1
|
D’Adamo CR, Nelson JL, Miller SN, Rickert Hong M, Lambert E, Tallman Ruhm H. Reversal of Autism Symptoms among Dizygotic Twins through a Personalized Lifestyle and Environmental Modification Approach: A Case Report and Review of the Literature. J Pers Med 2024; 14:641. [PMID: 38929862 PMCID: PMC11205016 DOI: 10.3390/jpm14060641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/04/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
The prevalence of autism has been increasing at an alarming rate. Even accounting for the expansion of autism spectrum disorder diagnostic (ASD) criteria throughout the 1990's, there has been an over 300% increase in ASD prevalence since the year 2000. The often debilitating personal, familial, and societal sequelae of autism are generally believed to be lifelong. However, there have been several encouraging case reports demonstrating the reversal of autism diagnoses, with a therapeutic focus on addressing the environmental and modifiable lifestyle factors believed to be largely underlying the condition. This case report describes the reversal of autism symptoms among dizygotic, female twin toddlers and provides a review of related literature describing associations between modifiable lifestyle factors, environmental exposures, and various clinical approaches to treating autism. The twins were diagnosed with Level 3 severity ASD "requiring very substantial support" at approximately 20 months of age following concerns of limited verbal and non-verbal communication, repetitive behaviors, rigidity around transitions, and extensive gastrointestinal symptoms, among other common symptoms. A parent-driven, multidisciplinary, therapeutic intervention involving a variety of licensed clinicians focusing primarily on addressing environmental and modifiable lifestyle factors was personalized to each of the twin's symptoms, labs, and other outcome measures. Dramatic improvements were noted within several months in most domains of the twins' symptoms, which manifested in reductions of Autism Treatment Evaluation Checklist (ATEC) scores from 76 to 32 in one of the twins and from 43 to 4 in the other twin. The improvement in symptoms and ATEC scores has remained relatively stable for six months at last assessment. While prospective studies are required, this case offers further encouraging evidence of ASD reversal through a personalized, multidisciplinary approach focusing predominantly on addressing modifiable environmental and lifestyle risk factors.
Collapse
Affiliation(s)
- Christopher R. D’Adamo
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Documenting Hope, Windsor, CT 06095, USA; (J.L.N.); (M.R.H.); (E.L.); (H.T.R.)
| | - Josephine L. Nelson
- Documenting Hope, Windsor, CT 06095, USA; (J.L.N.); (M.R.H.); (E.L.); (H.T.R.)
| | - Sara N. Miller
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Maria Rickert Hong
- Documenting Hope, Windsor, CT 06095, USA; (J.L.N.); (M.R.H.); (E.L.); (H.T.R.)
| | - Elizabeth Lambert
- Documenting Hope, Windsor, CT 06095, USA; (J.L.N.); (M.R.H.); (E.L.); (H.T.R.)
| | | |
Collapse
|
2
|
Al-Beltagi M. Pre-autism: What a paediatrician should know about early diagnosis of autism. World J Clin Pediatr 2023; 12:273-294. [PMID: 38178935 PMCID: PMC10762597 DOI: 10.5409/wjcp.v12.i5.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/07/2023] [Accepted: 09/25/2023] [Indexed: 12/08/2023] Open
Abstract
Autism, also known as an autism spectrum disorder, is a complex neurodevelopmental disorder usually diagnosed in the first three years of a child's life. A range of symptoms characterizes it and can be diagnosed at any age, including adolescence and adulthood. However, early diagnosis is crucial for effective management, prognosis, and care. Unfortunately, there are no established fetal, prenatal, or newborn screening programs for autism, making early detection difficult. This review aims to shed light on the early detection of autism prenatally, natally, and early in life, during a stage we call as "pre-autism" when typical symptoms are not yet apparent. Some fetal, neonatal, and infant biomarkers may predict an increased risk of autism in the coming baby. By developing a biomarker array, we can create an objective diagnostic tool to diagnose and rank the severity of autism for each patient. These biomarkers could be genetic, immunological, hormonal, metabolic, amino acids, acute phase reactants, neonatal brainstem function biophysical activity, behavioral profile, body measurements, or radiological markers. However, every biomarker has its accuracy and limitations. Several factors can make early detection of autism a real challenge. To improve early detection, we need to overcome various challenges, such as raising community awareness of early signs of autism, improving access to diagnostic tools, reducing the stigma attached to the diagnosis of autism, and addressing various culturally sensitive concepts related to the disorder.
Collapse
Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Dr. Sulaiman Al Habib Medical Group, Manama 26671, Manama, Bahrain
| |
Collapse
|
3
|
Zhang‐James Y, Buitelaar JK, van Rooij D, Faraone SV. Ensemble classification of autism spectrum disorder using structural magnetic resonance imaging features. JCPP ADVANCES 2021; 1:e12042. [PMID: 37431438 PMCID: PMC10242907 DOI: 10.1002/jcv2.12042] [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: 04/20/2021] [Accepted: 09/14/2021] [Indexed: 11/08/2022] Open
Abstract
Background Autism spectrum disorder (ASD) is characterized by a spectrum of social and communication impairments and rigid and stereotyped behaviors that have a neurodevelopmental origin. Although many imaging studies have reported structural and functional alterations in multiple brain regions, clinically useful diagnostic imaging biomarkers for ASD remain unavailable. Methods In this study, we applied machine learning (ML) models to regional volumetric and cortical thickness data from the largest structural magnetic resonance imaging (sMRI) dataset available from the Enhancing Neuro Imaging Genetics Through Meta-Analysis (ENIGMA) consortium (1833 subjects with ASD and 1838 without ASD; age range: 1.5-64; average age: 15.6; male/female ratio: 4.2:1). Results The highest classification accuracy on a hold-out test set was achieved using a stacked Extra Tree Classifier. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.62 (95% confidence interval [CI]: 0.57, 0.68) and the area under the precision-recall curve was 0.58. Learning curve analysis showed the good fit of the model and suggests that more training examples will not likely benefit model performance. Conclusions Our results suggest that sMRI volumetric and cortical thickness data alone may not provide clinically sufficient useful diagnostic biomarkers for ASD. Developing clinically useful imaging classifiers for ASD will benefit from combining other data modalities or feature types, such as functional MRI data and raw images that can leverage other machine learning (ML) techniques such as convolutional neural networks.
Collapse
Affiliation(s)
- Yanli Zhang‐James
- Department of Psychiatry and Behavioral SciencesSUNY Upstate Medical UniversitySyracuseNew YorkUSA
| | - Jan K. Buitelaar
- Radboudumc, Radboud University Medical CenterNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and BehaviourRadboud University Medical CenterNijmegenThe Netherlands
- Department of Cognitive NeuroscienceRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Daan van Rooij
- Donders Centre for Cognitive NeuroimagingRadboud University Medical CenterNijmegenThe Netherlands
| | - Stephen V. Faraone
- Department of Psychiatry and Behavioral SciencesSUNY Upstate Medical UniversitySyracuseNew YorkUSA
- Department of Neuroscience and PhysiologySUNY Upstate Medical UniversitySyracuseNew YorkUSA
| |
Collapse
|
4
|
Non-classical human leukocyte antigen class I in Tunisian children with autism. Cent Eur J Immunol 2021; 45:176-183. [PMID: 33456328 PMCID: PMC7792448 DOI: 10.5114/ceji.2020.97906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/16/2018] [Indexed: 11/17/2022] Open
Abstract
Autism spectrum disorders (ASD) are one of the most common childhood morbidities characterized by deficits in communication and social skills. Increasing evidence has suggested associations between immune genes located in the human leukocyte antigen (HLA) complex and etiology of autism. In this study, we investigated whether the non-classical class I HLA-G, -E, and -F polymorphisms are associated with genetic predisposition to autism in Tunisia. We aimed to find a correlation between HLA-G genotypes and soluble HLA-G (sHLA-G) levels. We have analyzed the HLA-G, -E, and -F genotypes of 15 autistic children and their parents. DNA typing of HLA class I genes was performed using PCR-SSP and PCR-RFLP methods. Also, we evaluated the serum levels of HLA-G (1 and 5) by a validated ELISA technique in autistic probands and their parents. No association was found between any polymorphism and autism in the study subjects. Additionally, we found no correlation between sHLA-G1 and sHLA-G5 and autism. Also, no significant difference in sHLA-G testing in parents and offspring was found. However, parents carrying [GG] genotype presented a higher sHLA-G levels than those carrying ([CC]+[GC]) genotypes (p = 0.037). From this preliminary study, we conclude that the investigated polymorphisms of HLA-G, -E, and -F genes did not lead to autism susceptibility in Tunisian children. However, the CGTIGA haplotype was found to be associated with the disease.
