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Ramazani Z, Nakhaee S, Sharafi K, Rezaei Z, Mansouri B. Autism spectrum disorder: Cadmium and mercury concentrations in different biological samples, a systematic literature review and meta-analysis of human studies. Heliyon 2024; 10:e27789. [PMID: 38496888 PMCID: PMC10944282 DOI: 10.1016/j.heliyon.2024.e27789] [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: 06/13/2023] [Revised: 02/28/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024] Open
Abstract
The present study was conducted to investigate the differences in cadmium (Cd) and mercury (Hg) concentrations between children with autism spectrum disorder (ASD) and controls. In this systematic review and meta-analysis study, three thousand one hundred forty-five studies were collected from scientific databases including Web of Science, Scopus, PubMed, and Google Scholar from January 2000 to October 2022 and were investigated for eligibility. As a result, 37 studies published in the period from 2003 to 2022 met our inclusion criteria and were considered in the meta-analysis. The heterogeneity assumption was evaluated using the Chi-squared-based Q-test and I-squared (I2) statistics. The pooled estimates were shown in the forest plots with Hedges' g (95% confidence interval) values. The random effects model demonstrated that there is no significant difference in the blood (Hedges' g: 0.14, 95% CI: 0.45, 0.72, p > 0.05), hair (Hedges' g: 0.12, 95% CI: 0.26, 0.50, p > 0.05), and urinary (Hedges' g: 0.05, 95% CI: 0.86, 0.76, p > 0.05) Cd levels of the case group versus control subjects. Moreover, the pooled findings of studies showed no significant difference in the blood (Hedges' g: 1.69, 95% CI: 0.09, 3.48, p > 0.05), hair (Hedges' g: 3.42, 95% CI: 1.96, 8.80, p > 0.05), and urinary (Hedges' g: 0.49, 95% CI: 1.29 - 0.30, p > 0.05) Hg concentrations. The results demonstrated no significant differences in Hg and Cd concentrations in different biological samples of children with ASD compared to control subjects.
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Affiliation(s)
- Zana Ramazani
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Kiomars Sharafi
- Research Center for Environmental Determinants of Health (RCEDH), Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zaynab Rezaei
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Schrenk D, Bignami M, Bodin L, Chipman JK, del Mazo J, Grasl‐Kraupp B, Hogstrand C, Hoogenboom L(R, Leblanc J, Nebbia CS, Nielsen E, Ntzani E, Petersen A, Sand S, Vleminckx C, Wallace H, Barregård L, Benford D, Broberg K, Dogliotti E, Fletcher T, Rylander L, Abrahantes JC, Gómez Ruiz JÁ, Steinkellner H, Tauriainen T, Schwerdtle T. Update of the risk assessment of inorganic arsenic in food. EFSA J 2024; 22:e8488. [PMID: 38239496 PMCID: PMC10794945 DOI: 10.2903/j.efsa.2024.8488] [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] [Indexed: 01/22/2024] Open
Abstract
The European Commission asked EFSA to update its 2009 risk assessment on arsenic in food carrying out a hazard assessment of inorganic arsenic (iAs) and using the revised exposure assessment issued by EFSA in 2021. Epidemiological studies show that the chronic intake of iAs via diet and/or drinking water is associated with increased risk of several adverse outcomes including cancers of the skin, bladder and lung. The CONTAM Panel used the benchmark dose lower confidence limit based on a benchmark response (BMR) of 5% (relative increase of the background incidence after adjustment for confounders, BMDL05) of 0.06 μg iAs/kg bw per day obtained from a study on skin cancer as a Reference Point (RP). Inorganic As is a genotoxic carcinogen with additional epigenetic effects and the CONTAM Panel applied a margin of exposure (MOE) approach for the risk characterisation. In adults, the MOEs are low (range between 2 and 0.4 for mean consumers and between 0.9 and 0.2 at the 95th percentile exposure, respectively) and as such raise a health concern despite the uncertainties.
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3
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Stojsavljević A, Lakićević N, Pavlović S. Mercury and Autism Spectrum Disorder: Exploring the Link through Comprehensive Review and Meta-Analysis. Biomedicines 2023; 11:3344. [PMID: 38137565 PMCID: PMC10741416 DOI: 10.3390/biomedicines11123344] [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: 10/29/2023] [Revised: 12/02/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Mercury (Hg) is a non-essential trace metal with unique neurochemical properties and harmful effects on the central nervous system. In this study, we present a comprehensive review and meta-analysis of peer-reviewed research encompassing five crucial clinical matrices: hair, whole blood, plasma, red blood cells (RBCs), and urine. We assess the disparities in Hg levels between gender- and age-matched neurotypical children (controls) and children diagnosed with autism spectrum disorder (ASD) (cases). After applying rigorous selection criteria, we incorporated a total of 60 case-control studies into our meta-analysis. These studies comprised 25 investigations of Hg levels in hair (controls/cases: 1134/1361), 15 in whole blood (controls/cases: 1019/1345), 6 in plasma (controls/cases: 224/263), 5 in RBCs (controls/cases: 215/293), and 9 in urine (controls/cases: 399/623). This meta-analysis did not include the data of ASD children who received chelation therapy. Our meta-analysis revealed no statistically significant differences in Hg levels in hair and urine between ASD cases and controls. In whole blood, plasma, and RBCs, Hg levels were significantly higher in ASD cases compared to their neurotypical counterparts. This indicates that ASD children could exhibit reduced detoxification capacity for Hg and impaired mechanisms for Hg excretion from their bodies. This underscores the detrimental role of Hg in ASD and underscores the critical importance of monitoring Hg levels in ASD children, particularly in early childhood. These findings emphasize the pressing need for global initiatives aimed at minimizing Hg exposure, thus highlighting the critical intersection of human-environment interaction and neurodevelopment health.
