagnoses. METHODS We conducted a secondary data analysis utilizing the Medicaid Analytic eXtract database between 2010-2015. Children six months-ten years were included in the analysis if they were in or had been adopted from Pennsylvania foster care. Logistic regression was used to calculate adjusted odds ratios (AOR) with 95% confidence intervals for the association between iron status and health outcomes. RESULTS A total of 50,311 children were included in our sample, of which 1,365 children (2.7%) were diagnosed with anemia. Children diagnosed with anemia had greater odds of delayed milestones (AOR: 2.38 [1.64-3.45]), specific delays in development (AOR: 1.59 [1.23-2.07]), adjustment disorder (AOR: 1.59 [1.06-2.39]), and irritability (AOR: 10.57 [3.36-33.25]), than children not diagnosed with anemia. CONCLUSION The prevalence of anemia among children between six months-ten years in or adopted from the Pennsylvania foster care system is within the national rate of U.S. childhood anemia. Odds of several relevant developmental and behavioral diagnoses were greater among children diagnosed with anemia than children who were not.
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Affiliation(s)
- Amrita Arcot
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States of America
| | - Xueyi Xing
- Evidence-to-Impact Collaborative, Social Science Research Institute, The Pennsylvania State University, University Park, PA, United States of America
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States of America
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Sarah A. Font
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, PA, United States of America
| | - Laura E. Murray-Kolb
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States of America
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4
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Islam N, Hathaway KL, Anderson BS, Sharp WG, Loechner KJ. Brief Report: Decreased Bone Health in Children with Autism Spectrum Disorder and Avoidant Restrictive Food Intake Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-05976-x. [PMID: 37179523 DOI: 10.1007/s10803-023-05976-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE Children with autism spectrum disorder (ASD) and food selectivity are at increased risk for nutritional deficiencies which could affect bone health. METHODS We report on four male patients with ASD and avoidant restrictive food intake disorder (ARFID) with significant bone conditions including rickets, vertebral compression fractures, osteopenia, and slipped capital femoral epiphyses. RESULTS Each patient was at risk for at least one nutritional deficiency. Two out of four patients had deficiencies in Vitamins A, B12, E, and zinc. Calcium and Vitamin D deficiency were noted in all four. Two out of four patients with Vitamin D deficiency developed rickets. CONCLUSION Provisional evidence suggests that children with ASD and ARFID are at elevated risk for serious adverse bone health outcomes.
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Affiliation(s)
- Noreen Islam
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA, 30322, USA.
| | - Kristin L Hathaway
- Children's Multidisciplinary Feeding Program, Marcus Autism Center, 1920 Briarcliff Rd NE, Atlanta, GA, 30329, USA
| | - Brooke S Anderson
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA, 30322, USA
| | - William G Sharp
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA, 30322, USA
- Children's Multidisciplinary Feeding Program, Marcus Autism Center, 1920 Briarcliff Rd NE, Atlanta, GA, 30329, USA
| | - Karen J Loechner
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA, 30322, USA
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Fiani D, Engler S, Fields S, Calarge CA. Iron Deficiency in Attention-Deficit Hyperactivity Disorder, Autism Spectrum Disorder, Internalizing and Externalizing Disorders, and Movement Disorders. Child Adolesc Psychiatr Clin N Am 2023; 32:451-467. [PMID: 37147046 DOI: 10.1016/j.chc.2022.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This article reviews the role of iron in brain development and function, with a focus on the association between iron deficiency (ID) and neuropsychiatric conditions. First, we describe how ID is defined and diagnosed. Second, the role of iron in brain development and function is summarized. Third, we review current findings implicating ID in a number of neuropsychiatric conditions in children and adolescents, including attention deficit hyperactivity disorder and other disruptive behavior disorders, depressive and anxiety disorders, autism spectrum disorder, movement disorders, and other situations relevant to mental health providers. Last, we discuss the impact of psychotropic medication on iron homeostasis.
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Affiliation(s)
- Dimitri Fiani
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 8080 N Stadium Dr. Ste 180.35, Houston, TX 77054, USA. https://twitter.com/dimitrifiani
| | - Solangia Engler
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Sherecce Fields
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Chadi Albert Calarge
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 8080 N Stadium Dr. Ste 180.35, Houston, TX 77054, USA; Department of Pediatrics, Baylor College of Medicine, 1102 Bates Avenue, Ste 790, Houston, TX 77030, USA.
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6
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Association of autism with lead poisoning in an environmental health clinic. Pediatr Res 2022:10.1038/s41390-022-02408-x. [PMID: 36496540 DOI: 10.1038/s41390-022-02408-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2022]
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7
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DelRosso LM, Reuter-Yuill LM, Cho Y, Ferri R, Mogavero MP, Picchietti DL. Clinical efficacy and safety of intravenous ferric carboxymaltose treatment for restless legs symptoms and low serum ferritin in children with autism spectrum disorder. Sleep Med 2022; 100:488-493. [PMID: 36265207 DOI: 10.1016/j.sleep.2022.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Restless legs syndrome (RLS) may be underdiagnosed in children with autism spectrum disorder (ASD) due to difficulty expressing the symptoms in their own words. In addition, administration of oral iron may be particularly difficult in children with ASD. METHODS This was a retrospective, open-label case series of children with ASD, restless legs (RL) symptoms, and serum ferritin <30 μg/L, who either had failed or did not tolerate oral iron, and were subsequently treated with intravenous (IV) ferric carboxymaltose (FCM). Patients received a single dose of IV FCM, 15 mg/kg up to a maximum dose of 750 mg. Data collected pre- and eight weeks post-infusion included presenting symptoms, serum ferritin, iron profile, and Clinical Global Impression Scale (CGI-Severity pre- and CGI-Improvement post-infusion). Adverse effects were assessed. RESULTS Nineteen children, 4-11 years old (12 male, median age 6, interquartile range (IQR 4-11) were included. A definite RLS diagnosis was identified in 6 verbal children (31.6%). RL symptoms (designated probable RLS) in the 13 other children met all RLS diagnostic criteria except "improvement of symptoms with movement," which was not definitively determined. Baseline median values were: ferritin 10 μg/L (IQR 10-16), iron 66.5 μg/dL (IQR 57-96), TIBC 382 μg/dL (IQR 360-411) and transferrin saturation 19% (IQR 14-28). Median CGI-S was 4 (moderate symptoms) (IQR 3-4). At eight weeks after IV FCM, all measures were improved. Median ferritin was 68 μg/L (IQR 62.5-109, p < 0.00045). Median CGI-I was 1 (very much improved) (IQR 1-2). All children meeting definite RLS criteria improved. Three children in the probable RLS group did not improve. Children meeting the full RLS criteria had lower baseline ferritin levels than those with a probable diagnosis (9 μg/L, IQR 9-10 vs. 13 μg/L, IQR 10-16, Mann-Whitney test p < 0.045). Adverse effects included lightheadedness, gastrointestinal discomfort, fever, and headache among others. CONCLUSIONS The majority of children (84.2%) with ASD, restless legs symptoms, and serum ferritin <30 μg/L had clinical improvement and significantly better serum iron parameters after a single IV FCM infusion. Although larger, randomized trials are needed, IV FCM appears to be a promising treatment for this subset of children with ASD.
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Affiliation(s)
- Lourdes M DelRosso
- Seattle Children's Hospital and University of Washington, Seattle, WA, USA.
| | - Lilith M Reuter-Yuill
- Western Michigan University, Kalamazoo, MI, Comprehensive Speech and Therapy Center, Jackson, MI, and Southern Illinois University, Carbondale, IL, USA
| | - Yeilim Cho
- Seattle Children's Hospital and University of Washington, Seattle, WA, USA
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology I.C., Oasi Research Institute - IRCCS, Troina, Italy
| | - Maria P Mogavero
- Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Italy
| | - Daniel L Picchietti
- University of Illinois School of Medicine, Carle Illinois College of Medicine, Carle Foundation Hospital, and University of Illinois School of Medicine, Urbana, IL, USA
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8
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Chen L, Guo X, Hou C, Tang P, Zhang X, Chong L, Li R. The causal association between iron status and the risk of autism: A Mendelian randomization study. Front Nutr 2022; 9:957600. [PMID: 36407516 PMCID: PMC9669792 DOI: 10.3389/fnut.2022.957600] [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: 05/31/2022] [Accepted: 10/18/2022] [Indexed: 11/20/2023] Open
Abstract
Emerging evidence indicates a connection between serum iron levels and autism, but the underlying causal association is yet unclear. Thus, we performed two-sample Mendelian randomization (MR) analysis to evaluate the causal link between iron status on autism, using genetic instruments (p < 5E-08) strongly associated with iron status (N = 48,972), including serum iron, ferritin, transferrin levels, and transferrin saturation. Summary statistics of autism was obtained from two independent studies conducted by Psychiatric Genomics Consortium (PGC, Ncases = 5,305, Ncontrols = 5,305) and FinnGen Consortium (FC, Round six, Ncases = 344, Ncontrols = 258,095), respectively. Using the inverse-variance weighted (IVW) method, the combined results of PGC and FC demonstrated that genetically determined serum transferrin level was significantly associated with an increased risk of autism [odds ratio (OR) = 1.16, 95% CI: 1.03-1.30, p = 0.013]. There was no significant causal effect of serum iron (OR = 0.99, 95% CI: 0.72-1.37, p = 0.951), ferritin (OR = 0.88, 95% CI: 0.47-1.64, p = 0.676), and transferrin saturation (OR = 0.89, 95% CI: 0.72-1.09, p = 0.252) on autism. No obvious pleiotropy was found in this MR study. Taken together, our findings highlight that elevation of serum transferrin level might be associated with a high risk of autism, suggesting a potential role of iron deficiency in autism development. Future studies are warranted to clarify the underlying mechanism, which will pave a new path for the prevention and treatment of autism.