Collapse
|
5
|
Castejon AM, Spaw JA, Rozenfeld I, Sheinberg N, Kabot S, Shaw A, Hardigan P, Faillace R, Packer EE. Improving Antioxidant Capacity in Children With Autism: A Randomized, Double-Blind Controlled Study With Cysteine-Rich Whey Protein. Front Psychiatry 2021; 12:669089. [PMID: 34658941 PMCID: PMC8514994 DOI: 10.3389/fpsyt.2021.669089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/16/2021] [Indexed: 12/27/2022] Open
Abstract
Previous studies indicate that children with autism spectrum disorder (ASD) have lower levels of glutathione. Nutritional interventions aim to increase glutathione levels suggest a positive effect on ASD behaviors, but findings are mixed or non-significant. A commercially available nutritional supplement comprising a cysteine-rich whey protein isolate (CRWP), a potent precursor of glutathione, was previously found to be safe and effective at raising glutathione in several conditions associated with low antioxidant capacity. Therefore, we investigated the effectiveness of a 90-day CRWP intervention in children with ASD and examined whether intracellular reduced and oxidized glutathione improvements correlated with behavioral changes. We enrolled 46 (of 81 screened) 3-5-year-old preschool children with confirmed ASD. Using a double-blind, randomized, placebo-controlled design, we evaluated the effectiveness of daily CRWP (powder form: 0.5 g/kg for children <20 kg or a 10-g dose for those >20 kg), compared with placebo (rice protein mimicking the protein load in the intervention group), on glutathione levels and ASD behaviors assessed using different behavioral scales such as Childhood Autism Rated Scale, Preschool Language Scale, Social Communication Questionnaire, Childhood Behavioral Checklist and the parent-rated Vineland Adaptive Behavior Scale, 2nd edition (VABS-II). Forty children (CRWP, 21; placebo, 19) completed the 90-day treatment period. Improvements observed in some behavioral scales were comparable. However, the VABS-II behavioral assessment, demonstrated significant changes only in children receiving CRWP compared to those observed in the placebo group in the composite score (effect size 0.98; 95% confidence intervals 1.42-4.02; p = 0.03). Further, several VABS-II domain scores such as adaptive behavior (p = 0.03), socialization (p = 0.03), maladaptive behavior (p = 0.04) and internalizing behavior (p = 0.02) also indicated significant changes. Children assigned to the CRWP group showed significant increases in glutathione levels (p = 0.04) compared to those in the placebo group. A subanalysis of the VABS-II scale results comparing responders (>1 SD change from baseline to follow up) and non-responders in the CRWP group identified older age and higher levels of total and reduced glutathione as factors associated with a response. CRWP nutritional intervention in children with ASD significantly improved both glutathione levels and some behaviors associated with ASD. Further studies are needed to confirm these results. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/study/NCT01366859, identifier: NCT01366859.
Collapse
Affiliation(s)
- Ana Maria Castejon
- Department of Pharmaceutical Sciences, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Jordan Ashley Spaw
- Department of Pharmaceutical Sciences, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Irina Rozenfeld
- Center for Collaborative Research, Institute for Neuro Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Nurit Sheinberg
- Mailman Segal Center, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Susan Kabot
- Mailman Segal Center, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Alexander Shaw
- Department of Pharmaceutical Sciences, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Patrick Hardigan
- Statistical Consulting Center, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Rogerio Faillace
- Department of Pediatrics, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Edward E Packer
- Department of Pediatrics, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| |
Collapse
|
6
|
Bernie C, Williams K, O'Connor B, Rogers S, May T. Referral, Assessment and Use of Screening Measures Related to Autism Spectrum Disorder at a Tertiary Hospital Setting. J Autism Dev Disord 2020; 51:2673-2685. [PMID: 33034784 DOI: 10.1007/s10803-020-04725-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Children with developmental concerns in Australia continue to experience inequitable healthcare and service-related delays, even when diagnostic risk is identified. This study sought to explore service and demographic pathway factors leading up to autism spectrum disorder (ASD) assessment, including value of screening measures applied at triage. Following a trial of centralised intake for referred young children with suspected ASD, observational, retrospective pathway data was explored using bivariate and regression analyses. The mean age of 159 children referred with autism symptoms was 3.6 years, and 64% were diagnosed with ASD. Service allocation was associated with diagnosis, whilst screening tool results were not. Improved pathways are needed to limit wasted waiting times and direct each child to needs-based services.
Collapse
Affiliation(s)
- C Bernie
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, 3058, Victoria, Australia.
- Department of Allied Health, The Royal Children's Hospital, Melbourne, VIC, Australia.
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - K Williams
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, 3058, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
- Department of Developmental Paediatrics, Monash Children's Hospital, Clayton, VIC, Australia
| | - B O'Connor
- Department of Allied Health, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - S Rogers
- Department of Allied Health, The Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Health and Human Services, Melbourne, VIC, Australia
| | - T May
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
| |
Collapse
|
7
|
Graham SF, Turkoglu O, Yilmaz A, Ustun I, Ugur Z, Bjorndhal T, Han B, Mandal R, Wishart D, Bahado-Singh RO. Targeted metabolomics highlights perturbed metabolism in the brain of autism spectrum disorder sufferers. Metabolomics 2020; 16:59. [PMID: 32333121 DOI: 10.1007/s11306-020-01685-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 04/17/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by deficiencies in social interactions and communication, combined with restricted and repetitive behavioral issues. OBJECTIVES As little is known about the etiopathophysiology of ASD and early diagnosis is relatively subjective, we aim to employ a targeted, fully quantitative metabolomics approach to biochemically profile post-mortem human brain with the overall goal of identifying metabolic pathways that may have been perturbed as a result of the disease while uncovering potential central diagnostic biomarkers. METHODS Using a combination of 1H NMR and DI/LC-MS/MS we quantitatively profiled the metabolome of the posterolateral cerebellum from post-mortem human brain harvested from people who suffered with ASD (n = 11) and compared them with age-matched controls (n = 10). RESULTS We accurately identified and quantified 203 metabolites in post-mortem brain extracts and performed a metabolite set enrichment analyses identifying 3 metabolic pathways as significantly perturbed (p < 0.05). These include Pyrimidine, Ubiquinone and Vitamin K metabolism. Further, using a variety of machine-based learning algorithms, we identified a panel of central biomarkers (9-hexadecenoylcarnitine (C16:1) and the phosphatidylcholine PC ae C36:1) capable of discriminating between ASD and controls with an AUC = 0.855 with a sensitivity and specificity equal to 0.80 and 0.818, respectively. CONCLUSION For the first time, we report the use of a multi-platform metabolomics approach to biochemically profile brain from people with ASD and report several metabolic pathways which are perturbed in the diseased brain of ASD sufferers. Further, we identified a panel of biomarkers capable of distinguishing ASD from control brains. We believe that these central biomarkers may be useful for diagnosing ASD in more accessible biomatrices.
