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Westmark PR, Lyon G, Gutierrez A, Boeck B, Van Hammond O, Ripp N, Pagan-Torres NA, Brower J, Held PK, Scarlett C, Westmark CJ. Effects of Soy Protein Isolate on Fragile X Phenotypes in Mice. Nutrients 2024; 16:284. [PMID: 38257177 PMCID: PMC10819477 DOI: 10.3390/nu16020284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Obesity is a pediatric epidemic that is more prevalent in children with developmental disabilities. We hypothesize that soy protein-based diets increase weight gain and alter neurobehavioral outcomes. Our objective herein was to test matched casein- and soy protein-based purified ingredient diets in a mouse model of fragile X syndrome, Fmr1KO mice. The experimental methods included assessment of growth; 24-7 activity levels; motor coordination; learning and memory; blood-based amino acid, phytoestrogen and glucose levels; and organ weights. The primary outcome measure was body weight. We find increased body weight in male Fmr1KO from postnatal day 6 (P6) to P224, male wild type (WT) from P32-P39, female Fmr1KO from P6-P18 and P168-P224, and female Fmr1HET from P9-P18 as a function of soy. Activity at the beginning of the light and dark cycles increased in female Fmr1HET and Fmr1KO mice fed soy. We did not find significant differences in rotarod or passive avoidance behavior as a function of genotype or diet. Several blood-based amino acids and phytoestrogens were significantly altered in response to soy. Liver weight was increased in WT and adipose tissue in Fmr1KO mice fed soy. Activity levels at the beginning of the light cycle and testes weight were greater in Fmr1KO versus WT males irrespective of diet. DEXA analysis at 8-months-old indicated increased fat mass and total body area in Fmr1KO females and lean mass and bone mineral density in Fmr1KO males fed soy. Overall, dietary consumption of soy protein isolate by C57BL/6J mice caused increased growth, which could be attributed to increased lean mass in males and fat mass in females. There were sex-specific differences with more pronounced effects in Fmr1KO versus WT and in males versus females.
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Affiliation(s)
- Pamela R. Westmark
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA;
| | - Greg Lyon
- Undergraduate Research Scholars Program, University of Wisconsin, Madison, WI 53706, USA; (G.L.); (O.V.H.)
| | - Alejandra Gutierrez
- Molecular Environmental Toxicology Master’s Program, University of Wisconsin, Madison, WI 53706, USA;
| | - Brynne Boeck
- Neurology Undergraduate Research, University of Wisconsin, Madison, WI 53706, USA; (B.B.); (N.R.)
| | - Olivia Van Hammond
- Undergraduate Research Scholars Program, University of Wisconsin, Madison, WI 53706, USA; (G.L.); (O.V.H.)
| | - Nathan Ripp
- Neurology Undergraduate Research, University of Wisconsin, Madison, WI 53706, USA; (B.B.); (N.R.)
| | - Nicole Arianne Pagan-Torres
- Molecular Environmental Toxicology Summer Research Opportunities Program, University of Wisconsin, Madison, WI 53706, USA;
| | - James Brower
- Wisconsin State Laboratory of Hygiene, University of Wisconsin, Madison, WI 53706, USA; (J.B.); (P.K.H.)
| | - Patrice K. Held
- Wisconsin State Laboratory of Hygiene, University of Wisconsin, Madison, WI 53706, USA; (J.B.); (P.K.H.)
| | - Cameron Scarlett
- School of Pharmacy, University of Wisconsin, Madison, WI 53706, USA;
| | - Cara J. Westmark
- Department of Neurology and Molecular Environmental Toxicology Center, University of Wisconsin, Madison, WI 53706, USA
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2
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Matthews JS, Adams JB. Ratings of the Effectiveness of 13 Therapeutic Diets for Autism Spectrum Disorder: Results of a National Survey. J Pers Med 2023; 13:1448. [PMID: 37888059 PMCID: PMC10608557 DOI: 10.3390/jpm13101448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
This study presents the results of the effectiveness of 13 therapeutic diets for autism spectrum disorder from 818 participants of a national survey, including benefits, adverse effects, and symptom improvements. The average Overall Benefit of diets was 2.36 (0 = no benefit, 4 = great benefit), which was substantially higher than for nutraceuticals (1.59/4.0) and psychiatric/seizure medications (1.39/4.0), p < 0.001. The average Overall Adverse Effects of diets was significantly lower than psychiatric/seizure medications (0.10 vs. 0.93, p < 0.001) and similar to nutraceuticals (0.16). Autism severity decreased slightly over time in participants who used diet vs. increasing slightly in those that did not (p < 0.001). Healthy and Feingold diets were the two top-rated diets by Overall Benefit; the ketogenic diet was the highest for nine symptoms (though had fewer respondents); and the gluten-free/casein-free diet was among the top for overall symptom improvements. Different diets were reported to affect different symptoms, suggesting that an individual's symptoms could be used to guide which diet(s) may be the most effective. The results suggest that therapeutic diets can be safe and effective interventions for improving some ASD-related symptoms with few adverse effects. We recommend therapeutic diets that include healthy foods and exclude problematic foods. Therapeutic diets are inexpensive treatments that we recommend for consideration by most people with ASD.
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Affiliation(s)
- Julie S. Matthews
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA;
| | - James B. Adams
- School of Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ 85287, USA
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3
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Westmark CJ. Toward an understanding of the role of the exposome on fragile X phenotypes. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 173:141-170. [PMID: 37993176 DOI: 10.1016/bs.irn.2023.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Fragile X syndrome (FXS) is the leading known monogenetic cause of autism with an estimated 21-50% of FXS individuals meeting autism diagnostic criteria. A critical gap in medical care for persons with autism is an understanding of how environmental exposures and gene-environment interactions affect disease outcomes. Our research indicates more severe neurological and metabolic outcomes (seizures, autism, increased body weight) in mouse and human models of autism spectrum disorders (ASD) as a function of diet. Thus, early-life exposure to chemicals in the diet could cause or exacerbate disease outcomes. Herein, we review the effects of potential dietary toxins, i.e., soy phytoestrogens, glyphosate, and polychlorinated biphenyls (PCB) in FXS and other autism models. The rationale is that potentially toxic chemicals in the diet, particularly infant formula, could contribute to the development and/or severity of ASD and that further study in this area has potential to improve ASD outcomes through dietary modification.
