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Liu J, Tan Y, Zhang F, Wang Y, Chen S, Zhang N, Dai W, Zhou L, Li JC. Metabolomic analysis of plasma biomarkers in children with autism spectrum disorders. MedComm (Beijing) 2024; 5:e488. [PMID: 38420161 PMCID: PMC10901282 DOI: 10.1002/mco2.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Autism spectrum disorder (ASD) presents a significant risk to human well-being and has emerged as a worldwide public health concern. Twenty-eight children with ASD and 33 healthy children (HC) were selected for the quantitative determination of their plasma metabolites using an ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) platform. A total of 1997 metabolites were detected in the study cohort, from which 116 metabolites were found to be differentially expressed between the ASD and HC groups. Through analytical algorithms such as least absolute shrinkage selection operator (LASSO), support vector machine (SVM), and random forest (RF), three potential metabolic markers were identified as FAHFA (18:1(9Z)/9-O-18:0), DL-2-hydroxystearic acid, and 7(S),17(S)-dihydroxy-8(E),10(Z),13(Z),15(E),19(Z)-docosapentaenoic acid. These metabolites demonstrated superior performance in distinguishing the ASD group from the HC group, as indicated by the area under curves (AUCs) of 0.935, 0.897, and 0.963 for the three candidate biomarkers, respectively. The samples were divided into training and validation sets according to 7:3. Diagnostic models were constructed using logistic regression (LR), SVM, and RF. The constructed three-biomarker diagnostic model also exhibited strong discriminatory efficacy. These findings contribute to advancing our understanding of the underlying mechanisms involved in the occurrence of ASD and provide a valuable reference for clinical diagnosis.
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Affiliation(s)
- Jun Liu
- Medical Research Center Yue Bei People's Hospital, Shantou University Medical College Shaoguan China
| | - Yuhua Tan
- Shaoguan Maternal and Child Health Hospital Shaoguan China
| | - Fan Zhang
- Medical Research Center Yue Bei People's Hospital, Shantou University Medical College Shaoguan China
| | - Yan Wang
- Shaoguan Maternal and Child Health Hospital Shaoguan China
| | - Shu Chen
- Shaoguan Maternal and Child Health Hospital Shaoguan China
| | - Na Zhang
- Shaoguan Maternal and Child Health Hospital Shaoguan China
| | - Wenjie Dai
- Medical Research Center Yue Bei People's Hospital, Shantou University Medical College Shaoguan China
| | - Liqing Zhou
- Medical Research Center Yue Bei People's Hospital, Shantou University Medical College Shaoguan China
| | - Ji-Cheng Li
- Medical Research Center Yue Bei People's Hospital, Shantou University Medical College Shaoguan China
- Institute of Cell Biology Zhejiang University Hangzhou China
- Major Disease Biomarkers Research Laboratory School of Basic Medical Science, Henan University Kaifeng China
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Jiang Y, Dang W, Nie H, Kong X, Jiang Z, Guo J. Omega-3 polyunsaturated fatty acids and/or vitamin D in autism spectrum disorders: a systematic review. Front Psychiatry 2023; 14:1238973. [PMID: 37654990 PMCID: PMC10466790 DOI: 10.3389/fpsyt.2023.1238973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
This systematic review aims to offer an updated understanding of the relationship between omega-3 supplementation and/or vitamin D and autism spectrum disorders (ASD). The databases PubMed, Cochrane Library, Web of Science, EMBASE, CINAHL, Vip, CNKI, Wanfang, China Biomedical Database databases were searched using keywords, and relevant literature was hand-searched. Papers (n = 1,151) were systematically screened and deemed eligible since 2002. Twenty clinical controlled studies were included in the final review. The findings were analyzed for intervention effects focusing on the core symptoms of ASD, included social functioning, behavioral functioning, speech function and biomarkers changes. The review found that the effects of omega-3 supplementation on ASD were too weak to conclude that core symptoms were alleviated. Vitamin D supplementation improved core symptoms, particularly behavioral functioning, however, the results of the literatures included in this study were slightly mixed, we cannot directly conclude that vitamin D supplementation has a beneficial effect on a specific symptom of ASD, but the overall conclusion is that vitamin D supplementation has a positive effect on behavioral functioning in ASD. Omega-3 and vitamin D combination supplementation has a good combined effect on social and behavioral outcomes in patients with ASD.