Collapse
Affiliation(s)
- Stewart F Graham
- Oakland University-William Beaumont School of Medicine, Rochester, MI, 48309, USA.
- Research Institute, Metabolomics Division, Beaumont Health, Royal Oak, MI, 48073, USA.
| | - Onur Turkoglu
- Oakland University-William Beaumont School of Medicine, Rochester, MI, 48309, USA
| | - Ali Yilmaz
- Oakland University-William Beaumont School of Medicine, Rochester, MI, 48309, USA
- Research Institute, Metabolomics Division, Beaumont Health, Royal Oak, MI, 48073, USA
| | - Ilyas Ustun
- Wayne State University, Civil and Environmental Engineering, Detroit, MI, USA
| | - Zafer Ugur
- Oakland University-William Beaumont School of Medicine, Rochester, MI, 48309, USA
- Research Institute, Metabolomics Division, Beaumont Health, Royal Oak, MI, 48073, USA
| | - Trent Bjorndhal
- Department of Biological and Computing Sciences, University of Alberta, Edmonton, AB, Canada
| | - BeomSoo Han
- Department of Biological and Computing Sciences, University of Alberta, Edmonton, AB, Canada
| | - Rupa Mandal
- Department of Biological and Computing Sciences, University of Alberta, Edmonton, AB, Canada
| | - David Wishart
- Department of Biological and Computing Sciences, University of Alberta, Edmonton, AB, Canada
| | - Ray O Bahado-Singh
- Oakland University-William Beaumont School of Medicine, Rochester, MI, 48309, USA
| |
Collapse
|
8
|
The Prevalence of Insomnia and the Link between Iron Metabolism Genes Polymorphisms, TF rs1049296 C>T, TF rs3811647 G>A, TFR rs7385804 A>C, HAMP rs10421768 A>G and Sleep Disorders in Polish Individuals with ASD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020400. [PMID: 31936202 PMCID: PMC7014185 DOI: 10.3390/ijerph17020400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023]
Abstract
Iron deficiency have been found to be linked to sleep disorders. Both genetic and environmental factors are risk factors for skewed iron metabolism, thus sleep disruptions in autism spectrum disorders (ASD). The aim of our study was to assess the prevalence of single nucleotide polymorphisms (SNPs) within transferrin gene (TF) rs1049296 C>T, rs3811647 G>A, transferrin receptor gene (TFR) rs7385804 A>C, and hepcidin antimicrobial peptide gene (HAMP) rs10421768 A>G in Polish individuals with ASD and their impact on sleep pattern. There were 61 Caucasian participants with ASD and 57 non-ASD controls enrolled. Genotypes were determined by real-time PCR using TaqMan SNP assays. The Athens Insomnia Scale (AIS) was used to identify sleep disruptions. There were 32 cases (57.14%) with insomnia identified. In the ASD group, the defined counts of genotypes were as follows: TF rs1049296, C/C n = 41 and C/T n = 20; TF rs3811647, G/G n = 22, G/A n = 34, and A/A n = 5; TFR rs7385804, A/A n = 22, A/C n = 29, and C/C n = 10; and HAMP rs10421768, A/A n = 34, A/G n = 23, and G/G n = 4. There were no homozygous carriers of the TF rs1049296 C>T minor allele in the ASD group. All analyzed SNPs were not found to be linked to insomnia. The investigated polymorphisms are not predictors of sleep disorders in the analyzed cohort of individuals with ASD.
Collapse
|
9
|
Efficacy and tolerability of riluzole in psychiatric disorders: A systematic review and preliminary meta-analysis. Psychiatry Res 2019; 278:294-302. [PMID: 31254879 DOI: 10.1016/j.psychres.2019.06.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/16/2019] [Accepted: 06/16/2019] [Indexed: 12/15/2022]
Abstract
There is a pressing need for better pharmacological treatment strategies for psychiatric disorders as current treatment often results in partial symptom remission and unwanted side effects. A point of entry may be the glutamatergic system since glutamatergic dysregulation contributes to multiple psychiatric disorders. We evaluated the evidence from randomized controlled trials (RCTs) regarding the use of the glutamatergic drug riluzole in mental illnesses; and conducted preliminary meta-analyses of its effectiveness in treating obsessive-compulsive disorder (OCD) and depression. A systematic search was performed using PubMed (Medline), Embase, Cochrane Database of Systematic Reviews and PsycINFO. Meta-analyses were performed using Comprehensive Meta-Analysis software. Twenty-three RCTs were included for qualitative analysis and showed positive effects of adjunctive/monotherapy riluzole in patients with OCD, depression, autism, substance abuse and schizophrenia. Seven studies were also used for quantitative analysis, which revealed positive but non-significant effects on OCD and depression. Riluzole was generally well tolerated with few serious adverse events. The studies included in this systematic review were highly heterogeneous and the number of studies was limited per diagnostic condition. Moreover, few studies have examined riluzole as a single treatment. We suggest carrying out further work to provide definitive evidence for the benefit of riluzole in psychiatric illness.
Collapse
|
10
|
Shomrat T, Nesher N. Updated View on the Relation of the Pineal Gland to Autism Spectrum Disorders. Front Endocrinol (Lausanne) 2019; 10:37. [PMID: 30804889 PMCID: PMC6370651 DOI: 10.3389/fendo.2019.00037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/16/2019] [Indexed: 12/20/2022] Open
Abstract
Identification of the biological features of autism is essential for designing an efficient treatment and for prevention of the disorder. Though the subject of extensive research, the neurophysiological features of autism remain unclear. One of the proposed biological causes of autism is malfunction of the pineal gland and deficiency of its principal hormone, melatonin. The main function of melatonin is to link and synchronize the body's homeostasis processes to the circadian and seasonal rhythms, and to regulate the sleep-wake cycle. Therefore, pineal dysfunction has been implicated based on the common observation of low melatonin levels and sleep disorders associated with autism. In this perspective, we highlight several recent findings that support the hypothesis of pineal gland/melatonin involvement in autism. Another common symptom of autism is abnormal neuroplasticity, such as cortical overgrowth and dendritic spine dysgenesis. Here, we synthesize recent information and speculate on the possibility that this abnormal neuroplasticity is caused by hyperactivity of endogenous N,N-dimethyltryptamine (DMT). The pineal gland was proposed as the source of DMT in the brain and therefore, our assumption is that besides melatonin deficiency, pineal dysfunction might also play a part in the development of autism through abnormal metabolism of DMT. We hope that this manuscript will encourage future research of the DMT hypothesis and reexamination of several observations that were previously attributed to other factors, to see if they could be related to pineal gland/melatonin malfunction. Such research could contribute to the development of autism treatment by exogenous melatonin and monitored light exposure.
