Polyphenols as food bioactive compounds in the context of Autism Spectrum Disorders: A critical mini-review

Nutritional Approaches in Autism Spectrum Disorder: A Scoping Review

PURPOSE OF REVIEW

This review was conducted to discuss the etiology of autism in the light of current information, to draw attention to the fact that defects in different biological mechanisms cause autism, and to examine the effectiveness of dietary interventions and supplements in relieving ASD symptoms.

RECENT FINDINGS

Autism spectrum disorder (ASD) is an extremely heterogeneous condition characterized by delays in reciprocal social interaction and communication skills, stereotyped behaviors, and a narrowed range of interests and limited activities. Comorbid conditions such as cognitive impairment, epilepsy, psychiatric diseases, and behavioral symptoms such as impaired social communication, repetitive behaviors, lack of interest in the environment, nutritional disorders, gastrointestinal diseases and abnormal (dysbiotic) states, sleep disorders, and dysmorphism are frequently encountered in individuals with ASD. Although nutrition is one of the environmental factors affecting ASD, it can also be effective in alleviating the behavioral and gastrointestinal symptoms of ASD. Various dietary models (GFCF diet, low glycemic index diet, ketogenic diet, specific carbohydrate diet, Mediterranean diet, GAPS, Feingold, Candida body ecology, allergy elimination diets, etc.) and supplements (vitamin D, polyunsaturated fatty acids, probiotics and prebiotics, phytochemicals) can be used to alleviate symptoms in individuals with ASD. The effectiveness and reliability of dietary interventions in individuals with ASD are a matter of significant debate, and the evidence for these practices is limited. Furthermore, there is no consensus on establishing an ideal nutritional model for individuals with ASD.

Exploring Dietary Interventions in Autism Spectrum Disorder

Autism spectrum disorder (ASD) involves social communication difficulties and repetitive behaviors, and it has a growing prevalence worldwide. Symptoms include cognitive impairments, gastrointestinal (GI) issues, feeding difficulties, and psychological problems. A significant concern in ASD is food selectivity, leading to nutrient deficiencies. Common GI issues in ASD, such as constipation and irritable bowel syndrome, stem from abnormal gut flora and immune system dysregulation. Sensory sensitivities and behavioral challenges exacerbate these problems, correlating with neurological symptom severity. Children with ASD also exhibit higher oxidative stress due to low antioxidant levels like glutathione. Therapeutic diets, including ketogenic, high-antioxidant, gluten-free and casein-free, and probiotic-rich diets, show potential in managing ASD symptoms like behavior, communication, GI issues, and oxidative stress, though the evidence is limited. Various studies have focused on different populations, but there is increasing concern about the impact among children. This review aims to highlight the food preferences of the ASD population, analyze the effect of the physicochemical and nutritional properties of foods on the selectivity in its consumption, GI problems, and antioxidant deficiencies in individuals with ASD, and evaluate the effectiveness of therapeutic diets, including diets rich in antioxidants, gluten-free and casein-free, ketogenic and essential fatty acids, and probiotic-rich diets in managing these challenges.

Liposomal Epigallocatechin-3-Gallate for the Treatment of Intestinal Dysbiosis in Children with Autism Spectrum Disorder: A Comprehensive Review

Autism Spectrum Disorder (ASD) is characterized by varying degrees of difficulty in social interaction and communication. These deficits are often associated with gastrointestinal symptoms, indicating alterations in both intestinal microbiota composition and metabolic activities. The intestinal microbiota influences the function and development of the nervous system. In individuals with ASD, there is an increase in bacterial genera such as Clostridium, as well as species involved in the synthesis of branched-chain amino acids (BCAA) like Prevotella copri. Conversely, decreased amounts of Akkermansia muciniphila and Bifidobacterium spp. are observed. Epigallocatechin-3-gallate (EGCG) is one of the polyphenols with the greatest beneficial activity on microbial growth, and its consumption is associated with reduced psychological distress. Therefore, the objective of this review is to analyze how EGCG and its metabolites can improve the microbial dysbiosis present in ASD and its impact on the pathology. The analysis reveals that EGCG inhibits the growth of pathogenic bacteria like Clostridium perfringens and Clostridium difficile. Moreover, it increases the abundance of Bifidobacterium spp. and Akkermansia spp. As a result, EGCG demonstrates efficacy in increasing the production of metabolites involved in maintaining epithelial integrity and improving brain function. This identifies EGCG as highly promising for complementary treatment in ASD.