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Affiliation(s)
- Li Chen
- Department of Geriatric Neurology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi’an, Shaanxi, China
| | - Xingzhi Guo
- Department of Geriatric Neurology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi’an, Shaanxi, China
- Institute of Medical Research, Northwestern Polytechnical University, Xi’an, Shaanxi, China
| | - Chen Hou
- Department of Geriatric Neurology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi’an, Shaanxi, China
| | - Peng Tang
- Department of Geriatric Neurology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi’an, Shaanxi, China
| | - Xin Zhang
- Department of Geriatric Neurology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi’an, Shaanxi, China
| | - Li Chong
- Department of Geriatric Neurology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi’an, Shaanxi, China
| | - Rui Li
- Department of Geriatric Neurology, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi’an, Shaanxi, China
- Institute of Medical Research, Northwestern Polytechnical University, Xi’an, Shaanxi, China
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9
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McWilliams S, Singh I, Leung W, Stockler S, Ipsiroglu OS. Iron deficiency and common neurodevelopmental disorders—A scoping review. PLoS One 2022; 17:e0273819. [PMID: 36173945 PMCID: PMC9522276 DOI: 10.1371/journal.pone.0273819] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/16/2022] [Indexed: 12/04/2022] Open
Abstract
Background A wealth of human and experimental studies document a causal and aggravating role of iron deficiency in neurodevelopmental disorders. While pre-, peri-, and early postnatal iron deficiency sets the stage for the risk of developing neurodevelopmental disorders, iron deficiency acquired at later ages aggravates pre-existing neurodevelopmental disorders. Yet, the association of iron deficiency and neurodevelopmental disorders in childhood and adolescence has not yet been explored comprehensively. In this scoping review, we investigate 1) the association of iron deficiency in children and adolescents with the most frequent neurodevelopmental disorders, ADHD, ASD, and FASD, and 2) whether iron supplementation improves outcomes in these disorders. Method Scoping review of studies published between 1994 and 2021 using “iron deficiency / iron deficiency anemia” AND “ADHD” OR “autism” OR “FASD” in four biomedical databases. The main inclusion criterion was that articles needed to have quantitative determination of iron status at any postnatal age with primary iron markers such as serum ferritin being reported in association with ADHD, ASD, or FASD. Results For ADHD, 22/30 studies and 4/4 systematic reviews showed an association of ADHD occurrence or severity with iron deficiency; 6/6 treatment studies including 2 randomized controlled trials demonstrated positive effects of iron supplementation. For ASD, 3/6 studies showed an association with iron deficiency, while 3/6 and 1/1 systematic literature review did not; 4 studies showed a variety of prevalence rates of iron deficiency in ASD populations; 1 randomized controlled trial found no positive effect of iron supplementation on behavioural symptoms of ASD. For FASD, 2/2 studies showed an association of iron deficiency with growth retardation in infants and children with prenatal alcohol exposure. Conclusion Evidence in favor of screening for iron deficiency and using iron supplementation for pediatric neurodevelopmental disorders comes primarily from ADHD studies and needs to be further investigated for ASD and FASD. Further analysis of study methodologies employed and populations investigated is needed to compare studies against each other and further substantiate the evidence created.
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Affiliation(s)
- Scout McWilliams
- H-Behaviours Research Lab (previously Sleep/Wake-Behaviour Research Lab), BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Ishmeet Singh
- H-Behaviours Research Lab (previously Sleep/Wake-Behaviour Research Lab), BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Wayne Leung
- H-Behaviours Research Lab (previously Sleep/Wake-Behaviour Research Lab), BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Sylvia Stockler
- H-Behaviours Research Lab (previously Sleep/Wake-Behaviour Research Lab), BC Children’s Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- Division of Biochemical Diseases, Department of Pediatrics, BC Children’s Hospital, University of British Columbia, Vancouver, Canada
- * E-mail:
| | - Osman S. Ipsiroglu
- H-Behaviours Research Lab (previously Sleep/Wake-Behaviour Research Lab), BC Children’s Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- Divisions of Child & Adolescent Psychiatry, Developmental Pediatrics and Respirology, Department of Pediatrics, Sleep/Wake-Behaviour Clinic at Sleep Program, BC Children’s Hospital, University of British Columbia, Vancouver, Canada
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10
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Tang CY, Wen F. Serum ferritin levels in children with attention deficit hyperactivity disorder and tic disorder. World J Clin Cases 2022; 10:7749-7759. [PMID: 36158507 PMCID: PMC9372851 DOI: 10.12998/wjcc.v10.i22.7749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/01/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Iron plays an important role in neurodevelopmental functions in the brain. Serum ferritin levels are different in children with attention deficit hyperactivity disorder and tic disorder than in healthy children.
AIM To explore the current status of iron deficiency in children with neurodevelopmental disorders and its sex and age effects.
METHODS A total of 1565 children with attention deficit hyperactivity disorder (ADHD), 1694 children with tic disorder (TD), 93 children with ASD and 1997 healthy control children were included between January 1, 2020, and December 31, 2021 at Beijing Children's Hospital. We describe the differences in age levels and ferritin levels between different disease groups and their sex differences. The differences between the sexes in each disease were analyzed using the t test. The incidence rate of low serum ferritin was used to describe the differences between different diseases and different age groups. A chi-square test was used to analyze the difference in the incidence of low serum ferritin between the disease group and the control group. Analysis of variance was used for comparisons between subgroups, and regression analysis was used for confounding factor control.
RESULTS A total of 1565 ADHD patients aged 5-12 years were included in this study, and the average serum ferritin levels of male and female children were 36.82 ± 20.64 μg/L and 35.64 ± 18.56 μg/L, respectively. A total of 1694 TD patients aged 5-12 years were included in this study, and the average serum ferritin levels of male and female children were 35.72 ± 20.15 μg/L and 34.54 ± 22.12 μg/L, respectively. As age increased, the incidence of low serum ferritin in ADHD and TD first decreased and then increased, and 10 years old was the turning point of rising levels. The incidence of ADHD with low serum ferritin was 8.37%, the incidence of TD with low serum ferritin was 11.04%, and the incidence of the healthy control group with low serum ferritin was 8.61%, among which male children with TD accounted for 9.25% and female children with TD accounted for 11.62%. There was a significant difference among the three groups (P < 0.05). In addition, there were 93 children with ASD with an average serum ferritin level of 30.99 ± 18.11 μg/L and a serum ferritin incidence of 15.05%.
CONCLUSION In conclusion, low serum ferritin is not a risk factor for ADHD or TD. The incidence of low serum ferritin levels in children with ADHD and TD between 5 and 12 years old decreases first and then increases with age.
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Affiliation(s)
- Cai-Yun Tang
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
| | - Fang Wen
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
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11
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De Giacomo A, Medicamento S, Pedaci C, Giambersio D, Giannico OV, Petruzzelli MG, Simone M, Corsalini M, Marzulli L, Matera E. Peripheral Iron Levels in Autism Spectrum Disorders vs. Other Neurodevelopmental Disorders: Preliminary Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074006. [PMID: 35409689 PMCID: PMC8997833 DOI: 10.3390/ijerph19074006] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023]
Abstract
Autism Spectrum Disorder (ASD) is characterized by deficits in social skills and specific behaviors and interests. Among other environmental factors, iron may play a role in the development of ASD. The aim of this study is to compare the iron status of children with ASD with that of children affected by neurodevelopmental disorders other than ASD (OND). A total of 167 patients were enrolled, including 93 children with ASD and 74 children with OND. In the two groups, we determined ferritin, iron, transferrin, hemoglobin, HCT, and MCV in the serum. We found a significant difference in serum ferritin and MCV levels between the two groups (p < 0.05), with lower ferritin and higher MCV values in the ASD group. There was no significant association with the other variables. Our results may support the hypothesis of altered iron status in ASD, justifying more frequent examinations of blood iron parameters in these children.
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Affiliation(s)
- Andrea De Giacomo
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
- Correspondence:
| | - Silvia Medicamento
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
| | - Chiara Pedaci
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
| | - Donatella Giambersio
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
| | | | - Maria Giuseppina Petruzzelli
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
| | - Marta Simone
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
| | - Massimo Corsalini
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
| | - Lucia Marzulli
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
| | - Emilia Matera
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.P.); (D.G.); (M.G.P.); (M.S.); (M.C.); (L.M.); (E.M.)
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12
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Baj J, Flieger W, Flieger M, Forma A, Sitarz E, Skórzyńska-Dziduszko K, Grochowski C, Maciejewski R, Karakuła-Juchnowicz H. Autism spectrum disorder: Trace elements imbalances and the pathogenesis and severity of autistic symptoms. Neurosci Biobehav Rev 2021; 129:117-132. [PMID: 34339708 DOI: 10.1016/j.neubiorev.2021.07.029] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 02/08/2023]
Abstract
The identification of biomarkers as diagnostic tools and predictors of response to treatment of neurological developmental disorders (NDD) such as schizophrenia (SZ), attention deficit hyperactivity disorder (ADHD), or autism spectrum disorder (ASD), still remains an important challenge for clinical medicine. Metallomic profiles of ASD patients cover, besides essential elements such as cobalt, chromium, copper, iron, manganese, molybdenum, zinc, selenium, also toxic metals burden of: aluminum, arsenic, mercury, lead, beryllium, nickel, cadmium. Performed studies indicate that children with ASD present a reduced ability of eliminating toxic metals, which leads to these metals' accumulation and aggravation of autistic symptoms. Extensive metallomic studies allow a better understanding of the importance of trace elements as environmental factors in the pathogenesis of ASD. Even though a mineral imbalance is a fact in ASD, we are still expecting relevant tests and the elaboration of reference levels of trace elements as potential biomarkers useful in diagnosis, prevention, and treatment of ASD.
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Affiliation(s)
- Jacek Baj
- Department of Anatomy, Medical University of Lublin, Jaczewskiego Street 8b, 20-400, Lublin, Poland.
| | - Wojciech Flieger
- Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1, 20-059, Lublin, Poland
| | - Michał Flieger
- Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1, 20-059, Lublin, Poland
| | - Alicja Forma
- Chair and Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego Street 8b, 20-090, Lublin, Poland
| | - Elżbieta Sitarz
- Chair and 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Gluska Street 1, 20-439, Lublin, Poland
| | - Katarzyna Skórzyńska-Dziduszko
- Chair and Department of Human Physiology, Medical University of Lublin, Radziwillowska Street 11, Lublin, 20-080, Poland
| | - Cezary Grochowski
- Laboratory of Virtual Man, Chair of Anatomy, Medical University of Lublin, Jaczewskiego Street 8b, 20-400, Lublin, Poland
| | - Ryszard Maciejewski
- Department of Anatomy, Medical University of Lublin, Jaczewskiego Street 8b, 20-400, Lublin, Poland
| | - Hanna Karakuła-Juchnowicz
- Chair and 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Gluska Street 1, 20-439, Lublin, Poland; Department of Clinical Neuropsychiatry, Medical University of Lublin, Gluska Street 1, 20-439, Lublin, Poland
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13
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Tu Z, Wang C, Davis AK, Hu M, Zhao C, Xin M, Lu QR, Zheng Y. The chromatin remodeler CHD8 governs hematopoietic stem/progenitor survival by regulating ATM-mediated P53 protein stability. Blood 2021; 138:221-233. [PMID: 34292326 PMCID: PMC8310427 DOI: 10.1182/blood.2020009997] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/06/2021] [Indexed: 01/15/2023] Open
Abstract
The Chd8 gene encodes a member of the chromodomain helicase DNA-binding (CHD) family of SNF2H-like adenosine triphosphate (ATP)-dependent chromatin remodeler, the mutations of which define a subtype of autism spectrum disorders. Increasing evidence from recent studies indicates that ATP-dependent chromatin-remodeling genes are involved in the control of crucial gene-expression programs in hematopoietic stem/progenitor cell (HSPC) regulation. In this study, we identified CHD8 as a specific and essential regulator of normal hematopoiesis. Loss of Chd8 leads to severe anemia, pancytopenia, bone marrow failure, and engraftment failure related to a drastic depletion of HSPCs. CHD8 forms a complex with ATM and its deficiency increases chromatin accessibility and drives genomic instability in HSPCs causing an activation of ATM kinase that further stabilizes P53 protein by phosphorylation and leads to increased HSPC apoptosis. Deletion of P53 rescues the apoptotic defects of HSPCs and restores overall hematopoiesis in Chd8-/- mice. Our findings demonstrate that chromatin organization by CHD8 is uniquely necessary for the maintenance of hematopoiesis by integrating the ATM-P53-mediated survival of HSPCs.