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Affiliation(s)
- Yuwei Jiang
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Wenjun Dang
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Hong Nie
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Xiangying Kong
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Zhimei Jiang
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Jin Guo
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, Heilongjiang, China
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Ferencova N, Visnovcova Z, Ondrejka I, Hrtanek I, Bujnakova I, Kovacova V, Macejova A, Tonhajzerova I. Peripheral Inflammatory Markers in Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder at Adolescent Age. Int J Mol Sci 2023; 24:11710. [PMID: 37511467 PMCID: PMC10380731 DOI: 10.3390/ijms241411710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are associated with immune dysregulation. We aimed to estimate the pro- and anti-inflammatory activity/balance in ASD and ADHD patients at a little-studied adolescent age with respect to sex. We evaluated 20 ASD patients (5 girls, average age: 12.4 ± 1.9 y), 20 ADHD patients (5 girls, average age: 13.4 ± 1.8 y), and 20 age- and gender-matched controls (average age: 13.2 ± 1.9 y). The evaluated parameters included (1) white blood cells (WBCs), neutrophils, monocytes, lymphocytes, platelets, platelet distribution width (PDW), mean platelet volume, and derived ratios, as well as (2) cytokines-interferon-gamma, interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10, tumor necrosis factor-alpha (TNF-α), and derived profiles and ratios. ASD adolescents showed higher levels of WBC, monocytes, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10, macrophages (M)1 profile, and anti-inflammatory profile than the controls, with ASD males showing higher monocytes, IL-6 and IL-10, anti-inflammatory profile, and a lower T-helper (Th)1/Th2+T-regulatory cell ratio than control males. The ADHD adolescents showed higher levels of PDW, IL-1β and IL-6, TNF-α, M1 profile, proinflammatory profile, and pro-/anti-inflammatory ratio than the controls, with ADHD females showing a higher TNF-α and pro-/anti-inflammatory ratio than the control females and ADHD males showing higher levels of IL-1β and IL-6, TNF-α, and M1 profile than the control males. Immune dysregulation appeared to be different for both neurodevelopmental disorders in adolescence.
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Affiliation(s)
- Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Iveta Bujnakova
- Society to Help People with Autism (SPOSA-Turiec), 03601 Martin, Slovakia
| | - Veronika Kovacova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Andrea Macejova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
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Vandana P, Simkin DR, Hendren RL, Arnold LE. Autism Spectrum Disorder and Complementary-Integrative Medicine. Child Adolesc Psychiatr Clin N Am 2023; 32:469-494. [PMID: 37147047 DOI: 10.1016/j.chc.2022.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects 0.6%-1.7% of children. The etiology of autism is hypothesized to include both biological and environmental factors (Watts, 2008). In addition to the core symptoms of social-communication delay and restricted, repetitive interests, co-occurring irritability/aggression, hyperactivity, and insomnia negatively impact adaptive functioning and quality of life of patients and families. Despite years of effort, no pharmacologic agent has been found that targets the core symptoms of ASD. The only FDA-approved agents are risperidone and aripiprazole for agitation and irritability in ASD, not for core symptoms. Though they effectively reduce irritability/violence, they do so at the expense of problematic side effects: metabolic syndrome, elevated liver enzymes, and extrapyramidal side effects. Thus, it is not surprising that many families of children with ASD turn to nonallopathic treatment, including dietary interventions, vitamins, and immunomodulatory agents subsumed under complementary-integrative medicine (CIM). Per recent studies, 27% to 88% of families report using a CIM treatment. In an extensive population-based survey of CIM, families of children with more severe ASD, comorbid irritability, GI symptoms, food allergies, seizures, and higher parental education tend to use CIM at higher rates. The perceived safety of CIM treatments as "natural treatment" over allopathic medication increases parental comfort in using these agents. The most frequently used CIM treatments include multivitamins, an elimination diet, and Methyl B12 injections. Those perceived most effective are sensory integration, melatonin, and antifungals. Practitioners working with these families should improve their knowledge about CIM as parents currently perceive little interest in and poor knowledge of CIM by physicians. This article reviews the most popular complementary treatments preferred by families with children with autism. With many of them having limited or poor quality data, clinical recommendations about the efficacy and safety of each treatment are discussed using the SECS versus RUDE criteria.