Common pregnancy complications and polyphenols intake: an overview

During pregnancy, the body undergoes a great amount of changes in order to support a healthy developing fetus. In this context, maternal dietary supplementation is widely encouraged to provide adequate nutrition for the newborn. In the past few years, studies have emerged highlighting the benefits of polyphenols intake during pregnancy. Indeed, despite differences among reports, such as experimental model, polyphenol employed, dosage and regimen of administration, there is no doubt that the ingestion of these molecules has a protective effect in relation to three pregnancy-associated diseases or conditions: preeclampsia, gestational diabetes and fetal growth restriction. In this review, we describe the effects of different polyphenols and polyphenol-rich extracts or juices on the main outcomes of these common pregnancy-associated complications, obtained in human, animal and in vitro studies. Therefore, this work provides a critical analysis of the literature, and a summary of evidences, from which future research using polyphenols can be designed and evaluated.

Attenuation of Autism-like Behaviors by an Anthocyanin-Rich Extract from Portuguese Blueberries via Microbiota-Gut-Brain Axis Modulation in a Valproic Acid Mouse Model

Autism Spectrum Disorders (ASDs) are a group of neurodevelopmental pathologies whose current treatment is neither curative nor effective. Anthocyanins are naturally occurring compounds abundant in blueberries and in other red fruits which have been shown to be successful in the treatment of several neurological diseases, at least in in vitro and in vivo disease models. The aim of the present work was to study the ability of an anthocyanin-rich extract (ARE) obtained from Portuguese blueberries to alleviate autism-like symptoms in a valproic acid (VPA) mouse model of ASD and to get insights into the underlying molecular mechanisms of such benefits. Therefore, pregnant BALB/c females were treated subcutaneously with a single dose of VPA (500 mg/kg) or saline on gestational day 12.5. Male offspring mice were orally treated with the ARE from Portuguese blueberries (30 mg/kg/day) or the vehicle for three weeks, and further subjected to behavioral tests and biochemical analysis. Our data suggested that the ARE treatment alleviated autism-like behaviors in in utero VPA-exposed mice and, at the same time, decreased both neuroinflammation and gut inflammation, modulated the gut microbiota composition, increased serotonin levels in cerebral prefrontal cortex and gut, and reduced the synaptic dysfunction verified in autistic mice. Overall, our work suggests that anthocyanins extracted from Portuguese blueberries could constitute an effective strategy to ameliorate typical autistic behaviors through modulation of the microbiota-gut-brain axis.

Neuroprotective Effects of Quercetin in Pediatric Neurological Diseases

Oxidative stress is a crucial event underlying several pediatric neurological diseases, such as the central nervous system (CNS) tumors, autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Neuroprotective therapy with natural compounds used as antioxidants has the potential to delay, ameliorate or prevent several pediatric neurological diseases. The present review provides an overview of the most recent research outcomes following quercetin treatment for CNS tumors, ASD and ADHD as well as describes the potential in vitro and in vivo ameliorative effect on oxidative stress of bioactive natural compounds, which seems like a promising future therapy for these diseases. The neuroprotective effects of quercetin against oxidative stress can also be applied in the management of several neurodegenerative disorders with effects such as anti-cancer, anti-inflammatory, anti-viral, anti-obesity and anti-microbial. Therefore, quercetin appears to be a suitable adjuvant for therapy against pediatric neurological diseases.

Antioxidant Effect of Beer Polyphenols and Their Bioavailability in Dental-Derived Stem Cells (D-dSCs) and Human Intestinal Epithelial Lines (Caco-2) Cells

Beer is one of the most consumed alcoholic beverages in the world, rich in chemical compounds of natural origin with high nutritional and biological value. It is made up of water, barley malt, hops, and yeast. The main nutrients are carbohydrates, amino acids, minerals, vitamins, and other compounds such as polyphenols which are responsible for the many health benefits associated with this consumption of drinks. Hops and malt are one of the raw materials for beer and are a source of phenolic compounds. In fact, about 30% of the polyphenols in beer comes from hops and 70%-80% from malt. Natural compounds of foods or plants exert an important antioxidant activity, counteracting the formation of harmful free radicals. In the presence of an intense stressing event, cells activate specific responses to counteract cell death or senescence which is known to act as a key-task in the onset of age-related pathologies and in the loss of tissue homeostasis. Many studies have shown positive effects of natural compounds as beer polyphenols on biological systems. The main aims of our research were to determine the polyphenolic profile of three fractions, coming from stages of beer production, the mashing process (must), the filtration process (prehopping solution), and the boiling process with the addition of hops (posthopping solution), and to evaluate the effects of these fractions on Dental-derived Stem Cells (D-dSCs) and human intestinal epithelial lines (Caco-2 cells). Furthermore, we underline the bioavailability of beer fraction polyphenols by carrying out the in vitro intestinal absorption using the Caco-2 cell model. We found an antioxidant, proliferating, and antisenescent effects of the fractions deriving from the brewing process on D-dSCs and Caco-2 cells. Finally, our results demonstrated that the bioavailability of polyphenols is greater in beer than in the control standards used, supporting the future clinical application of these compounds as potential therapeutic tools in precision and translational medicine.