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Affiliation(s)
- Aleksandar Stojsavljević
- Innovative Centre, Faculty of Chemistry, University of Belgrade, Studentski Trg 12–16, 11000 Belgrade, Serbia
| | - Novak Lakićević
- Clinical Centre of Montenegro, Clinic for Neurosurgery, Ljubljanska bb, 81000 Podgorica, Montenegro;
| | - Slađan Pavlović
- Institute for Biological Research “Siniša Stanković”—National Institute of the Republic of Serbia, University of Belgrade, Bulevar Despota Stefana 142, 11060 Belgrade, Serbia;
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Midya V, Alcala CS, Rechtman E, Gregory JK, Kannan K, Hertz-Picciotto I, Teitelbaum SL, Gennings C, Rosa MJ, Valvi D. Machine Learning Assisted Discovery of Interactions between Pesticides, Phthalates, Phenols, and Trace Elements in Child Neurodevelopment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:18139-18150. [PMID: 37595051 PMCID: PMC10666542 DOI: 10.1021/acs.est.3c00848] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023]
Abstract
A growing body of literature suggests that developmental exposure to individual or mixtures of environmental chemicals (ECs) is associated with autism spectrum disorder (ASD). However, investigating the effect of interactions among these ECs can be challenging. We introduced a combination of the classical exposure-mixture Weighted Quantile Sum (WQS) regression and a machine-learning method termed Signed iterative Random Forest (SiRF) to discover synergistic interactions between ECs that are (1) associated with higher odds of ASD diagnosis, (2) mimic toxicological interactions, and (3) are present only in a subset of the sample whose chemical concentrations are higher than certain thresholds. In a case-control Childhood Autism Risks from Genetics and Environment (CHARGE) study, we evaluated multiordered synergistic interactions among 62 ECs measured in the urine samples of 479 children in association with increased odds for ASD diagnosis (yes vs no). WQS-SiRF identified two synergistic two-ordered interactions between (1) trace-element cadmium (Cd) and the organophosphate pesticide metabolite diethyl-phosphate (DEP); and (2) 2,4,6-trichlorophenol (TCP-246) and DEP. Both interactions were suggestively associated with increased odds of ASD diagnosis in the subset of children with urinary concentrations of Cd, DEP, and TCP-246 above the 75th percentile. This study demonstrates a novel method that combines the inferential power of WQS and the predictive accuracy of machine-learning algorithms to discover potentially biologically relevant chemical-chemical interactions associated with ASD.
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Affiliation(s)
- Vishal Midya
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Cecilia Sara Alcala
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Elza Rechtman
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Jill K. Gregory
- Instructional
Technology Group,Icahn School of Medicine
at Mount Sinai, New York, New York 10029, United States
| | - Kurunthachalam Kannan
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Irva Hertz-Picciotto
- Department
of Public Health Sciences, School of Medicine, University of California at Davis, Davis, California 95616, United States
- UC
Davis MIND (Medical Investigations of Neurodevelopmental Disorders)
Institute, University of California at Davis, Sacramento, California 95817, United States
| | - Susan L. Teitelbaum
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Chris Gennings
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Maria J. Rosa
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Damaskini Valvi
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
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Stojsavljević A, Lakićević N, Pavlović S. Does Lead Have a Connection to Autism? A Systematic Review and Meta-Analysis. TOXICS 2023; 11:753. [PMID: 37755763 PMCID: PMC10536388 DOI: 10.3390/toxics11090753] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/20/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
Environmental pollutants, particularly toxic trace metals with neurotoxic potential, have been related to the genesis of autism. One of these metals that stands out, in particular, is lead (Pb). We conducted an in-depth systematic review and meta-analysis of peer-reviewed studies on Pb levels in biological materials retrieved from autistic children (cases) and neurotypical children (controls) in this work. A systematic review was conducted after the careful selection of published studies according to established criteria to gain a broad insight into the higher or lower levels of Pb in the biological materials of cases and controls, and the findings were then strengthened by a meta-analysis. The meta-analysis included 17 studies (hair), 13 studies (whole blood), and 8 studies (urine). The overall number of controls/cases was 869/915 (hair), 670/755 (whole blood), and 344/373 (urine). This meta-analysis showed significantly higher Pb levels in all three types of biological material in cases than in controls, suggesting a higher body Pb burden in autistic children. Thus, environmental Pb exposure could be related to the genesis of autism. Since no level of Pb can be considered safe, the data from this study undoubtedly point to the importance of regularly monitoring Pb levels in autistic children.
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Affiliation(s)
- Aleksandar Stojsavljević
- Innovative Centre, Faculty of Chemistry, University of Belgrade, Studentski Trg 12–16, 11000 Belgrade, Serbia
| | - Novak Lakićević
- Clinical Centre of Montenegro, Clinic for Neurosurgery, Ljubljanska bb, 81000 Podgorica, Montenegro;
| | - Slađan Pavlović
- Institute for Biological Research “Siniša Stanković”—National Institute of the Republic of Serbia, University of Belgrade, Bulevar Despota Stefana 142, 11060 Belgrade, Serbia;
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Ding M, Shi S, Qie S, Li J, Xi X. Association between heavy metals exposure (cadmium, lead, arsenic, mercury) and child autistic disorder: a systematic review and meta-analysis. Front Pediatr 2023; 11:1169733. [PMID: 37469682 PMCID: PMC10353844 DOI: 10.3389/fped.2023.1169733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/23/2023] [Indexed: 07/21/2023] Open
Abstract
Background Studies have found that toxic heavy metals exposure could induce the generation of reactive oxygen species (ROS), and is of epigenetic effect, which might be associated with the occurrence of Autistic Disorder (ASD). This systematic review and meta-analysis aims to elucidate the association between exposure to 4 heavy metals, cadmium (Cd), lead (Pb), arsenic(As), and mercury (Hg), and the occurrence of ASD in children. Methods We searched PubMed, Web of Science, Embase, and Cochrane Library, from their inception to October 2022, for epidemiological investigations that explore the association between exposure to Cd, Pb, As, or Hg and the occurrence of child ASD. Results A total of 53 studies were included, involving 5,054 individuals aged less than 18 (2,533 ASD patients and 2,521 healthy controls). Compared with the healthy controls, in hair and blood tests, concentrations of the 4 heavy metals were significantly higher in the ASD group than in the healthy control group, and the differences in Pb, arsenic and Hg were statistically significant (P < 0.05). In the urine test, concentrations of arsenic and Hg were significantly higher in the ASD group than in the healthy control group (P < 0.05), while the results of Cd and Pb were opposite to those of arsenic and Hg (P > 0.05). Subgroup analysis for geographic regions showed that ASD patients in Asia and Europe had higher concentrations of the 4 heavy metals, compared with the healthy controls, in which the differences in Pb, arsenic, and Hg were statistically significant (P < 0.05), while in North America, the healthy controls had higher Cd, arsenic, and Hg concentrations (P > 0.05). Conclusion Compared with the healthy control group, the ASD group had higher concentrations of Cd, Pb, arsenic, and Hg. These 4 heavy metals play different roles in the occurrence and progression of ASD. Moreover, there is significant heterogeneity among the included studies due to controversies about the study results among different countries and regions and different sources of detection materials. The results of this study firmly support the policies to limit heavy metals exposure, especially among pregnant women and young children, so as to help reduce the incidence of ASD.