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Affiliation(s)
- Pankhuree Vandana
- Division of Child & Adolescent Psychiatry, Columbia University Valegos College of Physicians and Surgeons, Center for Autism and the Developing Brain, 21 Bloomingdale Road, White Plains, NY 10605, USA.
| | | | - Robert L Hendren
- University of California San Francisco, Pritzker Building, 675 18th Street, San Francisco, CA 94143-3132, USA
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, Ohio State University, McCampbell 395E, 1581 Dodd Drive, Columbus, OH 43210, USA
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Keim SA, Jude A, Smith K, Khan AQ, Coury DL, Rausch J, Udaipuria S, Norris M, Bartram LR, Narayanan AR, Rogers LK. Randomized Controlled Trial of Omega-3 and -6 Fatty Acid Supplementation to Reduce Inflammatory Markers in Children with Autism Spectrum Disorder. J Autism Dev Disord 2022; 52:5342-5355. [PMID: 35013866 PMCID: PMC9271516 DOI: 10.1007/s10803-021-05396-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 12/26/2022]
Abstract
This double-blind, randomized controlled trial, tested fatty acid (FA) supplementation in children (ages 2- < 6 years) recently diagnosed with Autism Spectrum Disorder (ASD). Participants received daily oral FA supplement containing omega-3 and omega-6 FA, or a placebo for 90 days based on participant weight. Erythrocyte FAs and the cytokines, IL-1β, IL-2, IFNγ, were measured in plasma obtained from serial blood collections. Treatment increased omega-3 and omega-6 FA levels (1.40 mol% for EPA and 1.62 mol% for DHA) and reduced IL-2 levels compared to placebo (- 0.17 pg/mL, 95% CI - 0.31, - 0.02, d = - 0.62). Omega 3-6 treatment was tolerable and adherence was greater than 70%. Future research will assess the effects of Omega 3-6 treatment on ASD symptoms. Registered on 06/08/2018 with ClinicalTrials.gov: NCT03550209.
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Affiliation(s)
- Sarah A Keim
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA.
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA.
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
| | - Abigail Jude
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
| | - Katie Smith
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
| | - Aiman Q Khan
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
| | - Daniel L Coury
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Joseph Rausch
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Shivika Udaipuria
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
| | - Megan Norris
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
- Department of Psychology, College of Arts and Sciences, The Ohio State University, Columbus, OH, USA
| | - Lindsay R Bartram
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Anita R Narayanan
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Lynette K Rogers
- Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
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Esnafoglu E, Subaşı B. Association of low 25-OH-vitamin D levels and peripheral inflammatory markers in patients with autism spectrum disorder: Vitamin D and inflammation in Autism. Psychiatry Res 2022; 316:114735. [PMID: 35878480 DOI: 10.1016/j.psychres.2022.114735] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 11/22/2022]
Abstract
Inflammatory mechanisms and Vitamin D are reported to play important roles in the pathophysiology of Autism Spectrum Disorders (ASD). There are ample evidences that vitamin D has an anti-inflammatory effect. In this study, we aimed, for the first time, to investigate the 25-OH-vitamin D with inflammation markers in ASD patients. The study included 154 patients with ASD and 98 healthy subjects. 25-OH-Vitamin D levels and simple peripheral inflammatory markers such as Neutrophil-Lymphocyte ratio (NLR), C-reactive protein (CRP) and, sedimentation were measured in all subjects. K-SADS-PL-DSM 5 were administered to all subjects to evaluate the psychiatric diagnosis. Childhood Autism Rating Scale was used to asses severity of autism. In the patient group, high CRP rate, leukocyte, neutrophil and NLR were significantly high compared to the healthy control group. 25-OH-Vitamin D levels were found to be statistically significantly lower in the ASD group. While a significant negative correlation was found between 25-OH-Vitamin D and CRP, NLR, neutrophil counts in ASD patients, a positive correlation was found between lymphocyte counts. Especially in male ASD patients, the relationship between 25-OH-Vitamin D and inflammation markers was more pronounced. Our findings support the association of vitamin D and inflammation in ASD.