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Affiliation(s)
| | | | | | | | | | | | | | - Yi Zheng
- Division of Experimental Hematology and Cancer Biology, Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH
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14
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Nadeem MS, Murtaza BN, Al-Ghamdi MA, Ali A, Zamzami MA, Khan JA, Ahmad A, Rehman MU, Kazmi I. Autism - A Comprehensive Array of Prominent Signs and Symptoms. Curr Pharm Des 2021; 27:1418-1433. [PMID: 33494665 DOI: 10.2174/1381612827666210120095829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) is a multifaceted neurodevelopmental condition characterized by multiple psychological and physiological impairments in young children. According to the recent reports, 1 out of every 58 newly-born children is suffering from autism. The aetiology of the disorder is complex and poorly understood, hindering the adaptation of targeted and effective therapies. There are no well- established diagnostic biomarkers for autism. Hence the analysis of symptoms by the pediatricians plays a critical role in the early intervention. METHODS In the present report, we have emphasized 24 behavioral, psychological and clinical symptoms of autism. RESULTS Impaired social interaction, restrictive and narrow interests, anxiety, depression; aggressive, repetitive, rigid and self-injurious behavior, lack of consistency, short attention span, fear, shyness and phobias, hypersensitivity and rapid mood alterations, high level of food and toy selectivity; inability to establish friendships or follow the instructions; fascination by round spinning objects and eating non-food materials are common psychological characteristics of autism. Speech or hearing impairments, poor cognitive function, gastrointestinal problems, weak immunity, disturbed sleep and circadian rhythms, weak motor neuromuscular interaction, lower level of serotonin and neurotransmitters, headache and body pain are common physiological symptoms. CONCLUSION A variable qualitative and quantitative impact of this wide range of symptoms is perceived in each autistic individual, making him/her distinct, incomparable and exceptional. Selection and application of highly personalized medical and psychological therapies are therefore recommended for the management and treatment of autism.
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Affiliation(s)
- Muhammad Shahid Nadeem
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Bibi Nazia Murtaza
- Department of Zoology, Abbottabad University of Science and Technology (AUST), Abbottabad, Pakistan
| | - Maryam A Al-Ghamdi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Akbar Ali
- College of Pharmacy, Northern Border University Rafha 1321, Saudi Arabia
| | - Mazin A Zamzami
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Jalaluddin A Khan
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Aftab Ahmad
- College of Pharmacy, Northern Border University Rafha 1321, Saudi Arabia
| | - Mujaddad Ur Rehman
- Department of Zoology, Abbottabad University of Science and Technology (AUST), Abbottabad, Pakistan
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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15
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Talvio K, Kanninen KM, White AR, Koistinaho J, Castrén ML. Increased iron content in the heart of the Fmr1 knockout mouse. Biometals 2021; 34:947-954. [PMID: 34089433 PMCID: PMC8313461 DOI: 10.1007/s10534-021-00320-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/24/2021] [Indexed: 11/12/2022]
Abstract
Trace elements have important functions in several processes involved in cellular homeostasis and survival. Dysfunctional metal ion homeostasis can make an important impact on cellular defence mechanisms. We assessed the concentrations of 23 trace minerals in different tissues (brain, spleen, heart and liver) of Fmr1 knockout (KO) mice that display the main phenotype of Fragile X syndrome (FXS), an intellectual disability syndrome and the best-known monogenic model of autism spectrum disorder (ASD). Altogether, seven minerals—Cu, Fe, K, Mg, Mn, Na, and P—were above the detection limit with the analysis revealing increased iron content in the heart of Fmr1 KO mice. In addition, levels of iron were higher in the cerebellum of the transgenic mouse when compared to wild type controls. These results implicate a role for dysregulated iron homeostasis in FXS tissues and suggest that defective iron-related mechanisms contribute to increased tissue vulnerability in FXS.
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Affiliation(s)
- Karo Talvio
- Faculty of Medicine, Physiology, University of Helsinki, P.O. Box 63, 00290, Helsinki, Finland
| | - Katja M Kanninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anthony R White
- Department of Pathology, University of Melbourne, Melbourne, VIC, Australia.,Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jari Koistinaho
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland.,Neuroscience Center, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Maija L Castrén
- Faculty of Medicine, Physiology, University of Helsinki, P.O. Box 63, 00290, Helsinki, Finland.
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16
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Leader G, O'Reilly M, Gilroy SP, Chen JL, Ferrari C, Mannion A. Comorbid Feeding and Gastrointestinal Symptoms, Challenging Behavior, Sensory Issues, Adaptive Functioning and Quality of Life in Children and Adolescents with Autism Spectrum Disorder. Dev Neurorehabil 2021; 24:35-44. [PMID: 32496834 DOI: 10.1080/17518423.2020.1770354] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/12/2022]
Abstract
AIM Children and adolescents diagnosed with an autism spectrum disorder (ASD) often demonstrate difficulties with feeding. The goal of the current study was to investigate co-occurring issues that often accompany feeding problems in 120 children and adolescents with ASD. Method: This study investigated the relationship between feeding problems and gastrointestinal symptoms, challenging behavior and sensory issues, quality of life, adaptive functioning and use of complementary and alternative medicine (CAM). Results: High rates of feeding problems, gastrointestinal symptoms, challenging behavior and sensory issues were endorsed by caregivers. Considerable differences were observed in the levels of gastrointestinal symptoms, challenging behavior, sensory issues, quality of life and CAM practices.Conclusion: The results of this study extend the present literature by highlighting comorbid conditions related to feeding problems and how feeding problems impact quality of life and adaptive behavior.
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Affiliation(s)
| | | | | | - June L Chen
- East China Normal University , Shanghai, China
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17
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Leader G, Tuohy E, Chen JL, Mannion A, Gilroy SP. Feeding Problems, Gastrointestinal Symptoms, Challenging Behavior and Sensory Issues in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:1401-1410. [PMID: 31955310 DOI: 10.1007/s10803-019-04357-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Frequency of feeding problems, gastrointestinal (GI) symptoms, challenging behavior, sensory problems and comorbid psychopathology were assessed using the following questionnaires: Screening Tool for Feeding Problems for Children, GI Symptoms Inventory, Behavior Problems Inventory Short Form, Short Sensory Profile, and Autism Spectrum Disorder-Comorbidity Child (ASD-CC) in 136 children and adolescents with ASD. Eighty-four percent had food selectivity, followed by food refusal (78.7%), rapid eating (76.5%), chewing problems (60.3%), food stealing (49.3%) and vomiting (19.1%). Higher rates of GI symptoms, challenging behavior, and sensory issues were found in those who presented with rapid eating, food refusal and food stealing than those without these problems. Comorbid psychopathology predicted rapid eating, food selectivity and food refusal.
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Affiliation(s)
- Geraldine Leader
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland, Galway, Ireland.
| | - Elaine Tuohy
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland, Galway, Ireland
| | - June L Chen
- Department of Special Education, Faculty of Education, East China Normal University, Shanghai, China
| | - Arlene Mannion
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland, Galway, Ireland
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18
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Farajzadeh Valilou S, Alavi A, Pashaei M, Ghasemi Firouzabadi S, Shafeghati Y, Nozari A, Hadipour F, Hadipour Z, Maghsoodlou Estrabadi B, Gholamreza Noorazar S, Banihashemi S, Karimian J, Fattahi M, Behjati F. Whole-Exome Sequencing Identifies Three Candidate Homozygous Variants in a Consanguineous Iranian Family with Autism Spectrum Disorder and Skeletal Problems. Mol Syndromol 2020; 11:62-72. [PMID: 32655337 DOI: 10.1159/000506530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2020] [Indexed: 11/19/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterized by 3 core symptoms with impaired social communication, repetitive behavior, and/or restricted interests in early childhood. As a complex neurodevelopmental disorder (NDD), the phenotype and severity of autism are extremely heterogeneous. Genetic factors have a key role in the etiology of autism. In this study, we investigated an Azeri Turkish family with 2 ASD-affected individuals to identify probable ASD-causing variants. First, the affected individuals were karyotyped in order to exclude chromosomal abnormalities. Then, whole-exome sequencing was carried out in one affected sibling followed by cosegregation analysis for the candidate variants in the family. In addition, SNP genotyping was carried out in the patients to identify possible homozygosity regions. Both proband and sibling had a normal karyotype. We detected 3 possible causative variants in this family: c.5443G>A; p.Gly1815Ser, c.1027C>T; p.Arg343Trp, and c.382A>G; p.Lys128Glu, which are in the FBN1, TF, and PLOD2 genes, respectively. All of the variants cosegregated in the family, and SNP genotyping revealed that these 3 variants are located in the homozygosity regions. This family serves as an example of a multimodal polygenic risk for a complex developmental disorder. Of these 3 genes, confluence of the variants in FBN1 and PLOD2 may contribute to the autistic features of the patient in addition to skeletal problems. Our study highlights the genetic complexity and heterogeneity of NDDs such as autism. In other words, in some patients with ASD, multiple rare variants in different loci rather than a monogenic state may contribute to the development of phenotypes.
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Affiliation(s)
- Saeed Farajzadeh Valilou
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Afagh Alavi
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahdiyeh Pashaei
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Yousef Shafeghati
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Department of Medical Genetics and Sarem Cell Research Center (SCRC), Sarem Womens' Hospital, Tehran, Iran
| | - Ahoura Nozari
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Hadipour
- Department of Medical Genetics and Sarem Cell Research Center (SCRC), Sarem Womens' Hospital, Tehran, Iran
| | - Zahra Hadipour
- Department of Medical Genetics and Sarem Cell Research Center (SCRC), Sarem Womens' Hospital, Tehran, Iran
| | | | - Seyed Gholamreza Noorazar
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Susan Banihashemi
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Javad Karimian
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahshid Fattahi
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farkhondeh Behjati
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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19
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Skalny AV, Mazaletskaya AL, Ajsuvakova OP, Bjørklund G, Skalnaya MG, Notova SV, Chernova LN, Skalny AA, Burtseva TI, Tinkov AA. Hair trace element concentrations in autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). J Trace Elem Med Biol 2020; 61:126539. [PMID: 32438295 DOI: 10.1016/j.jtemb.2020.126539] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/09/2020] [Accepted: 04/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The existing data demonstrate that alteration of trace element and mineral status in children with neurodevelopmental disorders including ASD and ADHD. However, comparative analysis of the specific patterns of trace element and mineral metabolism in children with ASD and ADHD was not performed. Therefore, the primary objective of the present study was to assess hair trace element and mineral levels in boys with ADHD, ASD, as well as ADHD with ASD. METHODS Boys with ADHD (n = 52), ASD (n = 53), both ADHD and ASD (n = 52), as well as neurotypical controls (n = 52) were examined. Hair analysis was performed using inductively-coupled plasma mass-spectrometry. RESULTS The obtained data demonstrate that hair Co, Mg, Mn, and V levels were significantly reduced in children with ADHD and ASD, and especially in boys with ADHD + ASD. Hair Zn was found to be reduced by 20% (p = 0.009) only in children with ADHD + ASD as compared to healthy controls. Factor analysis demonstrated that ASD was associated with significant alteration of hair Co, Fe, Mg, Mn, and V levels, whereas impaired hair Mg, Mn, and Zn content was also significantly associated with ADHD. In regression models hair Zn and Mg were negatively associated with severity of neurodevelopmental disorders. The revealed similarity of trace element and mineral disturbances in ASD and ADHD may be indicative of certain similar pathogenetic features. CONCLUSION The obtained data support the hypothesis that trace elements and minerals, namely Mg, Mn, and Zn, may play a significant role in development of both ADHD and ASD. Improvement of Mg, Mn, and Zn status in children with ASD and ADHD may be considered as a nutritional strategy for improvement of neurodevelopmental disturbances, although clinical trials and experimental studies are highly required to support this hypothesis.