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Affiliation(s)
- Mengmeng Ding
- Correspondence: Mengmeng Ding Shanshan Shi Shuyan Qie
| | - Shanshan Shi
- Correspondence: Mengmeng Ding Shanshan Shi Shuyan Qie
| | - Shuyan Qie
- Correspondence: Mengmeng Ding Shanshan Shi Shuyan Qie
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Ling W, Zhao G, Wang W, Wang C, Zhang L, Zhang H, Lu D, Ruan S, Zhang A, Liu Q, Jiang J, Jiang G. Metallomic profiling and natural copper isotopic signatures of childhood autism in serum and red blood cells. CHEMOSPHERE 2023; 330:138700. [PMID: 37076087 DOI: 10.1016/j.chemosphere.2023.138700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/29/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
Excessive exposure to metals directly threatens human health, including neurodeve lopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder, leaving great harms to children themselves, their families, and even society. In view of this, it is critical to develop reliable biomarkers for ASD in early childhood. Here we used inductively coupled plasma mass spectrometry (ICP-MS) to identify the abnormalities in ASD-associated metal elements in children blood. Multi-collector inductively coupled plasma mass spectrometry (MC-ICP-MS) was applied to detect isotopic differences in copper (Cu) for further assessment on account of its core role in the brain. We also developed a machine learning classification method for unknown samples based on a support vector machine (SVM) algorithm. The results indicated significant differences in the blood metallome (chromium (Cr), manganese (Mn), cobalt (Co), magnesium (Mg), and arsenic (As)) between cases and controls, and a significantly lower Zn/Cu ratio was observed in the ASD cases. Interestingly, we found a strong association of serum copper isotopic composition (δ65Cu) with autistic serum. SVM was successfully applied to discriminate cases and controls based on the two-dimensional Cu signatures (Cu concentration and δ65Cu) with a high accuracy (94.4%). Overall, our findings revealed a new biomarker for potential early diagnosis and screening of ASD, and the significant alterations in the blood metallome also helped to understand the potential pathogenesis of ASD in terms of metallomics.
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Affiliation(s)
- Weibo Ling
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Gang Zhao
- Department of Child Health Care, Maternity and Child Healthcare Hospital of Nanshan District, 1 Wanxia Road, Nanshan District, Shenzhen, 518067, China
| | - Weichao Wang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chao Wang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518000, China
| | - Luyao Zhang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Huazhou Zhang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Dawei Lu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
| | - Shasha Ruan
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518000, China
| | - Aiqian Zhang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qian Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China; Taishan Institute for Ecology and Environment (TIEE), Jinan, 250100, China.
| | - Jie Jiang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518000, China.
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
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Nakhaee S, Amirabadizadeh A, Farnia V, Ali Azadi N, Mansouri B, Radmehr F. Association Between Biological Lead Concentrations and Autism Spectrum Disorder (ASD) in Children: a Systematic Review and Meta-Analysis. Biol Trace Elem Res 2023; 201:1567-1581. [PMID: 35499802 DOI: 10.1007/s12011-022-03265-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022]
Abstract
Studies have been conducted in different countries of the world to illustrate a link between autism spectrum disorder (ASD) and lead (Pb) in different specimens such as hair, blood, and urine. Therefore, we carried out a systematic review and meta-analysis to determine the association between Pb concentration in biological samples (blood, urine, and hair) and ASD in children through case-control and cross-sectional studies. In this systematic review, PubMed, Web of Sciences, Scopus, and Google Scholar were searched for relevant studies from January 2000 to February 2022. A random-effects model was used to pool the results. The effect sizes were standardized mean differences (proxied by Hedges' g) followed by a 95% confidence interval. Pooling data under the random effect model from blood and hair studies showed a significant difference between the children in the ASD group and the control group in blood lead level (Hedges' g: 1.21, 95% CI: 0.33-2.09, P = 0.01) and hair level (Hedges' g: 2.20, 95% CI: 0.56-3.85, P = 0.01). For urine studies, pooling data under the random effect model from eight studies indicated no significant difference between the children in the ASD group and control group in urinary lead level (Hedges' g: - 0.34, 95% CI: - 1.14,0.45, P = 0.40). Moreover, the funnel plot and the results of the Egger test for the blood and urine samples showed no publication bias, while, for the hair samples, the funnel plot illustrated the existence of publication bias.
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Affiliation(s)
- Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Alireza Amirabadizadeh
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, 9717113163, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nemam Ali Azadi
- Biostatistics Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Farnaz Radmehr
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alanazi MM, Ansari MA, Nadeem A, Attia SM, Bakheet SA, Al-Mazroua HA, Aldossari AA, Almutairi MM, Albekairi TH, Hussein MH, Al-Hamamah MA, Ahmad SF. Cadmium Exposure Is Associated with Behavioral Deficits and Neuroimmune Dysfunction in BTBR T+ Itpr3tf/J Mice. Int J Mol Sci 2023; 24:ijms24076575. [PMID: 37047547 PMCID: PMC10095149 DOI: 10.3390/ijms24076575] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Autism spectrum disorders (ASD) are neurobehavioral disabilities characterized by impaired social interactions, poor communication skills, and restrictive/repetitive behaviors. Cadmium is a common heavy metal implicated in ASD. In this study, we investigated the effects of Cd exposure on BTBR T+ Itpr3tf/J (BTBR) mice, an ASD model. We looked for changes in repetitive behaviors and sociability through experiments. We also explored the molecular mechanisms underlying the effects of Cd exposure, focusing on proinflammatory cytokines and pathways. Flow cytometry measured IL-17A-, IL-17F-, IL-21-, TNF-α-, STAT3-, and RORγt-expressing CD4+ T cells from the spleens of experimental mice. We then used RT-PCR to analyze IL-17A, IL-17F, IL-21, TNF-α, STAT3, and RORγ mRNA expression in the brain. The results of behavioral experiments showed that Cd exposure significantly increased self-grooming and marble-burying in BTBR mice while decreasing social interactions. Cd exposure also significantly increased the number of CD4+IL-17A+, CD4+IL-17F+, CD4+IL-21+, CD4+TNF-α+, CD4+STAT3+, and CD4+RORγt+ cells, while upregulating the mRNA expression of the six molecules in the brain. Overall, our results suggest that oral exposure to Cd aggravates behavioral and immune abnormalities in an ASD animal model. These findings have important implications for ASD etiology and provide further evidence of heavy metals contributing to neurodevelopmental disorders through proinflammatory effects.