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Affiliation(s)
- Erman Esnafoglu
- Depatment of Child and Adolescent Pychiatry, Faculty of Medicine, Ordu Universtiy, Egitim ve Arastirma Hastanesi, Cocuk Psikiyatrisi Poliklinigi, Bucak Mah, Ordu 52200, Turkey.
| | - Burak Subaşı
- Department of Psychiatry, Kayseri City Traning and Research Hospital, Kayseri, Turkey
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de la Torre-Aguilar MJ, Gomez-Fernandez A, Flores-Rojas K, Martin-Borreguero P, Mesa MD, Perez-Navero JL, Olivares M, Gil A, Gil-Campos M. Docosahexaenoic and Eicosapentaenoic Intervention Modifies Plasma and Erythrocyte Omega-3 Fatty Acid Profiles But Not the Clinical Course of Children With Autism Spectrum Disorder: A Randomized Control Trial. Front Nutr 2022; 9:790250. [PMID: 35425788 PMCID: PMC9002234 DOI: 10.3389/fnut.2022.790250] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/28/2022] [Indexed: 12/30/2022] Open
Abstract
BackgroundThe pathogenesis of autism spectrum disorder (ASD) is under investigation and one of the main alterations relates to the metabolic and inflammatory system dysfunctions. Indeed, based on a possible deficit of omega-3 fatty acids (FAs) of patients with ASD and looking for an anti-inflammatory effect, dietary supplements with omega-3 fatty acids have been proposed. We aimed to evaluate differences in plasma and erythrocyte FA profiles and plasma cytokines in patients with infantile ASD after supplementation with docosahexaenoic (DHA) and eicosapentaenoic (EPA) acids or placebo and both compared at baseline with a reference healthy group.MethodsA double-blind, randomized placebo-controlled intervention with DHA/EPA for 6 months was carried out in 54 children between 2 and 6 years diagnosed with ASD. They were selected and randomly assigned into two groups: 19 children received 800 mg/day of DHA and 25 mg/day of EPA, or placebo. In addition, another reference group of 59 healthy children of the same age was included. Plasma lipids and cytokines, and FA profiles in plasma and erythrocytes were measured at baseline and after 6 months of treatment in ASD children, and at baseline in the reference group.ResultsThere were no differences in demographic, anthropometric characteristics, and omega-3 intake between the healthy reference group and the ASD children at baseline. Children with ASD showed the higher plasma percentages of palmitic acid and total saturated FA and lower total omega-6 polyunsaturated FA (PUFA) compared with healthy children. An increased level of DHA and reduced EPA level in erythrocytes were detected in the ASD group vs. the reference group. After 6 months of treatment, the ASD group that received DHA enriched product significantly increased the plasma and erythrocyte percentages of DHA, but no differences were observed in the clinical test scores and other parameters as plasma cytokines between the two groups of ASD related to the intervention.ConclusionSpanish children with ASD exhibit an appropriate omega-3 FA status in plasma and erythrocytes. Neither a clinical improvement of ASD children nor a better anti-inflammatory or fatty acid state has been found after an intervention with DHA/EPA for 6 months. So, the prescription of n-3 LC-PUFA and other dietary supplements in ASD should be only indicated after a confirmed alteration of FA metabolism or omega-3 LC-PUFA deficiency evaluated by specific erythrocyte FA.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT03620097].