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Affiliation(s)
- Cara J Westmark
- Department of Neurology, University of Wisconsin-Madison, Medical Sciences Center, Room 3619, 1300 University Avenue, Madison, WI, United States; Molecular Environmental Toxicology Center, University of Wisconsin-Madison, Medical Sciences Center, Room 3619, 1300 University Avenue, Madison, WI, United States.
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4
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Alam S, Westmark CJ, McCullagh EA. Diet in treatment of autism spectrum disorders. Front Neurosci 2023; 16:1031016. [PMID: 37492195 PMCID: PMC10364988 DOI: 10.3389/fnins.2022.1031016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/31/2022] [Indexed: 07/27/2023] Open
Abstract
Altering the diet to treat disease dates to c. 400 BC when starvation was used to reduce seizures in persons with epilepsy. The current diversity of symptomology and mechanisms underlying autism spectrum disorders (ASDs) and a corresponding lack of disorder-specific effective treatments prompts an evaluation of diet as a therapeutic approach to improve symptoms of ASDs. In this review article, we summarize the main findings of nutritional studies in ASDs, with an emphasis on the most common monogenic cause of autism, Fragile X Syndrome (FXS), and the most studied dietary intervention, the ketogenic diet as well as other dietary interventions. We also discuss the gut microbiota in relation to pre- and probiotic therapies and provide insight into future directions that could aid in understanding the mechanism(s) underlying dietary efficacy.
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Affiliation(s)
- Sabiha Alam
- Department of Integrative Biology, Oklahoma State University, Stillwater, OK, United States
| | - Cara J. Westmark
- Department of Neurology, University of Wisconsin, Madison, WI, United States
- Molecular and Environmental Toxicology Center, University of Wisconsin, Madison, WI, United States
| | - Elizabeth A. McCullagh
- Department of Integrative Biology, Oklahoma State University, Stillwater, OK, United States
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5
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Westmark CJ, Brower J, Held PK. Improving Reproducibility to Enhance Scientific Rigor through Consideration of Mouse Diet. Animals (Basel) 2022; 12:ani12243448. [PMID: 36552368 PMCID: PMC9774320 DOI: 10.3390/ani12243448] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
Animal husbandry conditions, including rodent diet, constitute an example highlighting the importance of reporting experimental variables to enhance scientific rigor. In the present study, we examine the effects of three common rodent diets including two chows (Purina 5015 and Teklad 2019) and one purified ingredient diet (AIN-76A) on growth anthropometrics (body weight), behavior (nest building, actigraphy, passive avoidance) and blood biomarkers (ketones, glucose, amino acid profiles) in male and female C57BL/6J mice. We find increased body weight in response to the chows compared to purified ingredient diet albeit selectively in male mice. We did not find significantly altered behavior in female or male wild type C57BL/6J mice. However, amino acid profiles changed as an effect of sex and diet. These data contribute to a growing body of knowledge indicating that rodent diet impacts experimental outcomes and needs to be considered in study design and reporting.
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Affiliation(s)
- Cara J. Westmark
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA
- Molecular Environmental Toxicology Center, University of Wisconsin, Madison, WI 53706, USA
- Correspondence: ; Tel.: +1-608-262-9730
| | - James Brower
- Wisconsin State Laboratory of Hygiene, University of Wisconsin, Madison, WI 53706, USA
| | - Patrice K. Held
- Wisconsin State Laboratory of Hygiene, University of Wisconsin, Madison, WI 53706, USA
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Westmark CJ. Increased Incidence of Epilepsy in Response to Soy-Based Infant Formula in a National Korean Cohort Study. J Nutr 2022; 152:1378-1379. [PMID: 35512306 DOI: 10.1093/jn/nxac040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cara J Westmark
- From the Department of Neurology and Molecular Environmental Toxicology Center, University of Wisconsin, Madison, WI, USA
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Westmark CJ, Filon MJ, Maina P, Steinberg LI, Ikonomidou C, Westmark PR. Effects of Soy-Based Infant Formula on Weight Gain and Neurodevelopment in an Autism Mouse Model. Cells 2022; 11:1350. [PMID: 35456030 PMCID: PMC9025435 DOI: 10.3390/cells11081350] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023] Open
Abstract
Mice fed soy-based diets exhibit increased weight gain compared to mice fed casein-based diets, and the effects are more pronounced in a model of fragile X syndrome (FXS; Fmr1KO). FXS is a neurodevelopmental disability characterized by intellectual impairment, seizures, autistic behavior, anxiety, and obesity. Here, we analyzed body weight as a function of mouse age, diet, and genotype to determine the effect of diet (soy, casein, and grain-based) on weight gain. We also assessed plasma protein biomarker expression and behavior in response to diet. Juvenile Fmr1KO mice fed a soy protein-based rodent chow throughout gestation and postnatal development exhibit increased weight gain compared to mice fed a casein-based purified ingredient diet or grain-based, low phytoestrogen chow. Adolescent and adult Fmr1KO mice fed a soy-based infant formula diet exhibited increased weight gain compared to reference diets. Increased body mass was due to increased lean mass. Wild-type male mice fed soy-based infant formula exhibited increased learning in a passive avoidance paradigm, and Fmr1KO male mice had a deficit in nest building. Thus, at the systems level, consumption of soy-based diets increases weight gain and affects behavior. At the molecular level, a soy-based infant formula diet was associated with altered expression of numerous plasma proteins, including the adipose hormone leptin and the β-amyloid degrading enzyme neprilysin. In conclusion, single-source, soy-based diets may contribute to the development of obesity and the exacerbation of neurological phenotypes in developmental disabilities, such as FXS.