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Affiliation(s)
- Mohammed M. Alanazi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mushtaq A. Ansari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ahmed Nadeem
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sabry M. Attia
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Saleh A. Bakheet
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Haneen A. Al-Mazroua
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Abdullah A. Aldossari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed M. Almutairi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Thamer H. Albekairi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Marwa H. Hussein
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed A. Al-Hamamah
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sheikh F. Ahmad
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
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10
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Shiani A, Sharafi K, Omer AK, Kiani A, Karamimatin B, Massahi T, Ebrahimzadeh G. A systematic literature review on the association between exposures to toxic elements and an autism spectrum disorder. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159246. [PMID: 36220469 DOI: 10.1016/j.scitotenv.2022.159246] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND AND AIM Autism spectrum disorder (ASD) is a neurodevelopmental illness characterized by difficulties in social communication and repetitive behaviors. There have been many previous studies of toxic metals in ASD. Therefore, the priority of this study is to review the relationships between exposure to toxic metals and ASD. MATERIALS & METHODS This study was based on a comprehensive search of international databases, such as Web of Science, Science Direct, Scopus, PubMed, and Google Scholar, for all works related to the subject under discussion from 1982 to 2022. We further summarize published data linked to this topic and discuss with clarifying evidence that agrees and conflicts with the association between exposure to toxic metals, including mercury (Hg), lead (Pb), cadmium (Cd), arsenic (As), and aluminum (Al) and ASD. RESULTS 40 out of 63 papers met the requirements for meta-analysis. Blood Pb levels (standardized mean difference (SMD) = 0.81; 95 % confidence interval (CI): 0.36-1.25), blood Hg (SMD = 0.90; CI: 0.30-1.49), hair Pb (SMD = 1.47; CI: 0.03-2.92), urine As (SMD = 0.65; CI: 0.22-1.09), and urine Al levels (SMD = 0.85; CI: 0.40-1.29) in autistic individuals were significantly higher than those of healthy control (HC). Whereas, blood As levels (SMD = 1.33; CI: -1.32-3.97), hair As (SMD = 0.55; CI: -0.14-1.24), hair Cd (SMD = 0.60; CI: -0.31-1.51), hair Hg (SMD = 0.41; CI: -0.30-1.12), hair Al (SMD = 0.87; CI: -0.02-1.77), urine Pb (SMD = -0.68; CI: -2.55-1.20), urine Cd (SMD = -0.26; CI: -0.94-0.41), and urine Hg levels (SMD = 0.47; CI: -0.09-1.04) in autistic individuals were significantly lower than those of HC. CONCLUSION Toxic metal content significantly differed between individuals with ASD and HC in the current meta-analysis. The results assist in clarifying the significance of toxic metals as environmental factors in the development of ASD.
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Affiliation(s)
- Amir Shiani
- Department of Speech Therapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran; Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kiomars Sharafi
- Research Center for Environmental Determinants of Health (RCEDH), Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Department of Environmental Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Abdullah Khalid Omer
- Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran; Razga Company, Kurdistan Region, Iraq.
| | - Amir Kiani
- Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran; Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karamimatin
- Research Center for Environmental Determinants of Health (RCEDH), Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Tooraj Massahi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Gholamreza Ebrahimzadeh
- Department of Environmental Health Engineering, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
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Zhang J, Lin J, Zhao X, Yao F, Feng C, He Z, Cao X, Gao Y, Khan NU, Chen M, Luo P, Shen L. Trace Element Changes in the Plasma of Autism Spectrum Disorder Children and the Positive Correlation Between Chromium and Vanadium. Biol Trace Elem Res 2022; 200:4924-4935. [PMID: 35006555 DOI: 10.1007/s12011-021-03082-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/21/2021] [Indexed: 12/27/2022]
Abstract
Existing data demonstrate a significant correlation between autism spectrum disorder (ASD) and the status of biologically essential and toxic trace elements. However, there is still a lack of data on the steady state of trace elements in ASD. We performed a case-control study to explore the association between the risk of ASD and 23 trace elements in plasma. The results showed that children with ASD had considerably decreased lithium (Li), manganese (Mn), selenium (Se), barium (Ba), mercury (Hg), and tin (Sn) levels when compared to their age- and sex-matched controls. Meanwhile, children with ASD had considerably increased plasma chromium (Cr) and vanadium (V) concentrations. We also divided each group into subgroups based on age and gender and created element-related networks for each subgroup. We detected significant element correlations within or between subgroups, as well as changes in correlations that included all elements examined. Finally, more element correlations were observed among males, which may open a new avenue for understanding the complicated process behind the sex ratio of children with ASD. Overall, our data revealed a novel relationship between elements and ASD, which may extend current understanding about ASD.
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Affiliation(s)
- Jun Zhang
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518071, People's Republic of China
- School of Public Health, Key Laboratory of Environmental Pollution Monitoring Control Ministry of Education, Guizhou Medical University, Guiyang, 550025, People's Republic of China
| | - Jing Lin
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518071, People's Republic of China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, People's Republic of China
| | - Xiying Zhao
- Shenzhen Academy of Metrology and Quality Inspection, Shenzhen, 518055, People's Republic of China
| | - Fang Yao
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518071, People's Republic of China
- Brain Disease and Big Data Research Institute, Shenzhen University, Shenzhen, 518071, People's Republic of China
| | - Chengyun Feng
- Maternal and Child Health Hospital of Baoan, Shenzhen, 518100, People's Republic of China
| | - Zhijun He
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518071, People's Republic of China
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, Shenzhen, 518071, People's Republic of China
| | - Xueshan Cao
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518071, People's Republic of China
| | - Yan Gao
- Maternal and Child Health Hospital of Baoan, Shenzhen, 518100, People's Republic of China
| | - Naseer Ullah Khan
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518071, People's Republic of China
| | - Margy Chen
- Department of Psychology, Emory University, Atlanta, GA, 30322, USA
| | - Peng Luo
- School of Public Health, Key Laboratory of Environmental Pollution Monitoring Control Ministry of Education, Guizhou Medical University, Guiyang, 550025, People's Republic of China
| | - Liming Shen
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518071, People's Republic of China.
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Abd Wahil MS, Ja’afar MH, Md Isa Z. Assessment of Urinary Lead (Pb) and Essential Trace Elements in Autism Spectrum Disorder: a Case-Control Study Among Preschool Children in Malaysia. Biol Trace Elem Res 2022; 200:97-121. [PMID: 33661472 PMCID: PMC7930527 DOI: 10.1007/s12011-021-02654-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 12/27/2022]
Abstract
Lead (Pb) is a heavy metal which is abundant in the environment and known to cause neurotoxicity in children even at minute concentration. However, the trace elements calcium (Ca), magnesium (Mg), zinc (Zn) and iron (Fe) are essential to children due to its protective effect on neurodevelopment. The primary objective of this study was to assess the role of Pb and trace elements in the development of autism spectrum disorder (ASD) among preschool children. A total of 81 ASD children and 74 typically developed (TD) children aged between 3 and 6 years participated in the study. Self-administered online questionnaires were completed by the parents. A first-morning urine sample was collected in a sterile polyethene urine container and assayed for Pb, Ca, Mg, Zn and Fe using an inductively coupled plasma mass spectrometry (ICP-MS). Comparisons between groups revealed that the urinary Pb, Mg, Zn and Fe levels in ASD children were significantly lower than TD children. The odds of ASD reduced significantly by 5.0% and 23.0% with an increment of every 1.0 μg/dL urinary Zn and Fe, respectively. Post interaction analysis showed that the odds of ASD reduced significantly by 11.0% and 0.1% with an increment of every 1.0 μg/dL urinary Zn and Pb, respectively. A significantly lower urinary Pb level in ASD children than TD children may be due to their poor detoxifying mechanism. Also, the significantly lower urinary Zn and Fe levels in ASD children may augment the neurotoxic effect of Pb.