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Affiliation(s)
- Maria Jose de la Torre-Aguilar
- Pediatric Research and Metabolism Unit, Reina Sofia University Hospital, Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Antonio Gomez-Fernandez
- Pediatric Research and Metabolism Unit, Reina Sofia University Hospital, Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Katherine Flores-Rojas
- Pediatric Research and Metabolism Unit, Reina Sofia University Hospital, Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Pilar Martin-Borreguero
- Department of Child and Adolescent Clinical Psychiatry and Psychology, Reina Sofia University Hospital, Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain
| | - María Dolores Mesa
- Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix,” University of Granada, Parque Tecnológico de la Salud, Granada, Spain
| | - Juan Luis Perez-Navero
- Pediatric Research and Metabolism Unit, Reina Sofia University Hospital, Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
- CIBERER (Ciber Rare Diseases), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- *Correspondence: Juan Luis Perez-Navero, ,
| | | | - Angel Gil
- Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix,” University of Granada, Parque Tecnológico de la Salud, Granada, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Mercedes Gil-Campos
- Pediatric Research and Metabolism Unit, Reina Sofia University Hospital, Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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van der Wurff I, Oenema A, de Ruijter D, Vingerhoets C, van Amelsvoort T, Rutten B, Mulkens S, Köhler S, Schols A, de Groot R. A Scoping Literature Review of the Relation between Nutrition and ASD Symptoms in Children. Nutrients 2022; 14:nu14071389. [PMID: 35406004 PMCID: PMC9003544 DOI: 10.3390/nu14071389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023] Open
Abstract
Autism spectrum disorder (ASD) is characterized by impairments in social interaction, communication skills, and repetitive and restrictive behaviors and interests. Even though there is a biological basis for an effect of specific nutrition factors on ASD symptoms and there is scientific literature available on this relationship, whether nutrition factors could play a role in ASD treatment is unclear. The goal of the current literature review was to summarize the available scientific literature on the relation between nutrition and autism spectrum disorder (ASD) symptoms in childhood, and to formulate practical dietary guidelines. A comprehensive search strategy including terms for ASD, nutrition factors (therapeutic diets, dietary patterns, specific food products, fatty acids and micronutrients) and childhood was developed and executed in six literature databases (Cinahl, Cochrane, Ovid Embase, PsycInfo, PubMed and Web of Science). Data from meta-analyses, systematic reviews and original studies were qualitatively summarized. A total of 5 meta-analyses, 29 systematic reviews and 27 original studies were retrieved that focused on therapeutic diets, specific food products, fatty acids and micronutrients and ASD symptoms during childhood. Results of the available studies were sparse and inconclusive, and hence, no firm conclusions could be drawn. There is currently insufficient evidence for a relation between nutrition and ASD symptoms in childhood, making it impossible to provide practical nutrition guidelines; more methodological sound research is needed.
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Affiliation(s)
- Inge van der Wurff
- Health Psychology, Faculty of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands;
- Correspondence:
| | - Anke Oenema
- Department of Health Promotion, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.O.); (D.d.R.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
| | - Dennis de Ruijter
- Department of Health Promotion, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.O.); (D.d.R.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
| | - Claudia Vingerhoets
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Bart Rutten
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Sandra Mulkens
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Clinical Psychological Science, Maastricht University, 6200 MD Maastricht, The Netherlands
- SeysCentra, 6581 TE Malden, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Annemie Schols
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Respiratory Medicine, Maastricht University, 6202 AZ Maastricht, The Netherlands
| | - Renate de Groot
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands;
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Maniram J, Karrim SBS, Oosthuizen F, Wiafe E. Pharmacological Management of Core Symptoms and Comorbidities of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review. Neuropsychiatr Dis Treat 2022; 18:1629-1644. [PMID: 35968512 PMCID: PMC9371468 DOI: 10.2147/ndt.s371013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The pharmacological management of Autism Spectrum Disorder (ASD) in children remains a challenge due to limited effective management options and the absence of approved drugs to manage the core symptoms. This review aims to describe and highlight effective pharmacological management options employed in managing the core symptoms and comorbidities of ASD from eligible studies over the past decade. METHODS A search of databases; PubMed, Scopus, Science Direct, and PsychInfo for pharmacotherapeutic options for ASD was conducted in this systematic review. Duplicate studies were removed by utilizing the EndNote citation manager. The studies were subsequently screened independently by two authors. Eligible studies from 01 January 2012 to 01 January 2022 were included based on established eligibility criteria. A narrative synthesis was used for data analysis. RESULTS The systematic review provides a comprehensive list of effective management options for ASD comorbidities and core symptoms from 33 included studies. The management options for ASD comorbidities; insomnia, hyperactivity, irritability and aggression, gastrointestinal disturbances, and subclinical epileptiform discharges, were reviewed. Risperidone, aripiprazole, methylphenidate, guanfacine, levetiracetam, and atomoxetine are examples of effective pharmacological drugs against ASD comorbidities. Additionally, this review identified various drugs that improve the core symptoms of ASD and include but are not limited to, bumetanide, buspirone, intranasal oxytocin, intranasal vasopressin, and prednisolone. CONCLUSION This review has successfully summarized the pharmacological advancements made in the past decade to manage ASD. Although there is still no pharmacological cure for ASD core symptoms or additional drugs that have obtained regulatory approval for use in ASD, the availability of promising pharmacological agents are under evaluation and study.