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Affiliation(s)
- Cara J. Westmark
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA; (M.J.F.); (P.M.); (L.I.S.); (C.I.); (P.R.W.)
- Molecular Environmental Toxicology Center, University of Wisconsin, Madison, WI 53706, USA
| | - Mikolaj J. Filon
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA; (M.J.F.); (P.M.); (L.I.S.); (C.I.); (P.R.W.)
- Undergraduate Research Program, University of Wisconsin, Madison, WI 53706, USA
| | - Patricia Maina
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA; (M.J.F.); (P.M.); (L.I.S.); (C.I.); (P.R.W.)
- Molecular Environmental Toxicology Summer Research Opportunities Program, University of Wisconsin, Madison, WI 53706, USA
| | - Lauren I. Steinberg
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA; (M.J.F.); (P.M.); (L.I.S.); (C.I.); (P.R.W.)
- Undergraduate Research Program, University of Wisconsin, Madison, WI 53706, USA
| | - Chrysanthy Ikonomidou
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA; (M.J.F.); (P.M.); (L.I.S.); (C.I.); (P.R.W.)
| | - Pamela R. Westmark
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA; (M.J.F.); (P.M.); (L.I.S.); (C.I.); (P.R.W.)
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Issa NT, Wathieu H, Glasgow E, Peran I, Parasido E, Li T, Simbulan-Rosenthal CM, Rosenthal D, Medvedev AV, Makarov SS, Albanese C, Byers SW, Dakshanamurthy S. A novel chemo-phenotypic method identifies mixtures of salpn, vitamin D3, and pesticides involved in the development of colorectal and pancreatic cancer. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 233:113330. [PMID: 35189517 PMCID: PMC10202418 DOI: 10.1016/j.ecoenv.2022.113330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 05/24/2023]
Abstract
Environmental chemical (EC) exposures and our interactions with them has significantly increased in the recent decades. Toxicity associated biological characterization of these chemicals is challenging and inefficient, even with available high-throughput technologies. In this report, we describe a novel computational method for characterizing toxicity, associated biological perturbations and disease outcome, called the Chemo-Phenotypic Based Toxicity Measurement (CPTM). CPTM is used to quantify the EC "toxicity score" (Zts), which serves as a holistic metric of potential toxicity and disease outcome. CPTM quantitative toxicity is the measure of chemical features, biological phenotypic effects, and toxicokinetic properties of the ECs. For proof-of-concept, we subject ECs obtained from the Environmental Protection Agency's (EPA) database to the CPTM. We validated the CPTM toxicity predictions by correlating 'Zts' scores with known toxicity effects. We also confirmed the CPTM predictions with in-vitro, and in-vivo experiments. In in-vitro and zebrafish models, we showed that, mixtures of the motor oil and food additive 'Salpn' with endogenous nuclear receptor ligands such as Vitamin D3, dysregulated the nuclear receptors and key transcription pathways involved in Colorectal Cancer. Further, in a human patient derived cell organoid model, we found that a mixture of the widely used pesticides 'Tetramethrin' and 'Fenpropathrin' significantly impacts the population of patient derived pancreatic cancer cells and 3D organoid models to support rapid PDAC disease progression. The CPTM method is, to our knowledge, the first comprehensive toxico-physicochemical, and phenotypic bionetwork-based platform for efficient high-throughput screening of environmental chemical toxicity, mechanisms of action, and connection to disease outcomes.
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Affiliation(s)
- Naiem T Issa
- Department of Oncology, and Molecular and Experimental Therapeutic Research in Oncology Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Henri Wathieu
- Department of Oncology, and Molecular and Experimental Therapeutic Research in Oncology Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Eric Glasgow
- Department of Oncology, and Molecular and Experimental Therapeutic Research in Oncology Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Ivana Peran
- Department of Oncology, and Molecular and Experimental Therapeutic Research in Oncology Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Erika Parasido
- Department of Oncology, and Molecular and Experimental Therapeutic Research in Oncology Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Tianqi Li
- Department of Biochemistry and Molecular Biology, Georgetown University, Washington, DC 20057, USA
| | | | - Dean Rosenthal
- Department of Biochemistry and Molecular Biology, Georgetown University, Washington, DC 20057, USA
| | | | | | - Christopher Albanese
- Department of Oncology, and Molecular and Experimental Therapeutic Research in Oncology Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Stephen W Byers
- Department of Oncology, and Molecular and Experimental Therapeutic Research in Oncology Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA; Department of Biochemistry and Molecular Biology, Georgetown University, Washington, DC 20057, USA
| | - Sivanesan Dakshanamurthy
- Department of Oncology, and Molecular and Experimental Therapeutic Research in Oncology Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA; Department of Biochemistry and Molecular Biology, Georgetown University, Washington, DC 20057, USA.