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Affiliation(s)
- Anatoly V Skalny
- Yaroslavl State University, Sovetskaya St., 14, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia
| | | | - Olga P Ajsuvakova
- Yaroslavl State University, Sovetskaya St., 14, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, 8602, Mo i Rana, Norway
| | - Margarita G Skalnaya
- IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia
| | - Svetlana V Notova
- IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, 9 Yanvarya St., 29, 460000, Orenburg, Russia
| | | | - Andrey A Skalny
- Yaroslavl State University, Sovetskaya St., 14, 150003, Yaroslavl, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia
| | - Tatiana I Burtseva
- IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; Orenburg State University, Pobedy Ave., 46, 460000, Orenburg, Russia
| | - Alexey A Tinkov
- Yaroslavl State University, Sovetskaya St., 14, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia.
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20
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Bankaitis VA, Xie Z. The neural stem cell/carnitine malnutrition hypothesis: new prospects for effective reduction of autism risk? J Biol Chem 2019; 294:19424-19435. [PMID: 31699893 DOI: 10.1074/jbc.aw119.008137] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Autism spectrum disorders (ASDs) are developmental neuropsychiatric disorders with heterogeneous etiologies. As the incidence of these disorders is rising, such disorders represent a major human health problem with escalating social cost. Although recent years witnessed advances in our understanding of the genetic basis of some dysmorphic ASDs, little progress has been made in translating the improved understanding into effective strategies for ASD management or minimization of general ASD risk. Here we explore the idea, described in terms of the neural stem cell (NSC)/carnitine malnutrition hypothesis, that an unappreciated risk factor for ASD is diminished capacity for carnitine-dependent long-chain fatty acid β-oxidation in neural stem cells of the developing mammalian brain. The basic premise is that fetal carnitine status is a significant metabolic component in determining NSC vulnerability to derangements in their self-renewal program and, therefore, to fetal ASD risk. As fetal carnitine status exhibits a genetic component that relates to de novo carnitine biosynthesis and is sensitive to environmental and behavioral factors that affect maternal circulating carnitine levels, to which the fetus is exposed, we propose that reduced carnitine availability during gestation is a common risk factor that lurks beneath the genetically complex ASD horizon. One major prediction of the NSC/carnitine malnutrition hypothesis is that a significant component of ASD risk might be effectively managed from a public policy perspective by implementing a carnitine surveillance and dietary supplementation strategy for women planning pregnancies and for women in their first trimester of pregnancy. We argue that this prediction deserves serious clinical interrogation.
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Affiliation(s)
- Vytas A Bankaitis
- Department of Molecular and Cellular Medicine, Texas A&M University Health Science Center, College Station, Texas 77843-1114 .,Department of Biochemistry and Biophysics, Texas A&M University Health Science Center, College Station, Texas 77843-1114.,Department of Chemistry, Texas A&M University Health Science Center, College Station, Texas 77843-1114
| | - Zhigang Xie
- Department of Molecular and Cellular Medicine, Texas A&M University Health Science Center, College Station, Texas 77843-1114
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21
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Hauptman M, Stierman B, Woolf AD. Children With Autism Spectrum Disorder and Lead Poisoning: Diagnostic Challenges and Management Complexities. Clin Pediatr (Phila) 2019; 58:605-612. [PMID: 30938166 PMCID: PMC6982422 DOI: 10.1177/0009922819839237] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marissa Hauptman
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA, USA
| | - Bryan Stierman
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA, USA
| | - Alan D. Woolf
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA, USA
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22
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Siddiqi S, Urooj A, D'Souza MJ. Dietary Patterns and Anthropometric Measures of Indian Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:1586-1598. [PMID: 30554336 DOI: 10.1007/s10803-018-3850-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research literature on dietary patterns & eating habits of children with Autism Spectrum Disorder (ASD) in India is limited. To explore this, a pilot study (n = 53) which included 45 boys and 8 girls (age group of 2-13 years) was conducted. Three day food records, Food Frequency Questionnaire and Children Eating Behavior Inventory were used to assess the dietary intakes and mealtime behavior problems respectively. Findings revealed lower intake of fruits and vegetables which reflected on their micronutrient status which was significantly (p ≤ 0.05) in lower amounts predominantly B-Complex, Calcium and Iron. The study has suggested a strong need for future implementation of nutritional intervention programs at the earliest to expand food variety among children with ASD of this region.
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Affiliation(s)
- Seema Siddiqi
- Department of Studies in Food Science and Nutrition, University of Mysore, Mysuru, India
| | - Asna Urooj
- Department of Studies in Food Science and Nutrition, University of Mysore, Mysuru, India.
| | - Melwin James D'Souza
- Department of Studies in Food Science and Nutrition, University of Mysore, Mysuru, India
- Department of Food Nutrition and Dietetics, Milagres College, Mangaluru, India
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Ferguson BJ, Dovgan K, Severns D, Martin S, Marler S, Gross Margolis K, Bauman ML, Veenstra-VanderWeele J, Sohl K, Beversdorf DQ. Lack of Associations Between Dietary Intake and Gastrointestinal Symptoms in Autism Spectrum Disorder. Front Psychiatry 2019; 10:528. [PMID: 31402878 PMCID: PMC6669230 DOI: 10.3389/fpsyt.2019.00528] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Many individuals with autism spectrum disorder (ASD) have significant gastrointestinal (GI) symptoms, but their etiology is currently unknown. Dietary interventions are common in children and adolescents with ASD, including diets with increased omega-3 fatty acids or diets free of gluten and/or casein, which may also impact GI symptoms and nutrition. However, little is known about the relationship between nutritional intake and GI symptomatology in ASD. The objective of this study was to assess the relationships between GI symptoms, omega-3 intake, micronutrients, and macronutrients in children with ASD. Methods: A total of 120 children diagnosed with ASD participated in this multisite study. A food frequency questionnaire was completed by the patient's caretaker. The USDA Food Composition Database was utilized to provide nutritional data for the food items consumed by each participant. GI symptomatology was assessed using a validated questionnaire on pediatric gastrointestinal symptoms. Results: There were no significant associations between GI symptoms and the amount of omega-3 fatty acids and/or other micro- and macronutrients contained in the diet. Conclusions: This study suggests that dietary variations do not appear to drive GI symptoms, nor do GI symptoms drive dietary variations in those with ASD, although causation cannot be determined with this observational assessment. Furthermore, there may be other factors associated with lower GI tract symptoms in ASD, such as increased stress response.
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Affiliation(s)
- Bradley J Ferguson
- Department of Health Psychology, School of Health Professions, University of Missouri, Columbia, MO, United States.,Thompson Center for Autism & Neurodevelopmental Disorders, Columbia, MO, United States.,Department of Radiology, University of Missouri School of Medicine, Columbia, MO, United States
| | - Kristen Dovgan
- Department of Psychology, Marist College, Poughkeepsie, NY, United States
| | - Danielle Severns
- School of Medicine, University of Missouri, Columbia, MO, United States
| | - Shannon Martin
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
| | - Sarah Marler
- Medical Exploration of Neurodevelopmental Disorders Clinic (MEND), Vanderbilt University Medical Center, Nashville, TN, United States
| | - Kara Gross Margolis
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, & Nutrition & Morgan Stanley Children's Hospital, Columbia University Medical Center, Columbia, MO, United States
| | - Margaret L Bauman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States
| | | | - Kristin Sohl
- Thompson Center for Autism & Neurodevelopmental Disorders, Columbia, MO, United States.,Department of Child Health, University of Missouri, Columbia, MO, United States
| | - David Q Beversdorf
- Thompson Center for Autism & Neurodevelopmental Disorders, Columbia, MO, United States.,Department of Radiology, University of Missouri School of Medicine, Columbia, MO, United States.,Departments of Neurology & Psychological Sciences, William and Nancy Thompson Endowed Chair in Radiology, University of Missouri, Columbia, MO, United States
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24
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Skalny AV, Simashkova NV, Skalnaya AA, Klyushnik TP, Zhegalova IV, Grabeklis AR, Skalnaya MG, Tinkov AA. Trace element levels are associated with neuroinflammatory markers in children with autistic spectrum disorder. J Trace Elem Med Biol 2018; 50:622-628. [PMID: 29731309 DOI: 10.1016/j.jtemb.2018.04.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/27/2022]
Abstract
The objective of the present study was to estimate the association between brain inflammatory markers and serum trace element levels as assessed by inductively coupled plasma mass spectrometry at NexION 300D. Leukocyte elastase (LE), α1-proteinase inhibitor (α1-PI) activity, anti-nerve growth factor-antibodies (anti-NGF-Ab), and anti-myelin basic protein-antibodies (anti-MBP-Ab) levels were assessed as inflammatory markers. The obtained data demonstrate that the increase in LE and α1-PI activity is associated with higher serum Cr and Cu levels, respectively. The increase in Anti-NGF-Ab levels was associated with a nearly significant 16% increase in serum Mn levels. Autistic children with high MBP-Ab levels were characterized by 28% higher serum Mn and lower Mg concentration. The results of correlation analysis were generally in agreement with the outcome of group comparisons. Regression analysis demonstrated that serum Mg was significantly negatively associated with LE activity, whereas both serum Fe and V concentrations were characterized by a positive influence on the parameter. In turn, serum Cu was a significant predictor of α1-PI, as well as Cr levels. At the same time, the serum concentrations of Cd and Fe were found to be inversely associated with α1-PI levels. Serum Cd and Mn levels were significant positive predictors of anti-MBP-Ab levels, whereas Mg levels had a negative impact on anti-MBP-Ab values. Generally, the obtained data demonstrate the interrelationship between trace element homeostasis and neuroinflammation in autism. Hypothetically, modulation of trace element status may be used for reduction of neuroinflammatory response, although further studies are required to reveal the underlying mechanisms of the observed associations.
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Affiliation(s)
- Anatoly V Skalny
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia; Orenburg State University, Pobedy Ave., 13, Orenburg, 460352, Russia
| | - Natalia V Simashkova
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | | | - Tatiana P Klyushnik
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | - Irina V Zhegalova
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; I.M. Sechenov First Moscow State Medical University, Malaya Trubetskaya St., 8, Moscow, 119992, Russia
| | - Andrei R Grabeklis
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia
| | | | - Alexey A Tinkov
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia.
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25
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Cherif L, Boudabous J, Khemekhem K, Mkawer S, Ayadi H, Moalla Y. Feeding Problems in Children with Autism Spectrum Disorders. ACTA ACUST UNITED AC 2018. [DOI: 10.14302/issn.2640-690x.jfm-18-2252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background:
Feeding problems are common in autism. Parents are frequently worried about the health status of their children, which may be threatened by some consequent nutritional deficiencies. Despite this, feeding behaviours remain little explored by clinicians working with children with autism spectrum disorders and researches are lacking especially in Tunisia.