Collapse
|
11
|
Drozd HP, Karathanasis SF, Molosh AI, Lukkes JL, Clapp DW, Shekhar A. From bedside to bench and back: Translating ASD models. PROGRESS IN BRAIN RESEARCH 2018; 241:113-158. [PMID: 30447753 DOI: 10.1016/bs.pbr.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Autism spectrum disorders (ASD) represent a heterogeneous group of disorders defined by deficits in social interaction/communication and restricted interests, behaviors, or activities. Models of ASD, developed based on clinical data and observations, are used in basic science, the "bench," to better understand the pathophysiology of ASD and provide therapeutic options for patients in the clinic, the "bedside." Translational medicine creates a bridge between the bench and bedside that allows for clinical and basic science discoveries to challenge one another to improve the opportunities to bring novel therapies to patients. From the clinical side, biomarker work is expanding our understanding of possible mechanisms of ASD through measures of behavior, genetics, imaging modalities, and serum markers. These biomarkers could help to subclassify patients with ASD in order to better target treatments to a more homogeneous groups of patients most likely to respond to a candidate therapy. In turn, basic science has been responding to developments in clinical evaluation by improving bench models to mechanistically and phenotypically recapitulate the ASD phenotypes observed in clinic. While genetic models are identifying novel therapeutics targets at the bench, the clinical efforts are making progress by defining better outcome measures that are most representative of meaningful patient responses. In this review, we discuss some of these challenges in translational research in ASD and strategies for the bench and bedside to bridge the gap to achieve better benefits to patients.
Collapse
Affiliation(s)
- Hayley P Drozd
- Program in Medical Neurobiology, Stark Neurosciences Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Sotirios F Karathanasis
- Program in Medical Neurobiology, Stark Neurosciences Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Andrei I Molosh
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Jodi L Lukkes
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - D Wade Clapp
- Department of Pediatrics, Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Anantha Shekhar
- Program in Medical Neurobiology, Stark Neurosciences Institute, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States; Indiana Clinical and Translation Sciences Institute, Indiana University School of Medicine, Indianapolis, IN, United States.
| |
Collapse
|
12
|
Bitar T, Mavel S, Emond P, Nadal-Desbarats L, Lefèvre A, Mattar H, Soufia M, Blasco H, Vourc’h P, Hleihel W, Andres CR. Identification of metabolic pathway disturbances using multimodal metabolomics in autistic disorders in a Middle Eastern population. J Pharm Biomed Anal 2018; 152:57-65. [DOI: 10.1016/j.jpba.2018.01.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/17/2017] [Accepted: 01/06/2018] [Indexed: 12/21/2022]
|
13
|
Esnafoglu E, Ayyıldız SN, Cırrık S, Erturk EY, Erdil A, Daglı A, Noyan T. Evaluation of serum Neuron‐specific enolase, S100B, myelin basic protein and glial fibrilliary acidic protein as brain specific proteins in children with autism spectrum disorder. Int J Dev Neurosci 2017; 61:86-91. [DOI: 10.1016/j.ijdevneu.2017.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/12/2017] [Accepted: 06/30/2017] [Indexed: 12/11/2022] Open
Affiliation(s)
- Erman Esnafoglu
- Department of Child and Adolescent PsychiatryTraining and Research HospitalFaculty of MedicineOrdu UniversityOrduTurkey
| | - Sema Nur Ayyıldız
- Department of BiochemistryTraining and Research HospitalFaculty of MedicineOrdu UniversityOrduTurkey
| | - Selma Cırrık
- Department of Medical Physiology, Faculty of MedicineOrdu UniversityOrduTurkey
| | - Emine Yurdakul Erturk
- Department of PediatryTraining and Research HospitalFaculty of MedicineOrdu UniversityOrduTurkey
| | - Abdullah Erdil
- Department of PediatryTraining and Research HospitalFaculty of MedicineOrdu UniversityOrduTurkey
| | - Abdullah Daglı
- Department of PediatryTraining and Research HospitalFaculty of MedicineOrdu UniversityOrduTurkey
| | - Tevfik Noyan
- Department of BiochemistryTraining and Research HospitalFaculty of MedicineOrdu UniversityOrduTurkey
| |
Collapse
|
14
|
Anwar A, Marini M, Abruzzo PM, Bolotta A, Ghezzo A, Visconti P, Thornalley PJ, Rabbani N. Quantitation of plasma thiamine, related metabolites and plasma protein oxidative damage markers in children with autism spectrum disorder and healthy controls. Free Radic Res 2016; 50:S85-S90. [PMID: 27667096 DOI: 10.1080/10715762.2016.1239821] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIMS/HYPOTHESIS To assess thiamine and related metabolite status by analysis of plasma and urine in autistic children and healthy controls, correlations to clinical characteristics and link to plasma protein markers of oxidative damage. METHODS 27 children with autism (21 males and 6 females) and 21 (15 males and 6 females) age-matched healthy control children were recruited. The concentration of thiamine and related phosphorylated metabolites in plasma and urine and plasma protein content of dityrosine, N-formylkynurenine and 3-nitrotyrosine was determined. RESULTS Plasma thiamine and thiamine monophosphate concentrations were similar in both study groups (median [lower-upper quartile]): autistic children - 6.60 nM (4.48-8.91) and 7.00 nM (5.51-8.55), and healthy controls - 6.82 nM (4.47-7.02) and 6.82 nM (5.84-8.91), respectively. Thiamine pyrophosphate (TPP) was decreased 24% in autistic children compared to healthy controls: 6.82 nM (5.81-8.52) versus 9.00 nM (8.41-10.71), p < .01. Urinary excretion of thiamine and fractional renal clearance of thiamine did not change between the groups. No correlation was observed between clinical markers and the plasma and urine thiamine concentration. Plasma protein dityrosine content was increased 88% in ASD. Other oxidative markers were unchanged. CONCLUSIONS/INTERPRETATION Autistic children had normal plasma and urinary thiamine levels whereas plasma TPP concentration was decreased. The latter may be linked to abnormal tissue handling and/or absorption from gut microbiota of TPP which warrants further investigation. Increased plasma protein dityrosine may reflect increased dual oxidase activity in response to change in mucosal immunity and host-microbe homeostasis.