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9
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Ha EK, Lee SW, Kim JH, Shim S, Kim YH, Song JY, Koh HY, Shin YH, Han MY. Neurodevelopmental Outcomes in Infants Fed with Soy Formula: A Retrospective, National Population-Based Observational Cohort Study. J Nutr 2021; 151:3045-3052. [PMID: 34486658 DOI: 10.1093/jn/nxab229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/09/2021] [Accepted: 06/17/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Soy-based infant formulas are increasingly popular, but data regarding their effects on neurodevelopmental outcomes during early childhood is scanty. OBJECTIVE This study investigated the effect of consuming soy-based infant formula at 9-12 mo after birth on the subsequent development of epilepsy, neurodevelopmental disorders, and developmental status. METHODS This nationwide retrospective administrative study used health screening examinations and linked insurance claims data of children born in Korea during 2008 and 2009. Infants who received soy formula were compared with those who received cow's milk formula using propensity score matching that considered birth history, economic status, clinical conditions, and drug prescription records. Exposure was defined as soy formula feeding determined from questionnaires completed by the parents when children were 9-12 mo old. Outcomes were epilepsy, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and developmental status. Children were followed until 31 December, 2017. RESULTS A total of 153,841 eligible participants were enrolled; 11,535 (7.5%) children received soy formula, while 142,864 (92.5%) received cow's milk formula. The incidence rate of epilepsy during the follow-up period was 29.8 per 100,000 person-years (95% CI: 19.48, 41.65) in the soy formula group and 22.6 per 100,000 person-years (95% CI: 31.97, 59.07) in the cow's milk formula group, with no significant difference (aHR: 1.318; 95% CI: 0.825, 2.106). The 2 groups also had no difference based on prespecified analysis using different definitions of epilepsy. Likewise, no significant associations of soy formula with ADHD (aHR: 1.26; 95% CI: 1.00, 1.60) or ASD (aHR: 0.99; 95% CI: 0.54, 1.83), or delays of developmental stages were observed. CONCLUSIONS Feeding with soy formula rather than cow's milk formula had no apparent association with increased risks of epilepsy, ADHD, ASD, and developmental status, according to this cohort composed of a general pediatric population.
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Affiliation(s)
- Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.,Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Ju Hee Kim
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Somin Shim
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Young Hyeon Kim
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Joo Young Song
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Hyun Yong Koh
- FM Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Parental Reports on Early Autism Behaviors in Their Children with Fragile X Syndrome as a Function of Infant Feeding. Nutrients 2021; 13:nu13082888. [PMID: 34445048 PMCID: PMC8401950 DOI: 10.3390/nu13082888] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
This study evaluates the prevalence of autistic behaviors in fragile X syndrome as a function of infant diet. Retrospective survey data from the Fragile X Syndrome Nutrition Study, which included data on infant feeding and caregiver-reported developmental milestones for 190 children with fragile X syndrome enrolled in the Fragile X Online Registry with Accessible Database (FORWARD), were analyzed. Exploratory, sex-specific associations were found linking the use of soy-based infant formula with worse autistic behaviors related to language in females and self-injurious behavior in males. These findings prompt prospective evaluation of the effects of soy-based infant formula on disease comorbidities in fragile X syndrome, a rare disorder for which newborn screening could be implemented if there was an intervention. Gastrointestinal problems were the most common reason cited for switching to soy-based infant formula. Thus, these findings also support the study of early gastrointestinal problems in fragile X syndrome, which may underly the development and severity of disease comorbidities. In conjunction with comorbidity data from the previous analyses of the Fragile X Syndrome Nutrition Study, the findings indicate that premutation fragile X mothers should be encouraged to breastfeed.
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11
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Westmark CJ. Consumption of Breast Milk Is Associated with Decreased Prevalence of Autism in Fragile X Syndrome. Nutrients 2021; 13:nu13061785. [PMID: 34073785 PMCID: PMC8225095 DOI: 10.3390/nu13061785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/11/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023] Open
Abstract
Breastfeeding is associated with numerous health benefits, but early life nutrition has not been specifically studied in the neurodevelopmental disorder fragile X syndrome (FXS). Herein, I evaluate associations between the consumption of breast milk during infancy and the prevalence of autism, allergies, diabetes, gastrointestinal (GI) problems and seizures in FXS. The study design was a retrospective survey of families enrolled in the Fragile X Online Registry and Accessible Research Database (FORWARD). There was a 1.7-fold reduction in the prevalence of autism in FXS participants who were fed breast milk for 12 months or longer. There were strong negative correlations between increased time the infant was fed breast milk and the prevalence of autism and seizures and moderate negative correlations with the prevalence of GI problems and allergies. However, participants reporting GI problems or allergies commenced these comorbidities significantly earlier than those not fed breast milk. Parsing the data by sex indicated that males exclusively fed breast milk exhibited decreased prevalence of GI problems and allergies. These data suggest that long-term or exclusive use of breast milk is associated with reduced prevalence of key comorbidities in FXS, although breast milk is associated with the earlier development of GI problems and allergies.
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Affiliation(s)
- Cara J. Westmark
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA; ; Tel.: +1-608-262-9730
- Molecular & Environmental Toxicology Center, University of Wisconsin, Madison, WI 53706, USA
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12
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Westmark CJ, Kniss C, Sampene E, Wang A, Milunovich A, Elver K, Hessl D, Talboy A, Picker J, Haas-Givler B, Esler A, Gropman AL, Uy R, Erickson C, Velinov M, Tartaglia N, Berry-Kravis EM. Soy-Based Infant Formula is Associated with an Increased Prevalence of Comorbidities in Fragile X Syndrome. Nutrients 2020; 12:E3136. [PMID: 33066511 PMCID: PMC7602206 DOI: 10.3390/nu12103136] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/18/2022] Open
Abstract
A large number of adults and children consume soy in various forms, but little information is available regarding potential neurological side effects. Prior work indicates an association between the consumption of soy-based diets and seizure prevalence in mouse models of neurological disease and in children with autism. Herein, we sought to evaluate potential associations between the consumption of soy-based formula during infancy and disease comorbidities in persons with fragile X syndrome (FXS), while controlling for potentially confounding issues, through a retrospective case-control survey study of participants with FXS enrolled in the Fragile X Online Registry with Accessible Research Database (FORWARD). There was a 25% usage rate of soy-based infant formula in the study population. We found significant associations between the consumption of soy-based infant formula and the comorbidity of autism, gastrointestinal problems (GI) and allergies. Specifically, there was a 1.5-fold higher prevalence of autism, 1.9-fold GI problems and 1.7-fold allergies in participants reporting the use of soy-based infant formula. The major reason for starting soy-based infant formula was GI problems. The average age of seizure and allergy onset occurred long after the use of soy-based infant formula. We conclude that early-life feeding with soy-based infant formula is associated with the development of several disease comorbidities in FXS.