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Affiliation(s)
- Mohd Shahrol Abd Wahil
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Hasni Ja’afar
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Zaleha Md Isa
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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13
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Concentrations of Lead, Mercury, Arsenic, Cadmium, Manganese, and Aluminum in the Blood of Pakistani Children with and without Autism Spectrum Disorder and Their Associated Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168625. [PMID: 34444373 PMCID: PMC8392432 DOI: 10.3390/ijerph18168625] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/02/2021] [Accepted: 08/12/2021] [Indexed: 12/27/2022]
Abstract
Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with early onset in utero or childhood. Environmental exposure to six metals (Pb, Hg, As, Cd, Mn, Al) is believed to be associated with ASD directly or interactively with genes. Objective: To assess the association of ASD among Pakistani children with the six metals and genotype frequencies of three GST genes (GSTP1, GSTM1, GSTT1). Methods: We enrolled 30 ASD cases, age 2–12 years old, and 30 age- and sex-matched typically developing (TD) controls in Karachi, Pakistan. We assessed associations of ASD status with various factors using Conditional Logistic Regression models. We also used General Linear Models to assess possible interaction of blood Mn and Pb concentrations with the three GST genes in relation to ASD status. Results: The unadjusted difference between ASD and TD groups in terms of geometric mean blood Pb concentrations was marginally significant (p = 0.05), but for Al concentrations, the adjusted difference was marginally significant (p = 0.06). Conclusions: This is the first study reporting six blood metal concentrations of Pakistani children with ASD. Estimates provided for possible interactions of GST genes with Mn and Pb in relation to ASD status are valuable for designing future similar studies.
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Baj J, Flieger W, Flieger M, Forma A, Sitarz E, Skórzyńska-Dziduszko K, Grochowski C, Maciejewski R, Karakuła-Juchnowicz H. Autism spectrum disorder: Trace elements imbalances and the pathogenesis and severity of autistic symptoms. Neurosci Biobehav Rev 2021; 129:117-132. [PMID: 34339708 DOI: 10.1016/j.neubiorev.2021.07.029] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 02/08/2023]
Abstract
The identification of biomarkers as diagnostic tools and predictors of response to treatment of neurological developmental disorders (NDD) such as schizophrenia (SZ), attention deficit hyperactivity disorder (ADHD), or autism spectrum disorder (ASD), still remains an important challenge for clinical medicine. Metallomic profiles of ASD patients cover, besides essential elements such as cobalt, chromium, copper, iron, manganese, molybdenum, zinc, selenium, also toxic metals burden of: aluminum, arsenic, mercury, lead, beryllium, nickel, cadmium. Performed studies indicate that children with ASD present a reduced ability of eliminating toxic metals, which leads to these metals' accumulation and aggravation of autistic symptoms. Extensive metallomic studies allow a better understanding of the importance of trace elements as environmental factors in the pathogenesis of ASD. Even though a mineral imbalance is a fact in ASD, we are still expecting relevant tests and the elaboration of reference levels of trace elements as potential biomarkers useful in diagnosis, prevention, and treatment of ASD.
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Affiliation(s)
- Jacek Baj
- Department of Anatomy, Medical University of Lublin, Jaczewskiego Street 8b, 20-400, Lublin, Poland.
| | - Wojciech Flieger
- Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1, 20-059, Lublin, Poland
| | - Michał Flieger
- Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1, 20-059, Lublin, Poland
| | - Alicja Forma
- Chair and Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego Street 8b, 20-090, Lublin, Poland
| | - Elżbieta Sitarz
- Chair and 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Gluska Street 1, 20-439, Lublin, Poland
| | - Katarzyna Skórzyńska-Dziduszko
- Chair and Department of Human Physiology, Medical University of Lublin, Radziwillowska Street 11, Lublin, 20-080, Poland
| | - Cezary Grochowski
- Laboratory of Virtual Man, Chair of Anatomy, Medical University of Lublin, Jaczewskiego Street 8b, 20-400, Lublin, Poland
| | - Ryszard Maciejewski
- Department of Anatomy, Medical University of Lublin, Jaczewskiego Street 8b, 20-400, Lublin, Poland
| | - Hanna Karakuła-Juchnowicz
- Chair and 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Gluska Street 1, 20-439, Lublin, Poland; Department of Clinical Neuropsychiatry, Medical University of Lublin, Gluska Street 1, 20-439, Lublin, Poland
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15
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Dual-channel responsive fluorescent sensor for the logic-controlled detection and bioimaging of Zn2+ and Hg2+. J Mol Liq 2021. [DOI: 10.1016/j.molliq.2021.115279] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Ijomone OM, Olung NF, Akingbade GT, Okoh COA, Aschner M. Environmental influence on neurodevelopmental disorders: Potential association of heavy metal exposure and autism. J Trace Elem Med Biol 2020; 62:126638. [PMID: 32891009 PMCID: PMC7655547 DOI: 10.1016/j.jtemb.2020.126638] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023]
Abstract
Environmental factors have been severally established to play major roles in the pathogenesis of neurodevelopmental disorders including autism spectrum disorder (ASD). ASD is a neurodevelopmental disorder that is associated with symptoms that reduce the quality of life of affected individuals such as social interaction deficit, cognitive impairment, intellectual disabilities, restricted and repetitive behavioural patterns. ASD pathogenesis has been associated with environmental and genetic factors that alter physiologic processes during development. Here, we review literatures highlighting the environmental impact on neurodevelopmental disorders, and mechanisms by which environmental toxins may influence neurodevelopment. Furthermore, this review discusses reports highlighting neurotoxic metals (specifically, lead, mercury, cadmium, nickel and manganese) as environmental risk factors in the aetiology of ASD. This work, thus suggests that improving the environment could be vital in the management of ASD.
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Affiliation(s)
- Omamuyovwi M Ijomone
- The Neuro- Lab, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria; Department of Human Anatomy, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria.
| | - Nzube F Olung
- The Neuro- Lab, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria
| | - Grace T Akingbade
- The Neuro- Lab, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria; Department of Human Anatomy, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria
| | - Comfort O A Okoh
- The Neuro- Lab, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, NY, USA; IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
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Rahbar MH, Samms-Vaughan M, Lee M, Zhang J, Hessabi M, Bressler J, Bach MA, Grove ML, Shakespeare-Pellington S, Beecher C, McLaughlin W, Loveland KA. Interaction between a Mixture of Heavy Metals (Lead, Mercury, Arsenic, Cadmium, Manganese, Aluminum) and GSTP1, GSTT1, and GSTM1 in Relation to Autism Spectrum Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2020; 79:101681. [PMID: 33193808 PMCID: PMC7664834 DOI: 10.1016/j.rasd.2020.101681] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Exposure to many environmental chemicals, including metals, often does not occur in isolation, hence requires assessment of the associations between exposure to mixtures of chemicals and human health. OBJECTIVES To investigate associations of a metal mixture of lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), manganese (Mn), and aluminum (Al) in children with autism spectrum disorder (ASD), additively or interactively with each of three glutathione S-transferase (GST) genes (GSTP1, GSTT1, and GSTM1). METHOD Using data from 266 case-control pairs of Jamaican children (2-8 years old), we fitted negative and positive generalized weighted quantile sum (gWQS) regression models to assess the aforementioned associations. RESULTS Based on additive and interactive negative gWQS models adjusted for maternal age, parental education, child's parish, and seafood consumption, we found inverse associations of the overall mixture score with ASD [MOR (95% CI): 0.70 (0.49, 0.99); P < 0.05) and [MOR (95%CI): 0.46 (0.25, 0.84); P = 0.01], respectively. In an unadjusted negative gWQS model, we found a marginally significant interaction between GSTP1 and a mixture of three metals (Pb, Hg, and Mn) (P = 0.07) while the association was no longer significant after adjustment for the same covariates (P = 0.24). CONCLUSIONS Differences in diet between ASD and control groups may play a role in the inverse associations we found. The possible interactive association between Mn and GSTP1 in ASD based on gWQS is consistent with our previous reports. However, possible interaction of GSTP1 with Pb and Hg in ASD requires further investigation and replication.