Collapse
Affiliation(s)
- Attia Anwar
- a Warwick Medical School, Clinical Sciences Research Laboratories , University of Warwick, University Hospital Coventry , Coventry , UK
| | - Marina Marini
- b Department of Experimental, Diagnostic and Specialty Medicine , School of Medicine, University of Bologna , Bologna , Italy.,c Don Carlo Gnocchi Foundation ONLUS, IRCCS "S. Maria Nascente" , Milan , Italy
| | - Provvidenza Maria Abruzzo
- b Department of Experimental, Diagnostic and Specialty Medicine , School of Medicine, University of Bologna , Bologna , Italy.,c Don Carlo Gnocchi Foundation ONLUS, IRCCS "S. Maria Nascente" , Milan , Italy
| | - Alessandra Bolotta
- b Department of Experimental, Diagnostic and Specialty Medicine , School of Medicine, University of Bologna , Bologna , Italy.,c Don Carlo Gnocchi Foundation ONLUS, IRCCS "S. Maria Nascente" , Milan , Italy
| | - Alessandro Ghezzo
- b Department of Experimental, Diagnostic and Specialty Medicine , School of Medicine, University of Bologna , Bologna , Italy
| | - Paola Visconti
- d Child Neurology and Psychiatry Unit , IRCCS Institute of Neurological Sciences , Bologna , Italy
| | - Paul J Thornalley
- a Warwick Medical School, Clinical Sciences Research Laboratories , University of Warwick, University Hospital Coventry , Coventry , UK.,e Warwick Systems Biology, Clinical Sciences Research Laboratories , University of Warwick, University Hospital Coventry , Coventry , UK
| | - Naila Rabbani
- e Warwick Systems Biology, Clinical Sciences Research Laboratories , University of Warwick, University Hospital Coventry , Coventry , UK
| |
Collapse
|
15
|
Abstract
Excitatory neurotransmitter signaling through glutamate receptors modulates cognitive functions such as memory and learning, which are usually impaired in autism spectrum disorders (ASD). The aim of this study was to assess the clinical significance of plasma glutamate levels in ASD. Fifty-one children diagnosed with ASD, 51 typically developing children, and 51 children with intellectual disability matched for sex and age were assessed for plasma glutamate at admission. Plasma levels of glutamate were measured by liquid chromatography-tandem mass spectrometry and the severity of ASD was evaluated using the Childhood Autism Rating Scale Score. We found that the mean plasma glutamate levels were significantly (P<0.0001) higher in children with ASD compared with healthy controls and intellectual disability controls [36.1 (SD: 8.3) vs. 23.4 (4.2) vs. 24.7 (4.6) µM; P<0.001, respectively]. Levels of glutamate increased with increasing severity of ASD as defined by the Childhood Autism Rating Scale score. Receiver operating characteristics to diagnose ASD showed areas under the curve of glutamate of 0.92 [95% confidence interval (CI), 0.87-0.96], which was superior to high-sensitivity C-reactive protein [0.64 (95% CI, 0.55-0.75), P<0.001] and homocysteine (area under the curve, 0.72; 95% CI, 0.64-0.81; P<0.000). In multivariate logistic regression analysis, glutamate was an independent diagnosis indicator of ASD with an adjusted odds ratio of 1.362 (95% CI, 1.164-1.512; P<0.0001). The present study shows that autistic children had higher plasma levels of glutamate and elevated plasma glutamate levels may play an important role in the pathogenesis of autism. Further larger studies are required to support our findings.
Collapse
|
16
|
Skonieczna-Żydecka K, Gorzkowska I, Pierzak-Sominka J, Adler G. The Prevalence of Autism Spectrum Disorders in West Pomeranian and Pomeranian Regions of Poland. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:283-289. [PMID: 26771078 DOI: 10.1111/jar.12238] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The prevalence of autism spectrum disorders (ASD) varies worldwide from 1.4/10 000 children in the Arabian Peninsula to 185/10 000 children of Asian population. In Europe, the highest prevalence has been observed in Sweden, while the lowest in Croatia (115/10 000 and 2-3/10 000, respectively). There have been no epidemiological studies on the prevalence of ASD in Polish population. The aim of our study was to assess the prevalence of ASD in children aged 0-16 years, inhabitants of West Pomeranian and Pomeranian regions. MATERIAL AND METHODS In total, 2514 children (2038 males, 81.1%) were included. The estimates were based on the government registries, whereas data were obtained from Provincial Disability Services Commissions. RESULTS The prevalence of ASD in children aged 0-16 years varies between two regions of Poland - 32/10 000 in West Pomeranian and 38/10 000 in Pomeranian region. CONCLUSIONS The average prevalence of ASD was 35/10 000 children and was about 4-fold higher in males (P < 0.05). More studies are necessary.
Collapse
Affiliation(s)
| | - Izabela Gorzkowska
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | | | - Grażyna Adler
- Department of Gerontobiology, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
17
|
Perspective Biological Markers for Autism Spectrum Disorders: Advantages of the Use of Receiver Operating Characteristic Curves in Evaluating Marker Sensitivity and Specificity. DISEASE MARKERS 2015; 2015:329607. [PMID: 26648598 PMCID: PMC4655021 DOI: 10.1155/2015/329607] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/08/2015] [Accepted: 10/11/2015] [Indexed: 12/15/2022]
Abstract
Autism Spectrum Disorders (ASD) are a heterogeneous group of neurodevelopmental disorders. Recognized causes of ASD include genetic factors, metabolic diseases, toxic and environmental factors, and a combination of these. Available tests fail to recognize genetic abnormalities in about 70% of ASD children, where diagnosis is solely based on behavioral signs and symptoms, which are difficult to evaluate in very young children. Although it is advisable that specific psychotherapeutic and pedagogic interventions are initiated as early as possible, early diagnosis is hampered by the lack of nongenetic specific biological markers. In the past ten years, the scientific literature has reported dozens of neurophysiological and biochemical alterations in ASD children; however no real biomarker has emerged. Such literature is here reviewed in the light of Receiver Operating Characteristic (ROC) analysis, a very valuable statistical tool, which evaluates the sensitivity and the specificity of biomarkers to be used in diagnostic decision making. We also apply ROC analysis to some of our previously published data and discuss the increased diagnostic value of combining more variables in one ROC curve analysis. We also discuss the use of biomarkers as a tool for advancing our understanding of nonsyndromic ASD.
Collapse
|
18
|
Measurement in saliva from neurotypical adults of biomarkers pertinent to autism spectrum disorders. Future Sci OA 2015; 1:FSO70. [PMID: 28031921 PMCID: PMC5137858 DOI: 10.4155/fso.15.70] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: Measure biomarkers pertinent to autism in saliva from humans. Materials & methods: At 7:30 PM (reading instructions) and 8:30 PM (hearing instructions), neurotypical adults (6 M, 6 F) each spat into tubes containing protease inhibitors. Cells were counted, samples aliquoted, frozen and thawed. Rationale was given for choice of biomarkers. ELISA: CD26, IL-12, carnitine, C4B, GSH, GSSG, MT-2, testosterone, IFN-γ. Mass spectrometry: cystine, glutamine, glutamic acid, GABA, serotonin. Electrochemiluminescentimmunoassay: cortisol. Radioimmunoassay: melatonin. Results: Cells averaged 2.16 × 106/ml. M > F: CD-26, C4B, MT-2. Testosterone, cortisol. Glutamine, glutamic acid, IFN-γ, melatonin and GSSG were measurable. Remaining biomarkers were measured in <50% of samples. Concentrations were equal at both times. Conclusion: Saliva can be collected by literate individuals without added instruction. Ten biomarkers were measurable.
Collapse
|
19
|
Zwaigenbaum L, Bauman ML, Fein D, Pierce K, Buie T, Davis PA, Newschaffer C, Robins DL, Wetherby A, Choueiri R, Kasari C, Stone WL, Yirmiya N, Estes A, Hansen RL, McPartland JC, Natowicz MR, Carter A, Granpeesheh D, Mailloux Z, Smith Roley S, Wagner S. Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research. Pediatrics 2015; 136 Suppl 1:S41-59. [PMID: 26430169 PMCID: PMC9923900 DOI: 10.1542/peds.2014-3667d] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This article reviews current evidence for autism spectrum disorder (ASD) screening based on peer-reviewed articles published to December 2013. Screening provides a standardized process to ensure that children are systematically monitored for early signs of ASD to promote earlier diagnosis. The current review indicates that screening in children aged 18 to 24 months can assist in early detection, consistent with current American Academy of Pediatrics' recommendations. We identify ASD-specific and broadband screening tools that have been evaluated in large community samples which show particular promise in terms of accurate classification and clinical utility. We also suggest strategies to help overcome challenges to implementing ASD screening in community practice, as well as priorities for future research.