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Affiliation(s)
- Cara J. Westmark
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA
| | - Chad Kniss
- Survey Center, University of Wisconsin, Madison, WI 53706, USA; (C.K.); (K.E.)
| | - Emmanuel Sampene
- Department of Biostatistics & Medical Informatics, University of Wisconsin, Madison, WI 53792, USA;
| | - Angel Wang
- Department of Pediatrics, Rush University Medical Center, Chicago, IL 60612, USA; (A.W.); (E.M.B.-K.)
| | | | - Kelly Elver
- Survey Center, University of Wisconsin, Madison, WI 53706, USA; (C.K.); (K.E.)
| | - David Hessl
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA 95817, USA;
| | - Amy Talboy
- Departments of Human Genetics and Pediatrics, Emory University, Atlanta, GA 30322, USA;
| | | | - Barbara Haas-Givler
- Autism & Developmental Medicine Institute, Geisinger Lewisburg, Lewisburg, PA 17837, USA;
| | - Amy Esler
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55454, USA;
| | - Andrea L. Gropman
- Children’s National Health System, Washington, DC 20010, USA; (A.L.G.); (R.U.)
| | - Ryan Uy
- Children’s National Health System, Washington, DC 20010, USA; (A.L.G.); (R.U.)
| | - Craig Erickson
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
| | - Milen Velinov
- Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314, USA;
| | - Nicole Tartaglia
- Department of Pediatrics, University of Colorado, Aurora, CO 80045, USA;
| | - Elizabeth M. Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, IL 60612, USA; (A.W.); (E.M.B.-K.)
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13
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Sexual hormones regulate the redox status and mitochondrial function in the brain. Pathological implications. Redox Biol 2020; 31:101505. [PMID: 32201220 PMCID: PMC7212485 DOI: 10.1016/j.redox.2020.101505] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/11/2020] [Accepted: 03/09/2020] [Indexed: 12/13/2022] Open
Abstract
Compared to other organs, the brain is especially exposed to oxidative stress. In general, brains from young females tend to present lower oxidative damage in comparison to their male counterparts. This has been attributed to higher antioxidant defenses and a better mitochondrial function in females, which has been linked to neuroprotection in this group. However, these differences usually disappear with aging, and the incidence of brain pathologies increases in aged females. Sexual hormones, which suffer a decrease with normal aging, have been proposed as the key factors involved in these gender differences. Here, we provide an overview of redox status and mitochondrial function regulation by sexual hormones and their influence in normal brain aging. Furthermore, we discuss how sexual hormones, as well as phytoestrogens, may play an important role in the development and progression of several brain pathologies, including neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, stroke or brain cancer. Sex hormones are reduced with aging, especially in females, affecting redox balance. Normal aging is associated to a worse redox homeostasis in the brain. Young females show better mitochondrial function and higher antioxidant defenses. Development of brain pathologies is influenced by sex hormones and phytoestrogens.
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Seizure Induced by Defecation in a 15-Year Old Autistic Patient: A Case Report and Literature Review. IRANIAN JOURNAL OF CHILD NEUROLOGY 2020; 14:83-88. [PMID: 32952585 PMCID: PMC7468083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 09/28/2019] [Accepted: 10/02/2019] [Indexed: 11/04/2022]
Abstract
Epilepsy in autism is a relatively common phenomenon. However, reflex seizures provoked by multifactorial stimuli are rare in these patients. We here reported the first case of defecation-induced seizure in a 15-year old autistic girl. The patient had been diagnosed with epilepsy within the first year after birth; however, seizures induced by bowel movements were observed at the age of 15. Reflex seizures showed a myoclonic pattern represented with one-sided neck deflection. EEG showed an abnormal polyspike and wave pattern during defecation while the patterns were normal between the attacks. The patient was partially responsive to adrenocorticotropic hormone therapy with a reduced frequency of both reflexes and generalized seizures. Phenobarbital therapy was effective to manage recurrent seizure attacks. Although seizure is commonly encountered in autism, reflex seizures induced by defecation have not been previously reported in this condition.
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15
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Rosenfeld CS. Effects of Phytoestrogens on the Developing Brain, Gut Microbiota, and Risk for Neurobehavioral Disorders. Front Nutr 2019; 6:142. [PMID: 31555657 PMCID: PMC6727358 DOI: 10.3389/fnut.2019.00142] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 08/14/2019] [Indexed: 01/11/2023] Open
Abstract
Many pregnant and nursing women consume high amounts of soy and other plant products that contain phytoestrogens, such as genistein (GEN) and daidzein. Infants may also be provided soy based formulas. With their ability to bind and activate estrogen receptors (ESR) in the brain, such compounds can disrupt normal brain programming and lead to later neurobehavioral disruptions. However, other studies suggest that maternal consumption of soy and soy based formulas containing such phytoestrogens might lead to beneficial behavioral effects. Select gut microbes might also convert daidzein and to a lesser extent genistein to even more potent forms, e.g., equol derivatives. Thus, infant exposure to phytoestrogens may result in contrasting effects dependent upon the gut flora. It is also becoming apparent that consumption or exposure to these xenoestrogens may lead to gut dysbiosis. Phytoestrogen-induced changes in gut bacteria might in turn affect the brain through various mechanisms. This review will consider the evidence to date in rodent and other animal models and human epidemiological data as to whether developmental exposure to phytoestrogens, in particular genistein and daidzein, adversely or beneficially impact offspring neurobehavioral programming. Consideration will be given to potential mechanisms by which such compounds might affect neurobehavioral responses. A better understanding of effects perinatal exposure to phytoestrogen can exert on brain programming will permit pregnant women and those seeking to become pregnant to make better-educated choices. If phytoestrogen-induced gut dysbiosis contributes to neurobehavioral disruptions, remediation strategies may be designed to prevent such gut microbiota alterations and thereby improve neurobehavioral outcomes.