Aims:
To evaluate the frequency and the types of feeding problems in children with autism spectrum disorders.
Settings and Design:
A comparison was made between 57 children with autism spectrum disorders and 57 control groups regarding the feeding problems. Parents completed the children’s eating behavior inventory (CEBI). Autism severity is evaluated using the Childhood Autism Rating Scale. The SPSS statistical package, version 20.0 was used.
Results:
According to the CEBI, children with autism spectrum disorders showed more feeding problems than the control group (82.4% versus 56.1%, p=0.002). In fact, the parents of these children observed more pica habits on their children compared to the control group (p=0.000). They also observed more selectivity for starchy foods compared to the control group (p=0.000). The more the autistic symptoms were severe, the more children exhibited feeding problems (p=0.02).
Conclusions:
Our findings suggest that feeding problems are more common in children with autism. Clinical implications trigger the need for clinicians to provide the necessary assessment and treatment.
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Affiliation(s)
- Leila Cherif
- Hedi Chaker Hospital, Child and adolescent psychiatry Department, Avenue Majida Boulila, 3029 Sfax, Tunisie
| | - Jaweher Boudabous
- Hedi Chaker Hospital, Child and adolescent psychiatry Department, Avenue Majida Boulila, 3029 Sfax, Tunisie
| | - Khaoula Khemekhem
- Hedi Chaker Hospital, Child and adolescent psychiatry Department, Avenue Majida Boulila, 3029 Sfax, Tunisie
| | - Salma Mkawer
- Hedi Chaker Hospital, Child and adolescent psychiatry Department, Avenue Majida Boulila, 3029 Sfax, Tunisie
| | - Héla Ayadi
- Hedi Chaker Hospital, Child and adolescent psychiatry Department, Avenue Majida Boulila, 3029 Sfax, Tunisie
| | - Yousr Moalla
- Hedi Chaker Hospital, Child and adolescent psychiatry Department, Avenue Majida Boulila, 3029 Sfax, Tunisie
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26
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Sharp WG, Postorino V, McCracken CE, Berry RC, Criado KK, Burrell TL, Scahill L. Dietary Intake, Nutrient Status, and Growth Parameters in Children with Autism Spectrum Disorder and Severe Food Selectivity: An Electronic Medical Record Review. J Acad Nutr Diet 2018; 118:1943-1950. [PMID: 30005820 DOI: 10.1016/j.jand.2018.05.005] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 05/02/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Food selectivity is common in children with autism spectrum disorder (ASD). The clinical characteristics, however, of severe food selectivity in children with ASD is not well documented. OBJECTIVE This study examined the demographic characteristics, anthropometric parameters, risk of nutritional inadequacy, dietary variety, and problematic mealtime behaviors in a sample of children with ASD with severe food selectivity. DESIGN The study involved a cross-sectional electronic medical record review. Data extraction followed a systematic protocol for data extraction. PARTICIPANTS/SETTING Children (age 2 to 17 years) with ASD, severe food selectivity, and complete nutritional data who received a multidisciplinary evaluation at a specialty feeding clinic in the southeastern United States between January 2014 and January 2016. Criteria for severe food selectivity used in this clinical practice required complete omission of one or more food groups (eg, fruit, vegetable, protein, grain, dairy) or consuming a narrow range of items on a weekly basis (eg, five or fewer total food items). MAIN OUTCOME MEASURES Analyses examined demographic characteristics, dietary preferences, risk for nutritional inadequacies, anthropometric parameters, and problematic mealtime behaviors. RESULTS Of the 279 patients evaluated during the 24-month period, 70 children with ASD and severe food selectivity met inclusion criteria. Caregivers reported 67% of the sample (n=47) omitted vegetables and 27% omitted fruits (n=19). Seventy-eight percent consumed a diet at risk for five or more inadequacies. Risk for specific inadequacies included vitamin D (97% of the sample), fiber (91%) vitamin E (83%), and calcium (71%). Children with five or more nutritional inadequacies (n=55) were more likely to make negative statements during meals (P<0.05). Severe food selectivity was not associated with compromised growth or obesity. CONCLUSION Children with ASD and severe food selectivity may be at increased risk for nutritional inadequacies. Future research should examine causes, consequences, and remediation of severe food selectivity in this population.
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Bener A, Khattab AO, Bhugra D, Hoffmann GF. Iron and vitamin D levels among autism spectrum disorders children. Ann Afr Med 2018; 16:186-191. [PMID: 29063903 PMCID: PMC5676409 DOI: 10.4103/aam.aam_17_17] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Aim: The aim of this study was to investigate iron deficiency anemia and Vitamin D deficiency among autism children and to assess the importance of risk factors (determinants). Subjects and Methods: This was a case–control study conducted among children suffering from autism at the Hamad Medical Corporation in Qatar. A total of 308 cases and equal number of controls were enrolled. The Autism Diagnostic Observation Schedule-Generic was the instrument used for diagnosis of Autism. Results: The mean age (±standard deviation, in years) for autistic versus control children was 5.39 ± 1.66 versus 5.62 ± 1.81, respectively. The mean value of serum iron levels in autistic children was severely reduced and significantly lower than in control children (74.13 ± 21.61 μg/dL with a median 74 in autistic children 87.59 ± 23.36 μg/dL in controls) (P = 0.003). Similarly, the study revealed that Vitamin D deficiency was considerably more common among autistic children (18.79 ± 8.35 ng/mL) as compared to healthy children (22.18 ± 9.00 ng/mL) (P = 0.004). Finally, mean values of hemoglobin, ferritin, magnesium; potassium, calcium; phosphorous; glucose, alkaline phosphate, hematocrit, white blood cell, and mean corpuscular volume were all statistically significantly higher in healthy control children as compared to autistic children (P < 0.001). Multivariate logistic regression analysis revealed that serum iron deficiency, serum calcium levels, serum Vitamin D levels; ferritin, reduced physical activity; child order, body mass index percentiles, and parental consanguinity can all be considered strong predictors and major factors associated with autism spectrum disorders. Conclusion: This study suggests that deficiency of iron and Vitamin D as well as anemia were more common in autistic compared to control children.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics and Medical Informatics, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey; Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, England, UK
| | - Azhar O Khattab
- Department of Pediatrics, Rumailah and Hamad General Hospital, Hamad Medical Corporation; Department of Pediatrics, Weill Cornell Medical College, Ar-Rayyan, Qatar
| | - Dinesh Bhugra
- Institute of Psychiatry, Section of Cultural Psychiatry, King's College London, London, England, UK
| | - Georg F Hoffmann
- Department of Pediatrics, University of Heidelberg, Baden-Wurttemberg, Germany
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Ludlow AK, Rogers SL. Understanding the impact of diet and nutrition on symptoms of Tourette syndrome: A scoping review. J Child Health Care 2018; 22:68-83. [PMID: 29268618 DOI: 10.1177/1367493517748373] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Anecdotal reports frequently suggest some dietary involvement in the maintenance of tics in children with Tourette syndrome (TS). This scoping review aimed to (1) understand the possible influence of diet as a trigger of tics and (2) map out the existing studies documenting dietary interventions in children with TS. Current evidence suggests no single diet to benefit individuals with TS. However, reports from parents of children with TS suggest that certain allergens in food may exacerbate tic-related symptoms. For example, an increase in tics has been related to the consumption of caffeine and refined sugar. Moreover, oligoantigenic diets and sugar-free diets have been identified as significantly reducing tics. More research is urgently needed to develop more accurate guidance for parents and children with TS, as many have reported using dietary and nutritional supplements, despite the lack of evidence detailing any benefits, side effects and recommended doses.
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Affiliation(s)
- Amanda K Ludlow
- 1 Department of Psychology and Sport Sciences, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, UK
| | - Samantha L Rogers
- 2 Centre for Research in Primary and Community Care, School of Health and Social Work, University of Hertfordshire, College Lane, Hatfield, UK
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29
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Gunes S, Ekinci O, Celik T. Iron deficiency parameters in autism spectrum disorder: clinical correlates and associated factors. Ital J Pediatr 2017; 43:86. [PMID: 28934988 PMCID: PMC5609017 DOI: 10.1186/s13052-017-0407-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/19/2017] [Indexed: 12/19/2022] Open
Abstract
Background High prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) has been reported in children with autism spectrum disorder (ASD). However, there is a limited number of studies about the association between iron deficiency parameters and clinical symptoms of ASD. This study aims to compare hemoglobin, hematocrit, iron, ferritin, MCV, and RDW levels between ASD patients and healthy controls and to investigate the correlation between these values and clinical symptoms of ASD. Methods The sample consisted of 100 children in ASD patient group and 100 healthy controls, with an age range of 2–18 years. We used ferritin cutoff of < 10 ng/mL for preschoolers (< 6 years) and < 12 ng/mL for school-aged (> 6 years) children to evaluate ID. Anemia was defined as hemoglobin < 11.0 g/dL for preschoolers and < 12.0 g/dL for school-aged children. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (AuBC), and Aberrant Behavior Checklist (AbBC) were used to evaluate the severity of autistic symptoms and behavioral problems. Categorical variables were compared by using chi-square test. Normally distributed parametric variables were compared between groups by using Independent Samples t test. Pearson’s correlation analysis was used in order to examine the correlations. The p value < 0.05 was accepted to be statistically significant. Results Hemoglobin, hematocrit, iron, and MCV (p < 0.05) levels of children with ASD were lower than healthy controls. Hemoglobin, hematocrit, and MCV (p < 0.05) levels were found to be significantly lower in preschool ASD patients. Hemoglobin and hematocrit (p < 0.05) levels were significantly lower in ASD patients with intellectual disability. Hemoglobin (p < 0.05) levels were lower in patients with severe ASD. There was a significant negative correlation between hematocrit levels of children with ASD and CARS, AuBC, and AbBC total scores (p < 0.05). Conclusions Hemoglobin levels of children with ASD were lower than healthy children, but this was not sufficient to result in anemia. IDA in children with ASD might be associated with intellectual disability instead of ASD symptom severity.
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Affiliation(s)
- Serkan Gunes
- Department of Child and Adolescent Psychiatry, Hatay State Hospital, Hatay, Turkey.
| | - Ozalp Ekinci
- Department of Child and Adolescent Psychiatry, University of Health Sciences Medical Faculty, Istanbul, Turkey
| | - Tanju Celik
- Department of Pediatrics, Dr. Behçet Uz Research and Training Hospital, Izmir, Turkey
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30
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Meguid NA, Ghozlan SAS, Mohamed MF, Ibrahim MK, Dawood RM, Din NGBE, Abdelhafez TH, Hemimi M, Awady MKE. Expression of Reactive Oxygen Species-Related Transcripts in Egyptian Children With Autism. Biomark Insights 2017; 12:1177271917691035. [PMID: 28469396 PMCID: PMC5391985 DOI: 10.1177/1177271917691035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 01/04/2017] [Indexed: 12/27/2022] Open
Abstract
The molecular basis of the pathophysiological role of oxidative stress in autism is understudied. Herein, we used polymerase chain reaction (PCR) array to analyze transcriptional pattern of 84 oxidative stress genes in peripheral blood mononuclear cell pools isolated from 32 autistic patients (16 mild/moderate and 16 severe) and 16 healthy subjects (each sample is a pool from 4 autistic patients or 4 controls). The PCR array data were further validated by quantitative real-time PCR in 80 autistic children (55 mild/moderate and 25 severe) and 60 healthy subjects. Our data revealed downregulation in GCLM, SOD2, NCF2, PRNP, and PTGS2 transcripts (1.5, 3.8, 1.2, 1.7, and 2.2, respectively;P < .05 for all) in autistic group compared with controls. In addition, TXN and FTH1 exhibited 1.4- and 1.7-fold downregulation, respectively, in severe autistic patients when compared with mild/moderate group (P = .005 and .0008, respectively). This study helps in a better understanding of the underlying biology and related genetic factors of autism, and most importantly, it presents suggested candidate biomarkers for diagnosis and prognosis purposes as well as targets for therapeutic intervention.