Collapse
Affiliation(s)
- Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;
| | - Margaret L. Bauman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Deborah Fein
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Karen Pierce
- Department of Neurosciences, University of California San Diego, La Jolla, California
| | - Timothy Buie
- Harvard Medical School and Massachusetts General Hospital for Children, Boston, Massachusetts
| | | | - Craig Newschaffer
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Diana L. Robins
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Amy Wetherby
- Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, Florida
| | - Roula Choueiri
- Division of Developmental and Behavioral Pediatrics, University of Massachusetts Memorial Children’s Medical Center, Worcester, Massachusetts
| | - Connie Kasari
- Graduate School of Education & Information Studies, University of California Los Angeles, Los Angeles, California
| | | | - Nurit Yirmiya
- Department of Psychology, Hebrew University of Jerusalem Mount Scopus, Jerusalem, Israel
| | - Annette Estes
- Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Robin L. Hansen
- Department of Pediatrics, University of California Davis MIND Institute, Sacramento, California
| | | | | | - Alice Carter
- Department of Psychology, University of Massachusetts, Boston, Massachusetts
| | | | - Zoe Mailloux
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Susanne Smith Roley
- USC Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California; and
| | - Sheldon Wagner
- Behavioral Development & Educational Services, New Bedford, Massachusetts
| |
Collapse
|
20
|
Abstract
Network perspectives, in their emphasis on components and their interactions, might afford the best approach to the complexities of the ASD realm. Categorical approaches are unlikely to be fruitful as one should not expect to find a single or even predominant underlying cause of autism behavior across individuals. It is possible that the complex, highly interactive, heterogeneous and individualistic nature of the autism realm is intractable in terms of identifying clinically useful biomarker tests. It is hopeful from an emergenic perspective that small corrective changes in a single component of a deleterious network/configuration might have large beneficial consequences on developmental trajectories and in later treatment. It is suggested that the relationship between ASD and intellectual disability might be fundamentally different in single-gene versus nonsyndromic ASD. It is strongly stated that available biomarker "tests" for autism/ASD will do more harm than good. Finally, the serotonin-melatonin-oxidative stress-placental intersection might be an especially fruitful area of biological investigation.
Collapse
|
21
|
Chen SW, Zhong XS, Jiang LN, Zheng XY, Xiong YQ, Ma SJ, Qiu M, Huo ST, Ge J, Chen Q. Maternal autoimmune diseases and the risk of autism spectrum disorders in offspring: A systematic review and meta-analysis. Behav Brain Res 2015; 296:61-69. [PMID: 26327239 DOI: 10.1016/j.bbr.2015.08.035] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 12/21/2022]
Abstract
Although inherited and immune disorder factors are known to be involved in autism spectrum disorders (ASD), controversy still exists as to whether maternal autoimmune disease is an independent risk of ASD in offspring. We aimed to quantitatively summarize the risk of ASD in offspring in relation to maternal autoimmune diseases. A literature search in Pubmed, Web of science, Embase, and China national knowledge internet was conducted to identify relevant studies. Pooled odd ratio (OR) and its 95% confidence interval (CI) were computed by STATA version 12.0. Nine case-control studies and one cohort studies comprising 9775 cases and 952,211 controls were included in this study. A positive association between maternal autoimmune diseases and the risk of ASD in offspring was identified assuming a fixed effect model (pooled OR, 1.34; 95% CI, 1.23-1.46; I(2), 27.9%). There were statistically significant associations between maternal autoimmune diseases developed during pregnancy or maternal thyroid disease and the risk of ASD in offspring (pooled OR, 1.30, 1.29, respectively). Maternal autoimmune disease is likely to be an independent risk factor of ASD in offspring.
Collapse
Affiliation(s)
- Shao-Wei Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Xue-Shan Zhong
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Li-Na Jiang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China,; Institute of Acute Communicable Diseases Prevention and Control, Guangxi provincial Center for Disease Prevention and Control, Nanning 530000, China
| | - Xue-Yan Zheng
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Yi-Quan Xiong
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Shu-Juan Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Min Qiu
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Shu-Ting Huo
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Jing Ge
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China,.
| |
Collapse
|
22
|
QEEG spectral and coherence assessment of autistic children in three different experimental conditions. J Autism Dev Disord 2015; 45:406-24. [PMID: 24048514 PMCID: PMC4309919 DOI: 10.1007/s10803-013-1909-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We studied autistics by quantitative EEG spectral and coherence analysis during three experimental conditions: basal, watching a cartoon with audio (V–A), and with muted audio band (VwA). Significant reductions were found for the absolute power spectral density (PSD) in the central region for delta and theta, and in the posterior region for sigma and beta bands, lateralized to the right hemisphere. When comparing VwA versus the V–A in the midline regions, we found significant decrements of absolute PSD for delta, theta and alpha, and increments for the beta and gamma bands. In autistics, VwA versus V–A tended to show lower coherence values in the right hemisphere. An impairment of visual and auditory sensory integration in autistics might explain our results.
Collapse
|
23
|
Nadal-Desbarats L, Aïdoud N, Emond P, Blasco H, Filipiak I, Sarda P, Bonnet-Brilhault F, Mavel S, Andres CR. Combined 1H-NMR and 1H-13C HSQC-NMR to improve urinary screening in autism spectrum disorders. Analyst 2015; 139:3460-8. [PMID: 24841505 DOI: 10.1039/c4an00552j] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Autism spectrum disorders (ASD) are neurodevelopmental diseases with complex genetic and environmental etiological factors. Although genetic causes play a significant part in the etiology of ASD, metabolic disturbances may also play a causal role or modulate the clinical features of ASD. The number of ASD studies involving metabolomics is increasing, and sometime with conflicting findings. We assessed the metabolomics profiling of urine samples to determine a comprehensive biochemical signature of ASD. Furthermore, to date no study has combined metabolic profiles obtained from different analytical techniques to distinguish patient with ASD from healthy individuals. We obtained (1)H-NMR spectra and 2D (1)H-(13)C HSQC NMR spectra from urine samples of patients with ASD or healthy controls. We analyzed these spectra by multivariate statistical data analysis. The OPLS-DA model obtained from (1)H NMR spectra showed a good discrimination between ASD samples and non-ASD samples (R(2)Y(cum) = 0.70 and Q(2) = 0.51). Combining the (1)H NMR spectra and the 2D (1)H-(13)C HSQC NMR spectra increased the overall quality and predictive value of the OPLS-DA model (R(2)Y(cum) = 0.84 and Q(2) = 0.71), leading to a better sensitivity and specificity. Urinary excretion of succinate, glutamate and 3-methyl-histidine differed significantly between ASD and non-ASD samples. Urinary screening of children with neurodevelopmental disorders by combining NMR spectroscopies (1D and 2D) in multivariate analysis is a better sensitive and a straightforward method that could help the diagnosis ASD.
Collapse
Affiliation(s)
- Lydie Nadal-Desbarats
- Equipe neurogénétique et neurométabolomique INSERM U930, Université François Rabelais, PPF "Analyses des Systèmes Biologiques", UFR de Médecine, 10 BlvdTonnellé, 37044 Tours Cedex 9, 37000 Tours, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Smirnova L, Hogberg HT, Leist M, Hartung T. Developmental neurotoxicity - challenges in the 21st century and in vitro opportunities. ALTEX-ALTERNATIVES TO ANIMAL EXPERIMENTATION 2015; 31:129-56. [PMID: 24687333 DOI: 10.14573/altex.1403271] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 03/28/2014] [Indexed: 11/23/2022]
Abstract
In recent years neurodevelopmental problems in children have increased at a rate that suggests lifestyle factors and chemical exposures as likely contributors. When environmental chemicals contribute to neurodevelopmental disorders developmental neurotoxicity (DNT) becomes an enormous concern. But how can it be tackled? Current animal test- based guidelines are prohibitively expensive, at $ 1.4 million per substance, while their predictivity for human health effects may be limited, and mechanistic data that would help species extrapolation are not available. A broader screening for substances of concern requires a reliable testing strategy, applicable to larger numbers of substances, and sufficiently predictive to warrant further testing. This review discusses the evidence for possible contributions of environmental chemicals to DNT, limitations of the current test paradigm, emerging concepts and technologies pertinent to in vitro DNT testing and assay evaluation, as well as the prospect of a paradigm shift based on 21st century technologies.