Polyphenols of Traditional Apple Varieties in Interaction with Barley β-Glucan: A Study of the Adsorption Process

Apple polyphenols have been studied for various beneficial bioactivities. Especially interesting are traditional, old varieties of apples for which some initial studies have suggested significant bioactivities, but they are still not completely understood. Polyphenol bioactivities can be affected by interactions with dietary fibers such as β-glucans. The aim of this study was to investigate for the first time interactions between individual polyphenols from traditional, old apple varieties (“Božićnica” and “Batulenka”) and β-glucans by studying the adsorption process. Polyphenols were extracted from the peel and flesh of traditional apples by using an ultrasonic bath and characterized with high-performance liquid chromatography. The amounts of adsorbed (q_e) and un-adsorbed (c_e) polyphenols were modeled with adsorption isotherms (Langmuir, Dubinin–Radushkevich, and Hill) by using improved non-linear fitting in a novel R algorithm, developed specifically for the modeling of adsorption isotherms. Polyphenols adsorbed onto β-glucan from 9 to 203 (peel, “Božićnica”), 1 to 484 (peel, “Batulenka”), 5 to 160 (flesh, “Božićnica”), and 19 to 28 mg g⁻¹ (flesh, “Batulenka”). The adsorption was concentration dependent (polyphenols present in higher amount adsorbed in higher amounts). Physical sorption can be suggested. Polyphenols from traditional apples adsorb onto β-glucan and should be further studied.

Polifenollerin Bağırsak Mikrobiyota Kompozisyonunu Düzenleyici ve Nöroprotektif Etkileri

Trilyonlarca mikroorganizmadan oluşan ve doğumdan yaşlılığa kadar konakçı ile etkileşim halinde bulunan bağırsak mikrobiyotası; doğum şekli, beslenme alışkanlıkları, yaş, hastalık durumu, antibiyotik kullanımı, çevresel ve kültürel faktörlere bağlı olarak değişiklik göstermektedir. Böğürtlen, üzüm, elma, portakal, baklagiller, çay, kakao, bal ve şarap gibi polifenol açısından zengin gıdalar bağırsak mikrobiyota kompozisyonunu düzenleyebilmektedir. Bu durum polifenollerin bağırsak bakterileri üzerinde prebiyotik etki göstermeleri ile açıklanmaktadır. Bağırsak ve nörolojik hastalıkların gelişiminde, beyin ve bağırsak arasında çift yönlü ilişki ön plana çıkmaktadır. Bu ilişkiye beyin-bağırsak hattı denilmektedir. Mikrobiyota kompozisyonundaki olumsuz yöndeki değişiklikler sonucu görülen disbiyozis, beyin-bağırsak hattı dengesi için önemli sorun teşkil etmektedir. Polifenoller, beyin-bağırsak hattının modülasyonu yoluyla, bağırsak ve nörolojik hastalıkların tedavisinde yararlı etkiler sunmaktadır. Polifenollerin yararlı etkileri sadece bağırsak mikrobiyotasını düzenleyebilme yetenekleri ile değil, aynı zamanda beyin nöroenflamasyonunu azaltma, hafıza ve bilişsel işlevi geliştirme yetenekleriyle de açıklanabilmektedir. Bu özellikleri polifenolleri nörodejeneratif bozukluklar ve kardiyovasküler rahatsızlıklar başta olmak üzere birçok hastalıkla mücadele etmek için umut verici nutrasötikler konumuna getirmektedir. Bu makalenin amacı mikrobiyata çeşitliliğinde azalması ya da mikrobiyota kompozisyonunun arzu edilmeyen şekilde değişmesi ile ilişkilendirilen çeşitli bağırsak ve nörolojik hastalıklara karşı önemli işlevleri bulunan polifenollerin, insan sağlığına yararlı etkileri hakkında güncel bilgileri derlemektir.