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Affiliation(s)
- Jennal Maniram
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saira B S Karrim
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Frasia Oosthuizen
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Ebenezer Wiafe
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Clinical Pharmacy Services Unit, Directorate of Pharmacy, Ho Teaching Hospital, Ho, Ghana
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Veselinović A, Petrović S, Žikić V, Subotić M, Jakovljević V, Jeremić N, Vučić V. Neuroinflammation in Autism and Supplementation Based on Omega-3 Polyunsaturated Fatty Acids: A Narrative Review. ACTA ACUST UNITED AC 2021; 57:medicina57090893. [PMID: 34577816 PMCID: PMC8464922 DOI: 10.3390/medicina57090893] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 01/01/2023]
Abstract
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction across multiple contexts and restricted, repetitive patterns of behavior, interests and activities. The maternal status of polyunsaturated fatty acids (PUFA) regulates microglial activity and neuroinflammatory pathways during a child's brain development. In children with ASD, the metabolism of PUFA is thought to be deficient or abnormal, leading to increased production of proinflammatory cytokines, increased oxidative stress and an imbalance in the formation and action of neurotransmitters. In addition, nutritional deficits in omega-3 PUFA may affect gut microbiota and contribute to ASD by the gut-brain axis. The aim of this study was to review the possible role of neuroinflammation in ASD development and the effect of omega-3 PUFA supplementation in children with ASD. Due to a wide heterogeneity across RCTs, no definitive conclusion about omega-3 PUFA effects in ASD can be drawn. Supplementation with PUFA could be considered as one of the aspects in regulating the biological status of the organism and could provide added value to standard medical and psychological interventions for reducing behavioral deficits.
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Affiliation(s)
- Aleksandra Veselinović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Centre”, 11000 Belgrade, Serbia; (V.Ž.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-11-3208-552; Fax: +381-11-2624-168
| | - Snježana Petrović
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, 11000 Belgrade, Serbia; (S.P.); (V.V.)
| | - Vladica Žikić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Centre”, 11000 Belgrade, Serbia; (V.Ž.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Centre”, 11000 Belgrade, Serbia; (V.Ž.); (M.S.)
| | - Vladimir Jakovljević
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
- Department of Human Pathology, 1st Moscow State Medical University IM Sechenov, 119991 Moscow, Russia
| | - Nevena Jeremić
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Vesna Vučić
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, 11000 Belgrade, Serbia; (S.P.); (V.V.)