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Affiliation(s)
- Cheryl S. Rosenfeld
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States
- MU Informatics Institute, University of Missouri, Columbia, MO, United States
- Thompson Center for Autism and Neurobehavioral Disorders, University of Missouri, Columbia, MO, United States
- Biomedical Sciences, University of Missouri, Columbia, MO, United States
- Genetics Area Program, University of Missouri, Columbia, MO, United States
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16
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Westmark CJ. Fragile X and APP: a Decade in Review, a Vision for the Future. Mol Neurobiol 2019; 56:3904-3921. [PMID: 30225775 PMCID: PMC6421119 DOI: 10.1007/s12035-018-1344-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Abstract
Fragile X syndrome (FXS) is a devastating developmental disability that has profound effects on cognition, behavior, and seizure susceptibility. There are currently no treatments that target the underlying cause of the disorder, and recent clinical trials have been unsuccessful. In 2007, seminal work demonstrated that amyloid-beta protein precursor (APP) is dysregulated in Fmr1KO mice through a metabotropic glutamate receptor 5 (mGluR5)-dependent pathway. These findings raise the hypotheses that: (1) APP and/or APP metabolites are potential therapeutic targets as well as biomarkers for FXS and (2) mGluR5 inhibitors may be beneficial in the treatment of Alzheimer's disease. Herein, advances in the field over the past decade that have reproduced and greatly expanded upon these original findings are reviewed, and required experimentation to validate APP metabolites as potential disease biomarkers as well as therapeutic targets for FXS are discussed.
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Affiliation(s)
- Cara J Westmark
- Department of Neurology, University of Wisconsin-Madison, Medical Sciences Center, Room 3619, 1300 University Avenue, Madison, WI, USA.
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Khodamoradi M, Asadi-Shekaari M, Esmaeili-Mahani S, Sharififar F, Sheibani V. Effects of Hydroalcoholic Extract of Soy on Learning, Memory and Synaptic Plasticity Deficits Induced by Seizure in Ovariectomized Rats. Basic Clin Neurosci 2017; 8:395-403. [PMID: 29167726 PMCID: PMC5691171 DOI: 10.18869/nirp.bcn.8.5.395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Introduction: Previous studies have shown that seizure can induce cognitive impairment. On the other hand, soy phytoestrogens, which are mainly found in soybean (Glycine max (L.) Merr.), have beneficial effects on the nervous system. However, little is known about their probable effects on seizure. The present study aimed to examine the probable effects of soy extract, containing the phytoestrogen genistein on seizure-induced cognitive and synaptic plasticity impairment in Ovariectomized (OVX) rats. Methods: Rats were ovariectomized, implanted with guide cannula and then divided into 5 groups (n=7–8 in each group): PBS, KA, Saline-KA, Higher Dose Soy (HDS-KA), and Lower Dose Soy (LDS-KA) groups. Animals of the HDS-KA and LDS-KA groups received intraperitoneal administration of soy extract (20 and 2 mg/kg, respectively) and the Saline-KA group received normal saline once a day for 4 days. Sixty minutes after the last injection, Kainic Acid (KA) or PBS was injected into the left lateral ventricle via pre-implanted guide cannula to induce generalized seizures. The Morris water maze task and in vivo field potential recordings were conducted 7 days later. Results: Soy extract at both doses significantly improved learning impairment and at the higher dose (20 mg/kg) significantly prevented seizure-induced spatial memory impairment and deficit of long-term potentiation in the hippocampus. Conclusion: The soy extract containing the phytoestrogen genistein may have beneficial effects on memory deficit induced by seizure in OVX rats and this effect is accompanied by a beneficial effect on synaptic plasticity.
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Affiliation(s)
- Mehdi Khodamoradi
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Asadi-Shekaari
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Fariba Sharififar
- Herbal and Traditional Medicines Research Center, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Sheibani
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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18
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Westmark CJ. Soy-Based Therapeutic Baby Formulas: Testable Hypotheses Regarding the Pros and Cons. Front Nutr 2017; 3:59. [PMID: 28149839 PMCID: PMC5241282 DOI: 10.3389/fnut.2016.00059] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 12/23/2016] [Indexed: 12/18/2022] Open
Abstract
Soy-based infant formulas have been consumed in the United States since 1909, and currently constitute a significant portion of the infant formula market. There are efforts underway to generate genetically modified soybeans that produce therapeutic agents of interest with the intent to deliver those agents in a soy-based infant formula platform. The threefold purpose of this review article is to first discuss the pros and cons of soy-based infant formulas, then present testable hypotheses to discern the suitability of a soy platform for drug delivery in babies, and finally start a discussion to inform public policy on this important area of infant nutrition.
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Affiliation(s)
- Cara J Westmark
- Department of Neurology, University of Wisconsin , Madison, WI , USA
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19
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Lozano R, Azarang A, Wilaisakditipakorn T, Hagerman RJ. Fragile X syndrome: A review of clinical management. Intractable Rare Dis Res 2016; 5:145-57. [PMID: 27672537 PMCID: PMC4995426 DOI: 10.5582/irdr.2016.01048] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The fragile X mental retardation 1 gene, which codes for the fragile X mental retardation 1 protein, usually has 5 to 40 CGG repeats in the 5' untranslated promoter. The full mutation is the almost always the cause of fragile X syndrome (FXS). The prevalence of FXS is about 1 in 4,000 to 1 in 7,000 in the general population although the prevalence varies in different regions of the world. FXS is the most common inherited cause of intellectual disability and autism. The understanding of the neurobiology of FXS has led to many targeted treatments, but none have cured this disorder. The treatment of the medical problems and associated behaviors remain the most useful intervention for children with FXS. In this review, we focus on the non-pharmacological and pharmacological management of medical and behavioral problems associated with FXS as well as current recommendations for follow-up and surveillance.