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Affiliation(s)
- Nagwa A Meguid
- Department of Research on Children with Special Needs, Medical Research Division, National Research Centre, Giza, Egypt
| | - Said A S Ghozlan
- Department of Chemistry, Faculty of Science, Cairo University, Giza, Egypt
| | - Magda F Mohamed
- Department of Chemistry (Biochemistry Branch), Faculty of Science, Cairo University, Giza, Egypt
| | - Marwa K Ibrahim
- Microbial Biotechnology Department, Genetic Engineering Division, National Research Centre, Giza, Egypt
| | - Reham M Dawood
- Microbial Biotechnology Department, Genetic Engineering Division, National Research Centre, Giza, Egypt
| | - Noha G Bader El Din
- Microbial Biotechnology Department, Genetic Engineering Division, National Research Centre, Giza, Egypt
| | - Tawfeek H Abdelhafez
- Microbial Biotechnology Department, Genetic Engineering Division, National Research Centre, Giza, Egypt
| | - Maha Hemimi
- Department of Research on Children with Special Needs, Medical Research Division, National Research Centre, Giza, Egypt
| | - Mostafa K El Awady
- Microbial Biotechnology Department, Genetic Engineering Division, National Research Centre, Giza, Egypt
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Marí-Bauset S, Llopis-González A, Zazpe I, Marí-Sanchis A, Morales Suárez-Varela M. Comparison of nutritional status between children with autism spectrum disorder and typically developing children in the Mediterranean Region (Valencia, Spain). AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:310-322. [PMID: 27132010 DOI: 10.1177/1362361316636976] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This case-control study investigated nutrient intake, healthy eating index with 10 items on foods and nutrients, on 3-day food diaries and anthropometric measurements in 105 children with autism spectrum disorder and 495 typically developing children (6-9 years) in Valencia (Spain). Children with autism spectrum disorder were at a higher risk for underweight, eating more legumes, vegetables, fiber, and some micronutrients (traditional Mediterranean diet) but fewer dairy and cereal products, and less iodine, sodium, and calcium than their typically developing peers. Differences existed in total energy intake but healthy eating index and food variety score differences were not significant. Autism spectrum disorder group failed to meet dietary recommendations for thiamin, riboflavin, vitamin C, or calcium. Risk of inadequate intake of fiber, vitamin E, and sodium was lower in children with autism spectrum disorder than typically developing children. Results suggest that (1) risk of inadequate intake of some micronutrients in children with autism spectrum disorder and (2) cultural patterns and environment may influence food intake and anthropometric characteristics in autism spectrum disorder. Primary care should include anthropometric and nutritional surveillance in this population to identify intervention on a case-by-case basis. Future research should explore dietary patterns and anthropometric characteristics in different autism spectrum disorder populations in other countries, enhancing our understanding of the disorder's impact.
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Affiliation(s)
- Salvador Marí-Bauset
- 1 University of Valencia, Spain.,2 CIBERESP, Institute of Health Carlos III, Spain
| | - Agustín Llopis-González
- 1 University of Valencia, Spain.,2 CIBERESP, Institute of Health Carlos III, Spain.,3 Center for Public Health Research (CSISP-FISABIO), Spain
| | - Itziar Zazpe
- 4 University of Navarre, Spain.,5 CIBERobn, Institute of Health Carlos III, Spain
| | | | - Maria Morales Suárez-Varela
- 1 University of Valencia, Spain.,2 CIBERESP, Institute of Health Carlos III, Spain.,3 Center for Public Health Research (CSISP-FISABIO), Spain
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Patak J, Zhang-James Y, Faraone SV. Endosomal system genetics and autism spectrum disorders: A literature review. Neurosci Biobehav Rev 2016; 65:95-112. [PMID: 27048963 PMCID: PMC4866511 DOI: 10.1016/j.neubiorev.2016.03.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/25/2016] [Accepted: 03/27/2016] [Indexed: 01/01/2023]
Abstract
Autism spectrum disorders (ASDs) are a group of debilitating neurodevelopmental disorders thought to have genetic etiology, due to their high heritability. The endosomal system has become increasingly implicated in ASD pathophysiology. In an attempt to summarize the association between endosomal system genes and ASDs we performed a systematic review of the literature. We searched PubMed for relevant articles. Simons Foundation Autism Research Initiative (SFARI) gene database was used to exclude articles regarding genes with less than minimal evidence for association with ASDs. Our search retained 55 articles reviewed in two categories: genes that regulate and genes that are regulated by the endosomal system. Our review shows that the endosomal system is a novel pathway implicated in ASDs as well as other neuropsychiatric disorders. It plays a central role in aspects of cellular physiology on which neurons and glial cells are particularly reliant, due to their unique metabolic and functional demands. The system shows potential for biomarkers and pharmacological intervention and thus more research into this pathway is warranted.
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Affiliation(s)
- Jameson Patak
- Dept. of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY, United States.
| | - Yanli Zhang-James
- Dept of Psychiatry, Upstate Medical University, Syracuse, NY, United States.
| | - Stephen V Faraone
- Dept. of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY, United States; Dept of Psychiatry, Upstate Medical University, Syracuse, NY, United States; K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway.
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33
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Bakoyiannis I, Gkioka E, Daskalopoulou A, Korou LM, Perrea D, Pergialiotis V. An explanation of the pathophysiology of adverse neurodevelopmental outcomes in iron deficiency. Rev Neurosci 2015; 26:479-88. [PMID: 25951130 DOI: 10.1515/revneuro-2015-0012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/01/2015] [Indexed: 12/19/2022]
Abstract
Iron deficiency (ID) is a major public health problem worldwide among children aged 0-12 months. Several factors seem to contribute to the iron-deficient state in infancy, including insufficient antenatal and neonatal iron supplementation, exclusive breastfeeding, and early umbilical cord clamping after birth. The most concerning complications of ID, except for anemia, are related to altered long-term neurodevelopment. Clinical studies have shown a negative impact of ID anemia on fetal and neonatal behavior including impairments of motor maturity, autonomic response, memory/learning, and mood. ID-induced defects during infancy seem to persist later in life, even after ID treatment. The underlying mechanisms involve dysfunctional myelination, neurotransmission alterations, and altered synaptogenesis and/or dendritogenesis. The purpose of the present review is to summarize these mechanisms and to provide recommendations for future clinical research in the field.
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Evaluation of Periodic Limb Movements in Sleep and Iron Status in Children With Autism. Pediatr Neurol 2015; 53:343-9. [PMID: 26231264 PMCID: PMC4610130 DOI: 10.1016/j.pediatrneurol.2015.06.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Recent data suggest that both disordered sleep and low serum iron occur more frequently in children with autism compared with children with typical development. Iron deficiency has been linked to specific sleep disorders. The goal of the current study was to evaluate periodic limb movements in sleep and iron status in a group of children with autism compared with typically developing children and children with nonautism developmental delay to determine if iron status correlated with polysomnographic measures of latency and continuity and periodic limb movements in sleep. METHODS A total of 102 children (68 with autism, 18 typically developing, 16 with developmental delay) aged 2 to 7 years underwent a one-night modified polysomnography study and phlebotomy at the National Institutes of Health to measure serum markers of iron status (ferritin, iron, transferrin, percent transferrin saturation). RESULTS No serum iron marker was associated with periodic limb movements of sleep or any other sleep parameter; this did not differ among the diagnostic groups. No significant differences among groups were observed on serum iron markers or most polysomnogram parameters: periodic limb movements in sleep, periodic limb movements index, wake after sleep onset, or sleep efficiency. Children in the autism group had significantly less total sleep time. Serum ferritin was uniformly low across groups. CONCLUSIONS This study found no evidence that serum ferritin is associated with polysomnogram measures of latency or sleep continuity or that young children with autism are at increased risk for higher periodic limb movements index compared with typically developing and developmental delay peers.
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Marí-Bauset S, Llopis-González A, Zazpe-García I, Marí-Sanchis A, Morales-Suárez-Varela M. Nutritional status of children with autism spectrum disorders (ASDs): a case-control study. J Autism Dev Disord 2015; 45:203-12. [PMID: 25194628 DOI: 10.1007/s10803-014-2205-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Children with autism spectrum disorder (ASD) have problems of food selectivity, implying risks of nutritional deficiencies. The aim was to compare intakes of macro and micronutrients and body mass index in ASD and typically developing (TD) children. In a case-control study, 3-day food diaries and anthropometric measurements were completed for ASD (n = 40) and TD (n = 113) children (aged 6-10 years) living in the same area. Body mass indices were below the 5th percentile in 20 % of ASD versus 8.85% of TD children. We found intakes were lower for fluoride (p = 0.017) and higher for vitamin E (p = 0.001). There was limited food variety and inadequacy of some intakes suggests that routine monitoring of ASD children should include assessment of their dietary habits, as well as anthropometric measurements.
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Affiliation(s)
- Salvador Marí-Bauset
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avd. Vicente Andres Estellés S/N, 46100, Burjassot, Valencia, Spain
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Ranjan S, Nasser JA. Nutritional status of individuals with autism spectrum disorders: do we know enough? Adv Nutr 2015; 6:397-407. [PMID: 26178024 PMCID: PMC4496734 DOI: 10.3945/an.114.007914] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The incidence of individuals with autism spectrum disorders (ASDs) is on the rise; therefore, well-timed screening is important. Given that this is a nutritionally vulnerable population, it is imperative to conduct a detailed nutritional assessment so that timely and intensive interventions can be recommended. This review article summarizes the research, focusing on the nutritional status of individuals with ASDs based on their anthropometric measurements, biomarkers, and dietary assessments. Research examining anthropometric measurements reveals an abnormally accelerated rate of growth among children with autism but shows inconsistent findings on the prevalence of overweight/obesity in comparison with typically growing children. Although dysregulated amino acid metabolism, increased homocysteine, and decreased folate, vitamins B-6 and B-12, and vitamin D concentrations have been proposed as possible biomarkers for an early diagnosis of ASDs, research investigating their association with age, gender, severity, and other comorbid psychiatric/nonpsychiatric disorders is lacking. There is consensus that children with autism have selective eating patterns, food neophobia, limited food repertoire, and sensory issues. Although inadequate micronutrient but adequate macronutrient intakes are increasingly reported, there are inconsistent results about the extent and type of nutrient deficiencies. Identification and development of nutritional assessment indicators that serve as early warning signs during routine practice beginning at birth and extending throughout the child's growth are necessary. With this population aging, there is also a dire need to study the adult population. A more vigorous role by nutrition professionals is warranted because management of potential comorbidities and contributory factors may be particularly problematic.