Collapse
Affiliation(s)
- Lena Smirnova
- Centers for Alternatives to Animal Testing (CAAT) at Johns Hopkins Bloomberg School of Public Health, USA
| | | | | | | |
Collapse
|
25
|
Cozzolino R, De Magistris L, Saggese P, Stocchero M, Martignetti A, Di Stasio M, Malorni A, Marotta R, Boscaino F, Malorni L. Use of solid-phase microextraction coupled to gas chromatography–mass spectrometry for determination of urinary volatile organic compounds in autistic children compared with healthy controls. Anal Bioanal Chem 2014; 406:4649-62. [DOI: 10.1007/s00216-014-7855-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/23/2014] [Accepted: 04/24/2014] [Indexed: 11/30/2022]
|
26
|
Goldani AAS, Downs SR, Widjaja F, Lawton B, Hendren RL. Biomarkers in autism. Front Psychiatry 2014; 5:100. [PMID: 25161627 PMCID: PMC4129499 DOI: 10.3389/fpsyt.2014.00100] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 07/22/2014] [Indexed: 12/20/2022] Open
Abstract
Autism spectrum disorders (ASDs) are complex, heterogeneous disorders caused by an interaction between genetic vulnerability and environmental factors. In an effort to better target the underlying roots of ASD for diagnosis and treatment, efforts to identify reliable biomarkers in genetics, neuroimaging, gene expression, and measures of the body's metabolism are growing. For this article, we review the published studies of potential biomarkers in autism and conclude that while there is increasing promise of finding biomarkers that can help us target treatment, there are none with enough evidence to support routine clinical use unless medical illness is suspected. Promising biomarkers include those for mitochondrial function, oxidative stress, and immune function. Genetic clusters are also suggesting the potential for useful biomarkers.
Collapse
Affiliation(s)
| | - Susan R Downs
- Department of Psychiatry, University of California San Francisco , San Francisco, CA , USA
| | - Felicia Widjaja
- Department of Psychiatry, University of California San Francisco , San Francisco, CA , USA
| | - Brittany Lawton
- Department of Psychiatry, University of California San Francisco , San Francisco, CA , USA
| | - Robert L Hendren
- Department of Psychiatry, University of California San Francisco , San Francisco, CA , USA
| |
Collapse
|
27
|
Mavel S, Nadal-Desbarats L, Blasco H, Bonnet-Brilhault F, Barthélémy C, Montigny F, Sarda P, Laumonnier F, Vourc′h P, Andres CR, Emond P. 1H–13C NMR-based urine metabolic profiling in autism spectrum disorders. Talanta 2013; 114:95-102. [DOI: 10.1016/j.talanta.2013.03.064] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 03/16/2013] [Accepted: 03/25/2013] [Indexed: 01/04/2023]
|
28
|
Abdallah MW, Larsen N, Grove J, Nørgaard-Pedersen B, Thorsen P, Mortensen EL, Hougaard DM. Amniotic fluid inflammatory cytokines: potential markers of immunologic dysfunction in autism spectrum disorders. World J Biol Psychiatry 2013; 14:528-38. [PMID: 22175527 DOI: 10.3109/15622975.2011.639803] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aim of the study was to analyze cytokine profiles in amniotic fluid (AF) samples of children developing autism spectrum disorders (ASD) and controls, adjusting for maternal autoimmune disorders and maternal infections during pregnancy. METHODS AF samples of 331 ASD cases and 698 controls were analyzed for inflammatory cytokines using Luminex xMAP technology utilizing a historic birth cohort. Clinical data were retrieved from nationwide registers, and case-control differences in AF cytokine levels were assessed using chi-square tests, logistic and tobit regression models. RESULTS Overall, individuals with ASD had significantly elevated AF levels of TNF-α and TNF-β compared to controls. Analyzing individuals diagnosed only with ICD-10 codes yielded significantly elevated levels of IL-4, IL-10, TNF-α and TNF-β in ASD patients. Restricting analysis to infantile autism cases showed significantly elevated levels of IL-4, TNF-α and TNF-β compared to controls with no psychiatric comorbidities. Elevated levels of IL-6 and IL-5 were found in individuals with other childhood psychiatric disorders (OCPD) when compared to controls with no psychiatric comorbidities. CONCLUSIONS AF samples of individuals with ASD or OCPD showed differential cytokine profiles compared to frequency-matched controls. Further studies to examine the specificity of the reported cytokine profiles in ASD and OCPD are required.
Collapse
Affiliation(s)
- Morsi W Abdallah
- Department of Epidemiology, Aarhus University Faculty of Health Sciences , Aarhus , Denmark
| | | | | | | | | | | | | |
Collapse
|
29
|
Berger JM, Rohn TT, Oxford JT. Autism as the Early Closure of a Neuroplastic Critical Period Normally Seen in Adolescence. BIOLOGICAL SYSTEMS, OPEN ACCESS 2013; 1:10.4172/2329-6577.1000118. [PMID: 24353985 PMCID: PMC3864123 DOI: 10.4172/2329-6577.1000118] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The most severe cases of autism are diagnosed by extreme social dysfunction and other behavioral abnormalities. A number of genetic studies have been conducted to correlate behavioral phenotypes to genetic dysfunctions, but no "autism gene" has yet been discovered. In addition, environmental factors have been found to influence the development of autistic traits with high probability. This review will examine the role of a shortened period of neuroplasticity as a unifying feature of the autistic phenotype. The neuroplastic period of interest normally extends into adolescence, allowing for neural integration and the development of language and social skills. Early closure of this period may result in a shortened period of development, forcing the brain to rely on underdeveloped structures.
Collapse
Affiliation(s)
| | | | - Julia Thom Oxford
- Corresponding author;Department of Biological Sciences, Biomolecular Research Center, 1910 University Drive, Boise State University, Boise, Idaho, 83725-1515, , 208.426.2395
| |
Collapse
|
30
|
Current progress and challenges in the search for autism biomarkers. DISEASE MARKERS 2013; 35:55-65. [PMID: 24167349 PMCID: PMC3774962 DOI: 10.1155/2013/476276] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 04/06/2013] [Indexed: 11/17/2022]
Abstract
Autism spectrum disorders (ASD) encompass a range of neurodevelopmental conditions that are clinically and etiologically very heterogeneous. ASD is currently diagnosed entirely on behavioral criteria, but intensive research efforts are focused on identifying biological markers for disease risk and early diagnosis. Here, we discuss recent progress toward identifying biological markers for ASD and highlight specific challenges as well as ethical aspects of translating ASD biomarker research into the clinic.