Polyphenols in Alzheimer's Disease and in the Gut-Brain Axis

Polyphenolic antioxidants, including dietary plant lignans, modulate the gut-brain axis, which involves transformation of these polyphenolic compounds into physiologically active and neuroprotector compounds (called human lignans) through gut bacterial metabolism. These gut bacterial metabolites exert their neuroprotective effects in various neurodegenerative diseases, such as Alzheimer's disease (AD) and Parkinson's disease (PD), and also have protective effects against other diseases, such as cardiovascular diseases, cancer, and diabetes. For example, enterolactone and enterodiol, the therapeutically relevant polyphenols, are formed as the secondary gut bacterial metabolites of lignans, the non-flavonoid polyphenolic compounds found in plant-based foods. These compounds are also acetylcholinesterase inhibitors, and thereby have potential applications as therapeutics in AD and other neurological diseases. Polyphenols are also advanced glycation end product (AGE) inhibitors (antiglycating agents), and thereby exert neuroprotective effects in cases of AD. Thus, gut bacterial metabolism of lignans and other dietary polyphenolic compounds results in the formation of neuroprotective polyphenols-some of which have enhanced blood-brain barrier permeability. It is hypothesized that gut bacterial metabolism-derived polyphenols, when combined with the nanoparticle-based blood-brain barrier (BBB)-targeted drug delivery, may prove to be effective therapeutics for various neurological disorders, including traumatic brain injury (TBI), AD, and PD. This mini-review addresses the role of polyphenolic compounds in the gut-brain axis, focusing on AD.

Traditional, Indigenous Apple Varieties, a Fruit with Potential for Beneficial Effects: Their Quality Traits and Bioactive Polyphenol Contents

Earlier studies suggested that traditional apple varieties have quality traits well accepted by consumers and beneficial effects on human health. The aim was to collect 25 traditional apple varieties grown in Croatia and to determine, for the first time in so many details, their external (weight, height, width, shape, color), internal quality traits (firmness, starch decomposition index, maturity index, soluble solid concentration, total acids, soluble solid/total acids ratio, pH), and seed characteristics. In addition, individual polyphenols were determined in the flesh and peel, by using RP-HPLC. All was compared to the commercial variety ‘Idared’. Quality parameters of these varieties were similar to those of the commercial variety. The flesh and peel contained flavan-3-ols, dihydrochalcones, phenolic acids, and flavonols, while anthocyanins were additionally found in the peel. Total polyphenols in the peel (536–3801 mg kg⁻¹ fresh weight (FW)) and in the flesh (79–1294 mg kg⁻¹ FW) of the majority of varieties were higher than in the commercial variety. Principal component analysis showed possible clustering according to polyphenol amounts. According to the observed diversity of quality traits and bioactive polyphenol contents, the traditional varieties have potential for consumer acceptance and increased cultivation.

Nrf2 Activators as Dietary Phytochemicals Against Oxidative Stress, Inflammation, and Mitochondrial Dysfunction in Autism Spectrum Disorders: A Systematic Review

Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder with limited available treatments and diverse causes. In ASD patients, numerous researches demonstrated various alterations in inflammation/immune, oxidative stress, and mitochondrial dysfunction, and these alterations could be regulated by Nrf2. Hence, we aimed to systematically review the current evidence about the effects of Nrf2 activator supplementation on ASD objects from in vitro studies, animal studies, and clinical studies. Relevant articles were retrieved through searching for the Cochrane Library, PubMed, Web of Science, Scope, Embase, and CNKI databases (through September 23, 2020). Ultimately, we identified 22 preclinical studies, one cell culture study, and seven clinical studies, covering a total of five Nrf2 activators. For each Nrf2 activator, we focused on its definition, potential therapeutic mechanisms, latest research progress, research limitations, and future development directions. Our systematic review provided suggestive evidence that Nrf2 activators have a potentially beneficial role in improving autism-like behaviors and abnormal molecular alterations through oxidant stress, inflammation, and mitochondrial dysfunction. These dietary phytochemicals are considered to be relatively safer and effective for ASD treatment. However, there are few clinical studies to support the Nrf2 activators as dietary phytochemicals in ASD, even though several preclinical studies. Therefore, caution should be warranted in attempting to extrapolate their effects in human studies, and better design and more rigorous research are required before they can be determined as a therapeutic option.