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Affiliation(s)
- Sobhana Ranjan
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA
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Meguid N, Anwar M, Zaki S, Kandeel W, Ahmed N, Tewfik I. Dietary Patterns of Children with Autism Spectrum Disorder: A Study Based in Egypt. Open Access Maced J Med Sci 2015; 3:262-7. [PMID: 27275232 PMCID: PMC4877864 DOI: 10.3889/oamjms.2015.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 04/24/2015] [Accepted: 04/25/2015] [Indexed: 12/27/2022] Open
Abstract
AIM In the hope to assist in tailoring individualized nutritional therapy, this study aimed to assess the nutritional status of autistic children. MATERIAL AND METHODS This cross-sectional study included 80 autistic children, divided into two groups: group 1 (aged 3- 5 years) and group 2 (aged 6-9 years). Diagnosis was performed based on the criteria for autistic disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Autism Diagnostic Interview Revised and Autism Rating Scale. RESULTS Socio-demographic data, anthropometric measurements and dietary intake patterns were recorded using a validated questionnaire. The daily intakes of calories and nutrients were converted to percentages of the Recommended Dietary Allowance or Dietary Reference Intake based on age- and gender-normalized DRIs. Plotting on the Egyptian sex-specific growth chart, BMI-z scores of both age groups were slightly overweight. Autistic children suffered inadequate intake of some micronutrients such as vitamin D and C, calcium, folate, magnesium, phosphorus, zinc, and iron, some deficiencies were highly significant especially at older age. CONCLUSIONS Tailoring a specially designed balanced diet with appropriate micronutrient supplementation may ameliorate the severity of autism symptoms and related abnormal behaviours.
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Affiliation(s)
- Nagwa Meguid
- National Research Centre, Research on Children with Special Needs Department, Giza, Egypt
| | - Mona Anwar
- National Research Centre, Research on Children with Special Needs Department, Giza, Egypt
| | - Safaa Zaki
- National Research Centre, Child Health Department, Giza, Egypt
| | - Wafaa Kandeel
- National Research Centre, Biological Anthropology Department, Giza, Egypt
| | - Nihad Ahmed
- National Research Centre, Food Science and Nutrition Department, Giza, Egypt
| | - Ihab Tewfik
- Faculty of Science and Technology, University of Westminster, Life Science Department, London, United Kingdom
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Marshall J, Ware R, Ziviani J, Hill RJ, Dodrill P. Efficacy of interventions to improve feeding difficulties in children with autism spectrum disorders: a systematic review and meta-analysis. Child Care Health Dev 2015; 41:278-302. [PMID: 24962184 DOI: 10.1111/cch.12157] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2014] [Indexed: 12/23/2022]
Abstract
BACKGROUND Feeding difficulties are relatively common in children with autism spectrum disorders (ASD), but current evidence for their treatment is limited. This review systematically identifies, reviews and analyses the evidence for intervention in young children with ASD and feeding difficulties. METHODS A comprehensive search strategy was used to identify studies from January 2000 to October 2013. Studies were included if they described interventions where the goal was to increase desirable eating behaviours or decrease undesirable eating behaviours using an experimental design, including single-subject research methodology. Studies were reviewed for descriptive information, and research quality was appraised using a formal checklist. Individual study findings were compared using Improvement Rate Difference (IRD), a method for calculating effect size in single-subject research. RESULTS Overall, 23 papers were included. All studies reviewed had five or fewer participants, and reported on operant conditioning style intervention approaches, where the child is prompted to perform an action, and receives a contingent response. Where quality measures were not met, it was primarily due to lack of detail provided for the purposes of replication, or failure to meet social validity criteria. Meta-analysis indicated a medium-large effect size [mean = 0.69, 95% confidence interval (CI) 0.60 to 0.79] when the outcome measured was an increase in desirable behaviours (e.g. consuming food), but a small-negligible effect size (mean = 0.39, 95% CI 0.18 to 0.60) when the outcome measured was a decrease in undesirable mealtime behaviours (e.g. tantrums). Only a small proportion of studies reported outcomes in terms of increased dietary variety rather than volume of food consumed. CONCLUSIONS The reviewed literature consisted primarily of low-level evidence. Favourable intervention outcomes were observed in terms of increasing volume, but not necessarily variety of foods consumed in young children with ASD and feeding difficulties. Further research in the form of prospective randomized trials to further demonstrate experimental effect in this area is required.
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Affiliation(s)
- J Marshall
- Queensland Children's Medical Research Institute, Children's Nutrition Research Centre, The University of Queensland, Brisbane, Qld, Australia
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Chang J, Kueon C, Kim J. Influence of lead on repetitive behavior and dopamine metabolism in a mouse model of iron overload. Toxicol Res 2015; 30:267-76. [PMID: 25584146 PMCID: PMC4289927 DOI: 10.5487/tr.2014.30.4.267] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 09/30/2014] [Accepted: 10/06/2014] [Indexed: 12/12/2022] Open
Abstract
Exposures to lead (Pb) are associated with neurological problems including psychiatric disorders and impaired learning and memory. Pb can be absorbed by iron transporters, which are up-regulated in hereditary hemochromatosis, an iron overload disorder in which increased iron deposition in various parenchymal organs promote metal-induced oxidative damage. While dysfunction in HFE (High Fe) gene is the major cause of hemochromatosis, the transport and toxicity of Pb in Hfe-related hemochromatosis are largely unknown. To elucidate the relationship between HFE gene dysfunction and Pb absorption, H67D knock-in Hfe-mutant and wild-type mice were given drinking water containing Pb 1.6 mg/ml ad libitum for 6 weeks and examined for behavioral phenotypes using the nestlet-shredding and marble-burying tests. Latency to nestlet-shredding in Pb-treated wild-type mice was prolonged compared with non-exposed wild-types (p < 0.001), whereas Pb exposure did not alter shredding latency in Hfe-mutant mice. In the marble-burying test, Hfe-mutant mice showed an increased number of marbles buried compared with wild-type mice (p = 0.002), indicating more repetitive behavior upon Hfe mutation. Importantly, Pb-exposed wild-type mice buried more marbles than non-exposed wild-types, whereas the number of marbles buried by Hfe-mutant mice did not change whether or not exposed to Pb. These results suggest that Hfe mutation could normalize Pb-induced behavioral alteration. To explore the mechanism of repetitive behavior caused by Pb, western blot analysis was conducted for proteins involved in brain dopamine metabolism. The levels of tyrosine hydroxylase and dopamine transporter increased upon Pb exposure in both genotypes, whereas Hfe-mutant mice displayed down-regulation of the dopamine transporter and dopamine D1 receptor with D2 receptor elevated. Taken together, our data support the idea that both Pb exposure and Hfe mutation increase repetitive behavior in mice and further suggest that these behavioral changes could be associated with altered dopaminergic neurotransmission, providing a therapeutic basis for psychiatric disorders caused by Pb toxicity.
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Affiliation(s)
- JuOae Chang
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Chojin Kueon
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Jonghan Kim
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
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Seneff S, Swanson N, Li C. Aluminum and Glyphosate Can Synergistically Induce Pineal Gland Pathology: Connection to Gut Dysbiosis and Neurological Disease. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/as.2015.61005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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41
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Abstract
This review focuses on identifying up-to-date number of publications that compared DSM-IV/ICD-10 Asperger's disorder (AspD) to Autistic Disorder/High-functioning Autism (AD/HFA). One hundred and twenty-eight publications were identified through an extensive search of major electronic databases and journals. Based on more than 90 clinical variables been investigated, 94 publications concluded that there were statistically significant or near significant level of quantitative and/or qualitative differences between AspD and AD/HFA groups; 4 publications found both similarities and differences between the two groups; 30 publications concluded with no differences between the two groups. Although DSM-5 ASD will eliminate Asperger's disorder. However, it is plausible to predict that the field of ASD would run full circle during the next decade or two and that AspD will be back in the next edition of DSM.
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Affiliation(s)
- Luke Y Tsai
- Department of Psychiatry, University of Michigan Medical School, 2385 Placid Way, Ann Arbor, MI, 48105, USA,
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42
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Sidrak S, Yoong T, Woolfenden S. Iron deficiency in children with global developmental delay and autism spectrum disorder. J Paediatr Child Health 2014; 50:356-61. [PMID: 24372984 DOI: 10.1111/jpc.12483] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2013] [Indexed: 01/02/2023]
Abstract
AIM To investigate the prevalence of and risk factors for iron deficiency in children with global developmental delay and/or autism spectrum disorder (ASD). METHOD A retrospective review was conducted of the files of children referred to community paediatric clinics in South West Sydney from May 2009 to July 2011 who were diagnosed with global developmental delay and/or ASD. Data were extracted on iron studies and potential risk factors. Data were analysed using Pearson's ÷(2) -test and Fisher's exact test. RESULTS Subjects included 122 children. The prevalence of iron depletion was 2.5% (95% CI 0.5-7.0%); that of iron deficiency was 6.6% (95% CI 2.9-12.5%), and that of iron deficiency anaemia was 4.1% (95% CI 1.3-9.3%). In children with global developmental delay without ASD, the prevalence of iron depletion was 1.8% (95% CI 0-9.7%), that of iron deficiency 5.5% (95% CI 1.1-15.1%) and that of iron deficiency anaemia 5.5% (95% CI 1.1-15.1%). In children with ASD with or without global developmental delay, the prevalence of iron depletion was 3.0% (95% CI 0.4-10.4%), that of iron deficiency 7.5% (95% CI 2.5-16.6%) and that of iron deficiency anaemia 3.0% (95% CI 0.4-10.4%). Univariate analysis demonstrated three significant potential risk factors for iron depletion, iron deficiency and iron deficiency anaemia: problems sucking, swallowing or chewing (P = 0.002); poor eating behaviour (P = 0.008); and inadequate amounts of meat, chicken, eggs or fish (P = 0.002). CONCLUSION Iron deficiency and iron deficiency anaemia were more common in this clinical sample of children with global developmental delay and/or ASD than in the general population.
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Affiliation(s)
- Samuel Sidrak
- Department of Community Paediatrics, Sydney and South Western Sydney Local Health Districts, Sydney, New South Wales, Australia
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43
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The need for a comprehensive molecular characterization of autism spectrum disorders. Int J Neuropsychopharmacol 2014; 17:651-73. [PMID: 24229490 DOI: 10.1017/s146114571300117x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Autism spectrum disorders (ASD) are a heterogeneous group of disorders which have complex behavioural phenotypes. Although ASD is a highly heritable neuropsychiatric disorder, genetic research alone has not provided a profound understanding of the underlying causes. Recent developments using biochemical tools such as transcriptomics, proteomics and cellular models, will pave the way to gain new insights into the underlying pathological pathways. This review addresses the state-of-the-art in the search for molecular biomarkers for ASD. In particular, the most important findings in the biochemical field are highlighted and the need for establishing streamlined interaction between behavioural studies, genetics and proteomics is stressed. Eventually, these approaches will lead to suitable translational ASD models and, therefore, a better disease understanding which may facilitate novel drug discovery efforts in this challenging field.