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Affiliation(s)
- Mohammad H. Rahbar
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Maureen Samms-Vaughan
- Department of Child & Adolescent Health, The University of the West Indies (UWI), Mona Campus, Kingston, Jamaica
| | - MinJae Lee
- Division of Biostatistics, Department of Population & Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Jing Zhang
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Department of Biostatistics & Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Manouchehr Hessabi
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Jan Bressler
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - MacKinsey A. Bach
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Megan L. Grove
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | | | - Compton Beecher
- Department of Basic Medical Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Wayne McLaughlin
- Department of Basic Medical Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
- Caribbean Genetics (CARIGEN), The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Katherine A. Loveland
- Louis A Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA
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Sulaiman R, Wang M, Ren X. Exposure to Aluminum, Cadmium, and Mercury and Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis. Chem Res Toxicol 2020; 33:2699-2718. [DOI: 10.1021/acs.chemrestox.0c00167] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Rosalind Sulaiman
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York, Buffalo, New York 14214, United States
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York, Buffalo, New York 14214, United States
- Research and Education in Energy, Environment and Water Institute, University at Buffalo, Buffalo, New York 14260, United States
| | - Xuefeng Ren
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York, Buffalo, New York 14214, United States
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, The State University of New York, Buffalo, New York 14214, United States
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Geier DA, Kern JK, Geier MR. Down syndrome as a genetic model to evaluate the role of oxidative stress and transsulfuration abnormalities in autism spectrum disorder: A 10-year longitudinal cohort study. Dev Neurobiol 2019; 79:857-867. [PMID: 31742925 DOI: 10.1002/dneu.22726] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/09/2019] [Accepted: 11/15/2019] [Indexed: 01/18/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder in which evidence reveals oxidative stress and transsulfuration pathway abnormalities. Down syndrome (DS) is a genetic disorder characterized by similar oxidative stress and transsulfuration pathway abnormalities. This hypothesis-testing longitudinal cohort study determined whether transsulfuration abnormalities and oxidative stress are important susceptibility factors in ASD etiology by evaluating the rate of ASD diagnoses in DS as compared to the general population. The Independent Healthcare Research Database was analyzed for healthcare records prospectively generated in Florida Medicaid. A cohort of 101,736 persons (born: 1990-1999) with ≥10 outpatient office visits and continuously followed for 120 months after birth was examined. There were 942 children in the DS cohort (ICD-9 code: 758.0) and 100,749 children in the undiagnosed cohort (no DS diagnosis). ASD diagnoses were defined as autistic disorder (ICD-9 code: 299.00) or Asperger's disorder/pervasive developmental disorder-not otherwise specified (ICD-9 code: 299.80). ASDs were diagnosed in 5.31% of the DS cohort and 1.34% of the undiagnosed cohort. The risk ratio of being diagnosed with an ASD in the DS cohort as compared to the undiagnosed cohort was 3.97-fold significantly increased with a risk difference of 3.97%. Among children diagnosed with DS, less than 6% were also diagnosed with an ASD. Among children diagnosed with an ASD, less than 5% were also diagnosed with DS. Children diagnosed with DS are apparently more susceptible to ASD diagnosis relative to the general population suggesting oxidative stress and transsulfuration pathway abnormalities are important susceptibility factors in ASD.
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Affiliation(s)
- David A Geier
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,CoMeD, Inc., Silver Spring, MD, USA
| | - Janet K Kern
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,CoMeD, Inc., Silver Spring, MD, USA.,CONEM US Autism Research Group, Allen, TX, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,CoMeD, Inc., Silver Spring, MD, USA
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Wang M, Hossain F, Sulaiman R, Ren X. Exposure to Inorganic Arsenic and Lead and Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis. Chem Res Toxicol 2019; 32:1904-1919. [PMID: 31549506 DOI: 10.1021/acs.chemrestox.9b00134] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Inorganic arsenic (iAs) and lead (Pb) rank first and second on the U.S. Environmental Protection Agency's priority list of hazardous substances. Both are known neurotoxic metals that cause detrimental effects on brain development and lead to deficits in cognitive function and behavioral performance in children. Studies have indicated a potential link between iAs and Pb exposure and a higher risk for autism spectrum disorder (ASD). To provide further insight into whether developmental exposure to iAs or Pb is associated with ASD, we conducted a systematic review and combined data into a meta-analysis to evaluate the available human evidence on the relationships. We systematically reviewed relevant studies published through December 30, 2018 and identified 14 studies on iAs and 37 studies on Pb exposure and their respective associations with ASD. Among them, 8 (53.3%) and 19 (51.3%) studies reported a positive association for iAs and Pb, respectively, and none reported a sole inverse association. In the following meta-analysis, we found statistically significant higher iAs concentrations, in hair and in blood, for children diagnosed with ASD compared with controls across studies. However, the findings on Pb exposure were inconsistent, with a significant association for hair Pb, no association for urinary Pb, and an inverse association for blood Pb. After considering strengths and limitations of the body of research, we concluded that there is consistent evidence supporting a positive association between early life iAs exposure and diagnosis of ASD and inconsistent evidence for Pb exposure and ASD risk. We believe it is in the best interest of policy makers and the public to reduce exposures to iAs and Pb among pregnant women and children. Further, our research supports the need for large perspective human studies with accurate measurement and determination of the long-term body burden of iAs and Pb exposures to assess the impact of iAs and Pb exposures on ASD risk.