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Abstract
The search for economic and sustainable sources of polyunsaturated fatty acids (PUFAs) within the framework of the circular economy is encouraged by their proven beneficial effects on health. The extraction of monkfish liver oil (MLO) for the synthesis of omega-3 ethyl esters was performed to evaluate two blending systems and four green solvents in this work. Moreover, the potential solubility of the MLO in green solvents was studied using the predictive simulation software COnductor-like Screening MOdel for Realistic Solvents (COSMO-RS). The production of ethyl esters was performed by one or two-step reactions. Novozym 435, two resting cells (Aspergillus flavus and Rhizopus oryzae) obtained in our laboratory and a mix of them were used as biocatalysts in a solvent-free system. The yields for Novozym 435, R. oryzae and A. flavus in the one-step esterification were 63, 61 and 46%, respectively. The hydrolysis step in the two-step reaction led to 83, 88 and 93% of free fatty acids (FFA) for Novozym 435, R. oryzae and A. flavus, respectively. However, Novozym 435 showed the highest yield in the esterification step (85%), followed by R. oryzae (65%) and A. flavus (41%). Moreover, selectivity of polyunsaturated fatty acids of R. oryzae lipase was evidenced as it slightly esterified docosahexaenoic acid (DHA) in all the esterification reactions tested.
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Saad K, Abdallah AEM, Abdel-Rahman AA, Al-Atram AA, Abdel-Raheem YF, Gad EF, Abo-Elela MGM, Elserogy YM, Elhoufey A, Nigm DA, Nagiub Abdelsalam EM, Alruwaili TAM. Polymorphism of interleukin-1β and interleukin-1 receptor antagonist genes in children with autism spectrum disorders. Prog Neuropsychopharmacol Biol Psychiatry 2020; 103:109999. [PMID: 32526258 DOI: 10.1016/j.pnpbp.2020.109999] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 02/08/2023]
Abstract
In this study, we first investigated interleukin-1 beta (IL-1β) and IL-1 receptor antagonist (IL-1RA) levels in a cohort of Egyptian children with autism spectrum disorder (ASD) and in healthy controls. Second, we examined the single-nucleotide polymorphisms (SNPs) at positions -31 and - 511 of the IL-1β gene promoter and IL1RA and assessed the association between IL1B and IL1RA polymorphisms with ASD. We examined IL1β promoter polymorphism at -511 (IL-1β-511) and - 31 (IL-1β-31) and IL1RA gene polymorphism in 80 children with ASD and 60 healthy children. The children with ASD had significantly higher levels of IL-1β and IL-1RA than the controls. The children with ASD also had significantly higher frequencies of homozygous (CC) and heterozygous (TC) genotype variants of IL-1β-511, and IL-1RA than the controls. Moreover, the frequency of the IL-1β-511 allele (C) was higher in the ASD group than in the controls (p = .001). The homozygous and heterozygous variants of IL-1RA allele II were also significantly higher in the ASD group than in the control group. There was no significant association between the IL-1β-31 genotype and autism classes. However, there were significant differences in the distribution of the IL-1RA heterogeneous genotype and allele II among children with severe autism. The inflammatory role of cytokines has been implicated in a variety of neuropsychiatric pathologies, including autism. Our data show alterations in the IL-1β system, with abnormally increased serum levels of IL-1β and IL-1RA in the children with ASD. Further, polymorphisms in the IL-1β-511 and IL-1RA genotype variants correlated positively with autism severity and behavioral abnormalities. IL-1β-511 and IL-1RA gene polymorphisms could impact ASD risk and may be used as potential biomarkers of ASD. Variations in the IL-1β and IL-1RA systems may have a role in the pathophysiology of ASD.
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Affiliation(s)
- Khaled Saad
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | | | - Ahmed A Abdel-Rahman
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdulrahman A Al-Atram
- Department of Psychiatry, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | | | - Eman Fathallah Gad
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Yasser M Elserogy
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Amira Elhoufey
- Department of Community Health Nursing, Faculty of Nursing, Assiut University, Egypt; Department of Community Health Nursing, Alddrab University College, Jazan University, Saudi Arabia
| | - Dalia A Nigm
- Clinical Pathology Department, Faculty of Medicine, Assiut University, Egypt
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Effects of vitamin D supplementation on core symptoms, serum serotonin, and interleukin-6 in children with autism spectrum disorders: A randomized clinical trial. Nutrition 2020; 79-80:110986. [DOI: 10.1016/j.nut.2020.110986] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/25/2020] [Accepted: 08/02/2020] [Indexed: 11/22/2022]
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