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Affiliation(s)
- Reymundo Lozano
- Medical Investigation of Neurodevelopmental Disorders MIND Institute, UC Davis, CA, USA
- Department of Pediatrics, UC Davis, Sacramento, CA, USA
- Address correspondence to: Dr. Reymundo Lozano, Medical Investigation of Neurodevelopmental Disorders MIND Institute, UC Davis, CA, USA; Department of Pediatrics, UC Davis, Sacramento, CA, USA. E-mail:
| | - Atoosa Azarang
- Medical Investigation of Neurodevelopmental Disorders MIND Institute, UC Davis, CA, USA
- Department of Pediatrics, UC Davis, Sacramento, CA, USA
| | - Tanaporn Wilaisakditipakorn
- Medical Investigation of Neurodevelopmental Disorders MIND Institute, UC Davis, CA, USA
- Department of Pediatrics, UC Davis, Sacramento, CA, USA
| | - Randi J Hagerman
- Medical Investigation of Neurodevelopmental Disorders MIND Institute, UC Davis, CA, USA
- Department of Pediatrics, UC Davis, Sacramento, CA, USA
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20
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Schäfer T. Primär- und Sekundärprävention. ALLERGOLOGIE 2016. [DOI: 10.1007/978-3-642-37203-2_60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Ebrahimzadeh Bideskan AR, Lale Ataei M, Mansouri S, Hosseini M. The effects of tamoxifen and soy on dark neuron production in hippocampal formation after pentylenetetrazole-induced repeated seizures in rats. PATHOPHYSIOLOGY 2015; 22:125-35. [DOI: 10.1016/j.pathophys.2015.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 04/10/2015] [Accepted: 04/30/2015] [Indexed: 11/25/2022] Open
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Samsel A, Seneff S. Glyphosate, pathways to modern diseases III: Manganese, neurological diseases, and associated pathologies. Surg Neurol Int 2015; 6:45. [PMID: 25883837 PMCID: PMC4392553 DOI: 10.4103/2152-7806.153876] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/21/2015] [Indexed: 12/20/2022] Open
Abstract
Manganese (Mn) is an often overlooked but important nutrient, required in small amounts for multiple essential functions in the body. A recent study on cows fed genetically modified Roundup(®)-Ready feed revealed a severe depletion of serum Mn. Glyphosate, the active ingredient in Roundup(®), has also been shown to severely deplete Mn levels in plants. Here, we investigate the impact of Mn on physiology, and its association with gut dysbiosis as well as neuropathologies such as autism, Alzheimer's disease (AD), depression, anxiety syndrome, Parkinson's disease (PD), and prion diseases. Glutamate overexpression in the brain in association with autism, AD, and other neurological diseases can be explained by Mn deficiency. Mn superoxide dismutase protects mitochondria from oxidative damage, and mitochondrial dysfunction is a key feature of autism and Alzheimer's. Chondroitin sulfate synthesis depends on Mn, and its deficiency leads to osteoporosis and osteomalacia. Lactobacillus, depleted in autism, depend critically on Mn for antioxidant protection. Lactobacillus probiotics can treat anxiety, which is a comorbidity of autism and chronic fatigue syndrome. Reduced gut Lactobacillus leads to overgrowth of the pathogen, Salmonella, which is resistant to glyphosate toxicity, and Mn plays a role here as well. Sperm motility depends on Mn, and this may partially explain increased rates of infertility and birth defects. We further reason that, under conditions of adequate Mn in the diet, glyphosate, through its disruption of bile acid homeostasis, ironically promotes toxic accumulation of Mn in the brainstem, leading to conditions such as PD and prion diseases.
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Affiliation(s)
- Anthony Samsel
- Research Scientist and Consultant, Deerfield, NH 03037, USA
| | - Stephanie Seneff
- Spoken Language Systems Group, Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge MA 02139, USA
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23
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Schäfer T, Bauer CP, Beyer K, Bufe A, Friedrichs F, Gieler U, Gronke G, Hamelmann E, Hellermann M, Kleinheinz A, Klimek L, Koletzko S, Kopp M, Lau S, Müsken H, Reese I, Schmidt S, Schnadt S, Sitter H, Strömer K, Vagts J, Vogelberg C, Wahn U, Werfel T, Worm M, Muche-Borowski C. S3-Guideline on allergy prevention: 2014 update: Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Society for Pediatric and Adolescent Medicine (DGKJ). ACTA ACUST UNITED AC 2014; 23:186-199. [PMID: 26120530 PMCID: PMC4479452 DOI: 10.1007/s40629-014-0022-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The continued high prevalence of allergic diseases in Western industrialized nations combined with the limited options for causal therapy make evidence-based primary prevention necessary. The recommendations last published in the S3-guideline on allergy prevention in 2009 have been revised and a consensus reached on the basis of an up-to-date systematic literature search. Evidence was sought for the period between May 2008 and May 2013 in the Cochrane and MEDLINE electronic databases, as well as in the reference lists of recent review articles. In addition, experts were surveyed for their opinions. The relevance of retrieved literature was checked by means of two filter processes: firstly according to title and abstract, and secondly based on the full text of the articles. Included studies were given an evidence grade, and a bias potential (low/high) was specified for study quality. A formal consensus on the revised recommendations was reached by representatives of the relevant specialist societies and (self-help) organizations (nominal group process). Of 3,284 hits, 165 studies (one meta-analysis, 15 systematic reviews, 31 randomized controlled trials, 65 cohort studies, 12 case-control studies and 41 cross-sectional studies) were included and evaluated. Recommendations on the following remain largely unaltered: full breastfeeding for 4 months as a means of allergy prevention (hypoallergenic infant formula in the case of infants at risk); avoidance of overweight; fish consumption (during pregnancy/lactation and in the introduction of solid foods for infants); vaccination according to the recommendations of the German Standing Committee on Vaccination (Ständige Impfkommission, STIKO); avoidance of air pollutants and tobacco exposure and avoidance of indoor conditions conducive to the development of mold. The assertion that a reduction in house-dust mite allergen content as a primary preventive measure is not recommended also remains unchanged. The introduction of solid foods into infant diet should not be delayed. In the case of children at risk cats should not be acquired as domestic pets. Keeping dogs is not associated with an increased risk of allergy. The updated guideline includes a new recommendation to consider the increased risk of asthma following delivery by cesarean section. Additional statements have been formulated on pre- and probiotic agents, psychosocial factors, medications, and various nutritional components. Revising the guideline by using an extensive evidence base has resulted not only in an endorsement of the existing recommendations, but also in modifications and in the addition of new recommendations. The updated guideline enables evidence-based and up-to-date recommendations to be made on allergy prevention.