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44
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Marshall J, Hill RJ, Ziviani J, Dodrill P. Features of feeding difficulty in children with Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:151-158. [PMID: 24001171 DOI: 10.3109/17549507.2013.808700] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Parents of children with Autism Spectrum Disorders (ASD) commonly report concerns regarding feeding difficulties and poor nutrition. Feeding difficulties, in the form of undesirable mealtime behaviours and/or skill deficits, can cause parental concern and impact on family dynamics. Poor nutrition can have an impact on development and health outcomes. The purpose of this paper was to review recent research regarding feeding difficulties in children with ASD, in order to describe: (1) the most frequently reported undesirable mealtime behaviours and skill deficits; and (2) dietary intake and weight patterns as markers of nutrition. While the ASD population is a somewhat heterogeneous group, this literature review of 44 research studies identified a number of common issues for these children. Restricted dietary variety, food neophobia, food refusal, limiting diet based on texture, and a propensity towards being overweight were frequently reported. Gaining a better understanding of the common features of feeding difficulties experienced by children with ASD will assist in directing intervention studies. Findings from such studies have the potential to enhance developmental and nutritional outcomes for this group. Well-designed longitudinal research would be valuable in monitoring the impact of feeding difficulties for these children as they age.
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Affiliation(s)
- Jeanne Marshall
- Queensland Children's Medical Research Institute, The University of Queensland , Brisbane, QLD , Australia
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45
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Main PAE, Thomas P, Esterman A, Fenech MF. Necrosis is increased in lymphoblastoid cell lines from children with autism compared with their non-autistic siblings under conditions of oxidative and nitrosative stress. Mutagenesis 2014; 28:475-84. [PMID: 23766106 DOI: 10.1093/mutage/get025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Autism spectrum disorders are a heterogeneous group of neurodevelopmental conditions characterised by impairments in reciprocal social interaction, communication and stereotyped behaviours. As increased DNA damage events have been observed in a range of other neurological disorders, it was hypothesised that they would be elevated in lymphoblastoid cell lines (LCLs) obtained from children with autism compared with their non-autistic siblings. Six case-sibling pairs of LCLs from children with autistic disorder and their non-autistic siblings were obtained from the Autism Genetic Resource Exchange (AGRE) and cultured in standard RPMI-1640 tissue culture medium. Cells were exposed to medium containing either 0, 25, 50, 100 and 200 µM hydrogen peroxide (an oxidative stressor) or 0, 5, 10, 20 and 40 µM s-nitroprusside (a nitric oxide producer) for 1h. Following exposure, the cells were microscopically scored for DNA damage, cytostasis and cytotoxicity biomarkers as measured using the cytokinesis-block micronucleus cytome assay. Necrosis was significantly increased in cases relative to controls when exposed to oxidative and nitrosative stress (P = 0.001 and 0.01, respectively). Nuclear division index was significantly lower in LCLs from children with autistic disorder than their non-autistic siblings when exposed to hydrogen peroxide (P = 0.016), but there was no difference in apoptosis, micronucleus frequency, nucleoplasmic bridges or nuclear buds. Exposure to s-nitroprusside significantly increased the number of micronuclei in non-autistic siblings compared with cases (P = 0.003); however, other DNA damage biomarkers, apoptosis and nuclear division did not differ significantly between groups. The findings of this study show (i) that LCLs from children with autism are more sensitive to necrosis under conditions of oxidative and nitrosative stress than their non-autistic siblings and (ii) refutes the hypothesis that children with autistic disorder are abnormally susceptible to DNA damage.
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Affiliation(s)
- Penelope A E Main
- Sansom Institute of Health Research, University of South Australia, North Terrace, Adelaide, Australia
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46
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Napoli E, Dueñas N, Giulivi C. Potential therapeutic use of the ketogenic diet in autism spectrum disorders. Front Pediatr 2014; 2:69. [PMID: 25072037 PMCID: PMC4074854 DOI: 10.3389/fped.2014.00069] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/17/2014] [Indexed: 11/13/2022] Open
Abstract
The ketogenic diet (KGD) has been recognized as an effective treatment for individuals with glucose transporter 1 (GLUT1) and pyruvate dehydrogenase (PDH) deficiencies as well as with epilepsy. More recently, its use has been advocated in a number of neurological disorders prompting a newfound interest in its possible therapeutic use in autism spectrum disorders (ASD). One study and one case report indicated that children with ASD treated with a KGD showed decreased seizure frequencies and exhibited behavioral improvements (i.e., improved learning abilities and social skills). The KGD could benefit individuals with ASD affected with epileptic episodes as well as those with either PDH or mild respiratory chain (RC) complex deficiencies. Given that the mechanism of action of the KGD is not fully understood, caution should be exercised in ASD cases lacking a careful biochemical and metabolic characterization to avoid deleterious side effects or refractory outcomes.
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Affiliation(s)
- Eleonora Napoli
- Department of Molecular Biosciences, University of California Davis , Davis, CA , USA
| | - Nadia Dueñas
- Department of Molecular Biosciences, University of California Davis , Davis, CA , USA
| | - Cecilia Giulivi
- Department of Molecular Biosciences, University of California Davis , Davis, CA , USA ; Medical Investigations of Neurodevelopmental Disorders (M. I. N. D.) Institute , Sacramento, CA , USA
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47
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Luck AN, Bobst CE, Kaltashov IA, Mason AB. Human serum transferrin: is there a link among autism, high oxalate levels, and iron deficiency anemia? Biochemistry 2013; 52:8333-41. [PMID: 24152109 DOI: 10.1021/bi401190m] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
It has been previously suggested that large amounts of oxalate in plasma could play a role in autism by binding to the bilobal iron transport protein transferrin (hTF), thereby interfering with iron metabolism by inhibiting the delivery of iron to cells. By examining the effect of the substitution of oxalate for the physiologically utilized synergistic carbonate anion in each lobe of hTF, we sought to provide a molecular basis for or against such a role. Our work clearly shows both qualitatively (6 M urea gels) and quantitatively (kinetic analysis by stopped-flow spectrofluorimetry) that the presence of oxalate in place of carbonate in each binding site of hTF does indeed greatly interfere with the removal of iron from each lobe (in the absence and presence of the specific hTF receptor). However, we also clearly demonstrate that once the iron is bound within each lobe of hTF, neither anion can displace the other. Additionally, as verified by urea gels and electrospray mass spectrometry, formation of completely homogeneous hTF-anion complexes requires that all iron must first be removed and hTF then reloaded with iron in the presence of either carbonate or oxalate. Significantly, experiments described here show that carbonate is the preferred binding partner; i.e., even if an equal amount of each anion is available during the iron loading process, the hTF-carbonate complex is formed.
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Affiliation(s)
- Ashley N Luck
- Department of Biochemistry, University of Vermont, College of Medicine , 89 Beaumont Avenue, Burlington, Vermont 05405, United States
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48
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Mizejewski GJ, Lindau-Shepard B, Pass KA. Newborn screening for autism: in search of candidate biomarkers. Biomark Med 2013; 7:247-60. [PMID: 23547820 DOI: 10.2217/bmm.12.108] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) represents a wide range of neurodevelopmental disorders characterized by impairments in social interaction, language, communication and range of interests. Autism is usually diagnosed in children 3-5 years of age using behavioral characteristics; thus, diagnosis shortly after birth would be beneficial for early initiation of treatment. AIM This retrospective study sought to identify newborns at risk for ASD utilizing bloodspot specimens in an immunoassay. MATERIALS & METHODS The present study utilized stored frozen specimens from ASD children already diagnosed at 15-36 months of age. The newborn specimens and controls were analyzed by immunoassay in a multiplex system that included 90 serum biomarkers and subjected to statisical analysis. RESULTS Three sets of five biomarkers associated with ASD were found that differed from control groups. The 15 candidate biomarkers were then discussed regarding their association with ASD. CONCLUSION This study determined that a statistically selected panel of 15 biomarkers successfully discriminated presumptive newborns at risk for ASD from those of nonaffected controls.
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Affiliation(s)
- Gerald J Mizejewski
- Division of Translational Medicine, Wadsworth Center, NYS Department of Health, PO Box 509, Albany, NY 12201 0509, USA.
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49
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Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, Chen TJ, Bai YM. Association between psychiatric disorders and iron deficiency anemia among children and adolescents: a nationwide population-based study. BMC Psychiatry 2013; 13:161. [PMID: 23735056 PMCID: PMC3680022 DOI: 10.1186/1471-244x-13-161] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 05/28/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A great deal of evidence has shown that iron is an important component in cognitive, sensorimotor, and social-emotional development and functioning, because the development of central nervous system processes is highly dependent on iron-containing enzymes and proteins. Deficiency of iron in early life may increase the risk of psychiatric morbidity. METHODS Utilizing the National Health Insurance Database from 1996 to 2008, children and adolescents with a diagnosis of IDA were identified and compared with age and gender-matched controls (1:4) in an investigation of the increased risk of psychiatric disorders. RESULTS A total of 2957 patients with IDA, with an increased risk of unipolar depressive disorder (OR = 2.34, 95% CI = 1.58 ~ 3.46), bipolar disorder (OR = 5.78, 95% CI = 2.23 ~ 15.05), anxiety disorder (OR = 2.17, 95% CI = 1.49 ~ 3.16), autism spectrum disorder (OR = 3.08, 95% CI = 1.79 ~ 5.28), attention deficit hyperactivity disorder (OR = 1.67, 95% CI = 1.29 ~ 2.17), tic disorder (OR = 1.70, 95% CI = 1.03 ~ 2.78), developmental delay (OR = 2.45, 95% CI = 2.00 ~ 3.00), and mental retardation (OR = 2.70, 95% CI = 2.00 ~ 3.65), were identified. A gender effect was noted, in that only female patients with IDA had an increased OR of bipolar disorder (OR = 5.56, 95% CI = 1.98 ~ 15.70) and tic disorder (OR = 2.95, 95% CI = 1.27 ~ 6.86). CONCLUSION Iron deficiency increased the risk of psychiatric disorders, including mood disorders, autism spectrum disorder, attention deficit hyperactivity disorder, and developmental disorders. Further study is required to clarify the mechanism in the association between IDA and psychiatric disorder.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Sheue Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
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50
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Marshall J, Hill RJ, Dodrill P. A survey of practice for clinicians working with children with autism spectrum disorders and feeding difficulties. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2013; 15:279-285. [PMID: 23577744 DOI: 10.3109/17549507.2013.777972] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The aim of this study was to document information from allied health clinicians about children on their caseload with autism spectrum disorders and feeding difficulties. An electronic survey was disseminated to clinicians working with this group around Australia, where 150 responses were returned and 96 were able to be analysed. Variability in responses was observed for service delivery models, frequency of input, referral reasons, and intervention choices. The majority of respondents identified limited-to-average knowledge of feeding therapy options for this population. Clinician confidence was significantly correlated with perceived therapy success. Results of the survey suggest a need for clinical guidelines in the area to direct practice. Low levels of clinician confidence and perceived therapy success also highlight a need for ongoing research and training.
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Affiliation(s)
- Jeanne Marshall
- Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, QLD, Australia.
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