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Affiliation(s)
- Meng Wang
- Research and Education in Energy, Environment and Water Institute , University at Buffalo , Buffalo , New York 14260 , United States
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Hessabi M, Rahbar MH, Dobrescu I, Bach MA, Kobylinska L, Bressler J, Grove ML, Loveland KA, Mihailescu I, Nedelcu MC, Moisescu MG, Matei BM, Matei CO, Rad F. Concentrations of Lead, Mercury, Arsenic, Cadmium, Manganese, and Aluminum in Blood of Romanian Children Suspected of Having Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2303. [PMID: 31261817 PMCID: PMC6651707 DOI: 10.3390/ijerph16132303] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/15/2022]
Abstract
Environmental exposure to lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), manganese (Mn), and aluminum (Al) has been associated with neurodevelopmental disorders including autism spectrum disorder (ASD). We conducted a pilot study during May 2015-May 2107 to estimate blood concentrations of six metals (Pb, Hg, As, Cd, Mn, and Al) and identify their associated factors for children with ASD or suspected of having ASD in Romania. Sixty children, age 2-8 years, were administered versions of ADOS or ADI-R translated from English to Romanian. After assessment, 2-3 mL of blood was obtained and analyzed for the concentrations of the six metals. The mean age of children was 51.9 months and about 90% were male. More than half (65%) of the children were born in Bucharest. Over 90% of concentrations of As and Cd were below limits of detection. Geometric mean concentrations of Pb, Mn, Al, and Hg were 1.14 μg/dL, 10.84 μg/L, 14.44 μg/L, and 0.35 μg/L, respectively. Multivariable linear regression analysis revealed that children who were female, had less educated parents, exhibited pica, and ate cold breakfast (e.g., cereal), watermelon, and lamb had significantly higher concentrations of Pb compared to their respective referent categories (all p < 0.05 except for eating lamb, which was marginally significant, p = 0.053). Although this is the first study that provides data on concentrations of the six metals for Romanian children with ASD, the findings from this study could be useful for designing future epidemiologic studies for investigating the role of these six metals in ASD in Romanian children.
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Affiliation(s)
- Manouchehr Hessabi
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Mohammad H Rahbar
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Iuliana Dobrescu
- Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy of Carol Davila, Psychiatry Clinical Hospital Alexandru Obregia, Bucharest, sector 4, 041914, Romania
| | - MacKinsey A Bach
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Liana Kobylinska
- Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy of Carol Davila, Psychiatry Clinical Hospital Alexandru Obregia, Bucharest, sector 4, 041914, Romania
| | - Jan Bressler
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Megan L Grove
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Katherine A Loveland
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | - Ilinca Mihailescu
- Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy of Carol Davila, Psychiatry Clinical Hospital Alexandru Obregia, Bucharest, sector 4, 041914, Romania
| | - Maria Cristina Nedelcu
- Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy of Carol Davila, Psychiatry Clinical Hospital Alexandru Obregia, Bucharest, sector 4, 041914, Romania
| | - Mihaela Georgeta Moisescu
- Department of Biophysics and Cellular Biotechnology, University of Medicine and Pharmacy of Carol Davila, Bucharest, sector 5, 050747, Romania
| | - Bogdan Mircea Matei
- Department of Biophysics and Cellular Biotechnology, University of Medicine and Pharmacy of Carol Davila, Bucharest, sector 5, 050747, Romania
| | - Christien Oktaviani Matei
- Department of Biophysics and Cellular Biotechnology, University of Medicine and Pharmacy of Carol Davila, Bucharest, sector 5, 050747, Romania
| | - Florina Rad
- Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy of Carol Davila, Psychiatry Clinical Hospital Alexandru Obregia, Bucharest, sector 4, 041914, Romania.
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Guo BQ, Li HB, Liu YY. Association between hair lead levels and autism spectrum disorder in children: A systematic review and meta-analysis. Psychiatry Res 2019; 276:239-249. [PMID: 31121530 DOI: 10.1016/j.psychres.2019.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 05/11/2019] [Indexed: 01/08/2023]
Abstract
A number of studies measured lead levels in hair from children with autism spectrum disorder (ASD) to detect the relationship between cumulated lead exposure and the development of ASD, but results are inconsistent. We aimed to conduct a systematic review and meta-analysis using the published studies to explore the actual association of hair lead levels with ASD in children. We searched PubMed, Embase, PsycINFO, and Cochrane Library databases (up to December 11, 2018). The random-effects model was applied to summarize effect sizes. Subgroup and meta-regression analyses were performed simultaneously. Twenty eligible studies involving 1787 participants (941 autistic children and 846 healthy subjects) were included. Our results of primary analysis showed that there were no statistically significant differences in the levels of hair lead between children with ASD and healthy individuals (Hedges's g = 0.251; 95% confidence interval: -0.121, 0.623; P = 0.187). We identified 2 sources of between-study heterogeneity: analytical technology and the sample size of patients. Additionally, no publication bias was observed in this meta-analysis. In conclusion, this study does not support the association of hair lead levels with ASD in children, and the involvement of cumulated lead exposure in the occurrence of ASD.
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Affiliation(s)
- Bao-Qiang Guo
- Department of Child and Adolescent Health, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, Henan 453003, China.
| | - Hong-Bin Li
- Department of Child and Adolescent Health, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, Henan 453003, China
| | - Ying-Ying Liu
- Key Laboratory of Environmental Pollutants and Health Effects Assessment, School of Public Health, Xinxiang Medical University, Xinxiang, Henan 453003, China
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23
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Lee M, Rahbar MH, Samms-Vaughan M, Bressler J, Bach MA, Hessabi M, Grove ML, Shakespeare-Pellington S, Coore Desai C, Reece JA, Loveland KA, Boerwinkle E. A generalized weighted quantile sum approach for analyzing correlated data in the presence of interactions. Biom J 2019; 61:934-954. [PMID: 31058353 DOI: 10.1002/bimj.201800259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/26/2019] [Accepted: 03/13/2019] [Indexed: 12/23/2022]
Abstract
A weighted quantile sum (WQS) regression has been used to assess the associations between environmental exposures and health outcomes. However, the currently available WQS approach, which is based on additive effects, does not allow exploring for potential interactions of exposures with other covariates in relation to a health outcome. In addition, the current WQS cannot account for clustering, thus it may not be valid for analysis of clustered data. We propose a generalized WQS approach that can assess interactions by estimating stratum-specific weights of exposures in a mixture, while accounting for potential clustering effect of matched pairs of cases and controls as well as censored exposure data due to being below the limits of detection. The performance of the proposed method in identifying interactions is evaluated through simulations based on various scenarios of correlation structures among the exposures and with an outcome. We also assess how well the proposed method performs in the presence of the varying levels of censoring in exposures. Our findings from the simulation study show that the proposed method outperforms the traditional WQS, as indicated by higher power of detecting interactions. We also find no strong evidence that the proposed method falsely identifies interactions when there are no true interactive effects. We demonstrate application of the proposed method to real data from the Epidemiological Research on Autism Spectrum Disorder (ASD) in Jamaica (ERAJ) by examining interactions between exposure to manganese and glutathione S-transferase family gene, GSTP1 in relation to ASD.