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Affiliation(s)
| | | | - Kirsten Beyer
- Charité Allergy Center, Clinic for Pediatrics with Special Focus on Pneumology and Immunology, Charité University Hospital, Berlin, Germany
| | - Albrecht Bufe
- Department of Experimental Pneumology, Ruhr University Bochum, Bochum, Germany
| | | | - Uwe Gieler
- Dermatological Clinic, Gießen and Marburg University Clinic, Gießen site, Gießen, Germany
| | | | - Eckard Hamelmann
- Clinic for Pediatric Medicine, Ruhr University Bochum, Bochum, Germany
| | | | | | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Sibylle Koletzko
- Dr. von Haunersches Children's Hospital, Pediatric Clinic and Pediatric Polyclinic of the Ludwig Maximilian University, Munich, Germany
| | - Matthias Kopp
- Clinic for Pediatric Medicine, Schleswig-Holstein University Clinic, Lübeck Campus, Lübeck, Germany
| | - Susanne Lau
- Charité Allergy Center, Clinic for Pediatrics with Special Focus on Pneumology and Immunology, Charité University Hospital, Berlin, Germany
| | | | - Imke Reese
- Nutrition Counseling and Therapy with Special Focus on Allergology, Munich, Germany
| | | | - Sabine Schnadt
- German Allergy and Asthma Association, Monchengladbach, Germany
| | - Helmut Sitter
- Institute for Theoretical Surgery, Marburg University, Marburg, Germany
| | - Klaus Strömer
- Professional Association of German Dermatologists, Mönchengladbach, Germany
| | - Jennifer Vagts
- Dermatological Center, Elbe Clinics Stade/Buxtehude, Buxtehude, Germany
| | - Christian Vogelberg
- Clinic and Polyclinic for Pediatric Medicine, Carl Gustav Carus University Clinic, Dresden, Germany
| | - Ulrich Wahn
- Charité Allergy Center, Clinic for Pediatrics with Special Focus on Pneumology and Immunology, Charité University Hospital, Berlin, Germany
| | - Thomas Werfel
- Clinic and Polyclinic for Dermatology and Venereology, Hannover Medical School, Hannover, Germany
| | - Margitta Worm
- Charité Allergy Center, Clinic for Dermatology, Venereology, and Allergology, Charité University Hospital, Charité Campus Mitte, Berlin, Germany
| | - Cathleen Muche-Borowski
- German Association of the Scientific Medical Societies, Marburg, Germany ; Institute for General Medicine, Hamburg-Eppendorf University Clinic, Germany, Germany
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25
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Westmark CJ. A hypothesis regarding the molecular mechanism underlying dietary soy-induced effects on seizure propensity. Front Neurol 2014; 5:169. [PMID: 25232349 PMCID: PMC4153031 DOI: 10.3389/fneur.2014.00169] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 08/21/2014] [Indexed: 11/13/2022] Open
Abstract
Numerous neurological disorders including fragile X syndrome, Down syndrome, autism, and Alzheimer’s disease are co-morbid with epilepsy. We have observed elevated seizure propensity in mouse models of these disorders dependent on diet. Specifically, soy-based diets exacerbate audiogenic-induced seizures in juvenile mice. We have also found potential associations between the consumption of soy-based infant formula and seizure incidence, epilepsy comorbidity, and autism diagnostic scores in autistic children by retrospective analyses of medical record data. In total, these data suggest that consumption of high levels of soy protein during postnatal development may affect neuronal excitability. Herein, we present our theory regarding the molecular mechanism underlying soy-induced effects on seizure propensity. We hypothesize that soy phytoestrogens interfere with metabotropic glutamate receptor signaling through an estrogen receptor-dependent mechanism, which results in elevated production of key synaptic proteins and decreased seizure threshold.
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Affiliation(s)
- Cara Jean Westmark
- Department of Neurology, Medical Sciences Center, University of Wisconsin , Madison, WI , USA
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Abstract
The effects of soy-based infant formulas on childhood development are not well understood. This exploratory study evaluates the severity of autistic behaviors in association with the use of soy-based infant formula in a population of high-functioning autistic children. Medical record data were analyzed from the Simons Foundation Autism Research Initiative Simplex Collection, which included data on infant formula use and autism diagnostic scores for 1,949 autistic children. We found exploratory associations between the use of soy-based infant formula and several autistic behaviors as assessed by line-item analysis of the Aberrant Behavior Checklist, Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. This study provides preliminary data that the use of soy-based infant formula may be associated with specific autistic behaviors.
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