Collapse
|
31
|
Gesundheit B, Rosenzweig JP, Naor D, Lerer B, Zachor DA, Procházka V, Melamed M, Kristt DA, Steinberg A, Shulman C, Hwang P, Koren G, Walfisch A, Passweg JR, Snowden JA, Tamouza R, Leboyer M, Farge-Bancel D, Ashwood P. Immunological and autoimmune considerations of Autism Spectrum Disorders. J Autoimmun 2013; 44:1-7. [PMID: 23867105 DOI: 10.1016/j.jaut.2013.05.005] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 05/26/2013] [Accepted: 05/30/2013] [Indexed: 12/22/2022]
Abstract
Autism Spectrum Disorders (ASD) are a group of heterogeneous neurodevelopmental conditions presenting in early childhood with a prevalence ranging from 0.7% to 2.64%. Social interaction and communication skills are impaired and children often present with unusual repetitive behavior. The condition persists for life with major implications for the individual, the family and the entire health care system. While the etiology of ASD remains unknown, various clues suggest a possible association with altered immune responses and ASD. Inflammation in the brain and CNS has been reported by several groups with notable microglia activation and increased cytokine production in postmortem brain specimens of young and old individuals with ASD. Moreover several laboratories have isolated distinctive brain and CNS reactive antibodies from individuals with ASD. Large population based epidemiological studies have established a correlation between ASD and a family history of autoimmune diseases, associations with MHC complex haplotypes, and abnormal levels of various inflammatory cytokines and immunological markers in the blood. In addition, there is evidence that antibodies that are only present in some mothers of children with ASD bind to fetal brain proteins and may be a marker or risk factor for ASD. Studies involving the injection of these ASD specific maternal serum antibodies into pregnant mice during gestation, or gestational exposure of Rhesus monkeys to IgG subclass of these antibodies, have consistently elicited behavioral changes in offspring that have relevance to ASD. We will summarize the various types of studies associating ASD with the immune system, critically evaluate the quality of these studies, and attempt to integrate them in a way that clarifies the areas of immune and autoimmune phenomena in ASD research that will be important indicators for future research.
Collapse
|
32
|
GC-MS-based urine metabolic profiling of autism spectrum disorders. Anal Bioanal Chem 2013; 405:5291-300. [DOI: 10.1007/s00216-013-6934-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 03/12/2013] [Accepted: 03/20/2013] [Indexed: 01/05/2023]
|
33
|
Randolph-Gips M, Srinivasan P. Modeling autism: a systems biology approach. J Clin Bioinforma 2012; 2:17. [PMID: 23043674 PMCID: PMC3507704 DOI: 10.1186/2043-9113-2-17] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 08/09/2012] [Indexed: 12/13/2022] Open
Abstract
Autism is the fastest growing developmental disorder in the world today. The prevalence of autism in the US has risen from 1 in 2500 in 1970 to 1 in 88 children today. People with autism present with repetitive movements and with social and communication impairments. These impairments can range from mild to profound. The estimated total lifetime societal cost of caring for one individual with autism is $3.2 million US dollars. With the rapid growth in this disorder and the great expense of caring for those with autism, it is imperative for both individuals and society that techniques be developed to model and understand autism. There is increasing evidence that those individuals diagnosed with autism present with highly diverse set of abnormalities affecting multiple systems of the body. To this date, little to no work has been done using a whole body systems biology approach to model the characteristics of this disorder. Identification and modelling of these systems might lead to new and improved treatment protocols, better diagnosis and treatment of the affected systems, which might lead to improved quality of life by themselves, and, in addition, might also help the core symptoms of autism due to the potential interconnections between the brain and nervous system with all these other systems being modeled. This paper first reviews research which shows that autism impacts many systems in the body, including the metabolic, mitochondrial, immunological, gastrointestinal and the neurological. These systems interact in complex and highly interdependent ways. Many of these disturbances have effects in most of the systems of the body. In particular, clinical evidence exists for increased oxidative stress, inflammation, and immune and mitochondrial dysfunction which can affect almost every cell in the body. Three promising research areas are discussed, hierarchical, subgroup analysis and modeling over time. This paper reviews some of the systems disturbed in autism and suggests several systems biology research areas. Autism poses a rich test bed for systems biology modeling techniques.
Collapse
Affiliation(s)
- Mary Randolph-Gips
- Systems Engineering and Computer Engineering, University of Houston - Clear Lake, 2700 Bay Area Bvd, Houston, TX, 77058, USA.
| | | |
Collapse
|
34
|
Distinct plasma profile of polar neutral amino acids, leucine, and glutamate in children with Autism Spectrum Disorders. J Autism Dev Disord 2012; 42:827-36. [PMID: 21713591 DOI: 10.1007/s10803-011-1314-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The goal of this investigation was to examine plasma amino acid (AA) levels in children with Autism Spectrum Disorders (ASD, N = 27) and neuro-typically developing controls (N = 20). We observed reduced plasma levels of most polar neutral AA and leucine in children with ASD. This AA profile conferred significant post hoc power for discriminating children with ASD from healthy children. Furthermore, statistical correlations suggested the lack of a typical decrease of glutamate and aspartate with age, and a non-typical increase of isoleucine and lysine with age in the ASD group. Findings from this limited prospective study warrant further examination of plasma AA levels in larger cross-sectional and longitudinal cohorts to adequately assess for relationships with developmental and clinical features of ASD.
Collapse
|
35
|
Midtvedt T. The gut: a triggering place for autism - possibilities and challenges. MICROBIAL ECOLOGY IN HEALTH AND DISEASE 2012; 23:18982. [PMID: 23990818 PMCID: PMC3747739 DOI: 10.3402/mehd.v23i0.18982] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND During the recent years, a substantial amount of new data has underlined the importance of the gut as a triggering place for autism. Temporary improvements in clinical status following dietary alterations and the same that may occur after an antibiotic therapy are reported. Additionally, increasing numbers of bacteria belonging to certain groups, such as clostridia, desulfovibrios, and sutterella, have been reported. So far, however, presence of any bacterial group has never been causatively linked to autism, and every time a new candidate organism is introduced the same questions have to be asked: What is the cause? What is the consequence? What is the confounder? The possibilities of answering these questions are hampered by difficulties in obtaining adequate samples. Therefore, more efforts have been made to those biochemical methods that probe possible functional alterations in the gastrointestinal (GI) microbiota in autistic children. CONCLUSION Autism is a disorder involving many organs and their functions, including the GI microbiota. More knowledge about the GI microbiota and its cross-talks with the host creates possibilities for future diagnostic and therapeutic improvements.
Collapse
Affiliation(s)
- Tore Midtvedt
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
36
|
Corley MJ, Meyza KZ, Blanchard DC, Blanchard RJ. Reduced sulfate plasma concentrations in the BTBR T+tf/J mouse model of autism. Physiol Behav 2012; 107:663-5. [PMID: 22538115 DOI: 10.1016/j.physbeh.2012.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 04/10/2012] [Accepted: 04/10/2012] [Indexed: 12/13/2022]
Abstract
Clinical studies have shown that children diagnosed with autism show abnormal sulfate chemistry, which is critical for cellular and metabolic processes. To determine if the inbred BTBR T+tf/J mouse shows autism-relevant aberrations in sulfate chemistry, the present study examined plasma sulfate concentrations in BTBR T+tf/J, inbred C57BL/6J, and outbred CD-1 mice. Results showed that the BTBR T+tf/J mouse exhibits significantly lower plasma sulfate concentrations in comparison to both C57BL/6J and CD-1 mice. These results suggest that the BTBR mouse shows autism-relevant abnormalities in sulfate chemistry and may serve additional utility in examining the role of sulfate and sulfate-dependent systems in relation to autism-relevant behavioral aberrations.
Collapse
Affiliation(s)
- Michael J Corley
- Department of Psychology, University of Hawaii, Honolulu, HI, USA.
| | | | | | | |
Collapse
|