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Affiliation(s)
- MinJae Lee
- Division of Clinical and Translational Sciences, Department of Internal Medicine, University of Texas McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Mohammad H Rahbar
- Division of Clinical and Translational Sciences, Department of Internal Medicine, University of Texas McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Jan Bressler
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - MacKinsey A Bach
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Manouchehr Hessabi
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Megan L Grove
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | - Jody-Ann Reece
- The University of the West Indies (UWI), Mona Campus, Kingston, Jamaica
| | | | - Eric Boerwinkle
- The University of Texas Health Science Center at Houston, Houston, TX, USA
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Grabeklis AR, Skalny AV, Skalnaya AA, Zhegalova IV, Notova SV, Mazaletskaya AL, Skalnaya MG, Tinkov AA. Hair Mineral and Trace Element Content in Children with Down's Syndrome. Biol Trace Elem Res 2019; 188:230-238. [PMID: 30209729 DOI: 10.1007/s12011-018-1506-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/02/2018] [Indexed: 10/28/2022]
Abstract
The objective of the present study was to assess the level of minerals and trace elements in 40 children with Down's syndrome and 40 controls aged 1-2 years old. Hair mineral and trace element analysis was performed using inductively coupled plasma mass spectrometry. The obtained data demonstrate that hair levels of Mg, P, I, Cr, Si, Zn, and Pb in Down's syndrome patients exceeded the respective control values by 36, 36, 93, 57, 45, 28, and 54%, whereas hair mercury was more than twofold lower in children with Down's syndrome. The observed difference in the levels of trace elements was age-dependent. In particular, in 1-year-olds, major differences were observed for essential elements (Cr, Si, Zn), whereas in 2-year-olds-for toxic elements (Hg, Pb). At the same time, hair P levels in Down's syndrome patients were 14 and 35% higher at the age of 1 and 2 years in comparison to the respective controls. Multiple regression analysis demonstrated that a model incorporating all elements, being characterized by a significant group difference, accounted for 42.5% of status variability. At the same time, only hair phosphorus was significantly interrelated with Down's syndrome status (β = 0.478; p < 0.001). Principal component analysis (PCA) used As, Ca, Cr, Fe, Hg, I, Mg, P, Pb, Se, Si, Sn, and Zn as predictors, with the resulting R2 = 0.559. The OPLS-DA models also separated between Down's and health control groups. Therefore, 1-2-year-old patients with Down's syndrome are characterized by significant alterations of mineral and trace element status.
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Affiliation(s)
- Andrey R Grabeklis
- Yaroslavl State University, Yaroslavl, Russia
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Anatoly V Skalny
- Yaroslavl State University, Yaroslavl, Russia.
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation.
- All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia.
| | | | - Irina V Zhegalova
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Svetlana V Notova
- Orenburg State University, Orenburg, Russia
- Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, Russia
| | | | - Margarita G Skalnaya
- Yaroslavl State University, Yaroslavl, Russia
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Alexey A Tinkov
- Yaroslavl State University, Yaroslavl, Russia
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
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25
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Association between catatonia and levels of hair and serum trace elements and minerals in autism spectrum disorder. Biomed Pharmacother 2019; 109:174-180. [DOI: 10.1016/j.biopha.2018.10.051] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 12/28/2022] Open
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26
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Doenyas C. Novel Personalized Dietary Treatment for Autism Based on the Gut-Immune-Endocrine-Brain Axis. Front Endocrinol (Lausanne) 2019; 10:508. [PMID: 31456745 PMCID: PMC6700238 DOI: 10.3389/fendo.2019.00508] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 07/12/2019] [Indexed: 01/22/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition manifesting with impaired social interaction and communication, and restricted and repetitive behaviors and interests. In this perspective article, a more comprehensive approach than the gut-brain axis, hereby termed the "gut-immune-endocrine-brain" axis, is taken, based on which a personalized treatment plan for ASD is presented. ASD has no known etiology or cure, making desperate parents willing to try any treatment that worked for an individual with ASD, without much regard for its effectiveness, safety or side effects. This has been the case for restrictive dietary interventions as gluten-free/casein-free and ketogenic diets and recently, probiotics have emerged as the new such fad. One of the concerns about these dietary and probiotic treatments is their non-specificity: they may not be effective for all individuals with ASD, not all probiotic strains may have the beneficial qualities advertised indiscriminately for probiotics, and strains conferring benefits in one condition may not be probiotic in another. Not all children with ASD show immune reactivity to dietary proteins in wheat and milk, and wheat and milk may not be the only dietary elements to which reactivity is exhibited, where dietary aquaporins that resemble human aquaporins may elicit antibody reactivity in genetically susceptible individuals, which may include individuals with ASD. These observations are utilized to formulate a three-step plan to create effective, targeted, personalized treatments with as few side effects as possible, enabled by a systems approach connecting the various findings for dietary, immune, and neuroautoimmune reactivity in individuals with ASD.
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Skalny AV, Simashkova NV, Skalnaya AA, Klyushnik TP, Zhegalova IV, Grabeklis AR, Skalnaya MG, Tinkov AA. Trace element levels are associated with neuroinflammatory markers in children with autistic spectrum disorder. J Trace Elem Med Biol 2018; 50:622-628. [PMID: 29731309 DOI: 10.1016/j.jtemb.2018.04.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/27/2022]
Abstract
The objective of the present study was to estimate the association between brain inflammatory markers and serum trace element levels as assessed by inductively coupled plasma mass spectrometry at NexION 300D. Leukocyte elastase (LE), α1-proteinase inhibitor (α1-PI) activity, anti-nerve growth factor-antibodies (anti-NGF-Ab), and anti-myelin basic protein-antibodies (anti-MBP-Ab) levels were assessed as inflammatory markers. The obtained data demonstrate that the increase in LE and α1-PI activity is associated with higher serum Cr and Cu levels, respectively. The increase in Anti-NGF-Ab levels was associated with a nearly significant 16% increase in serum Mn levels. Autistic children with high MBP-Ab levels were characterized by 28% higher serum Mn and lower Mg concentration. The results of correlation analysis were generally in agreement with the outcome of group comparisons. Regression analysis demonstrated that serum Mg was significantly negatively associated with LE activity, whereas both serum Fe and V concentrations were characterized by a positive influence on the parameter. In turn, serum Cu was a significant predictor of α1-PI, as well as Cr levels. At the same time, the serum concentrations of Cd and Fe were found to be inversely associated with α1-PI levels. Serum Cd and Mn levels were significant positive predictors of anti-MBP-Ab levels, whereas Mg levels had a negative impact on anti-MBP-Ab values. Generally, the obtained data demonstrate the interrelationship between trace element homeostasis and neuroinflammation in autism. Hypothetically, modulation of trace element status may be used for reduction of neuroinflammatory response, although further studies are required to reveal the underlying mechanisms of the observed associations.
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Affiliation(s)
- Anatoly V Skalny
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia; Orenburg State University, Pobedy Ave., 13, Orenburg, 460352, Russia
| | - Natalia V Simashkova
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | | | - Tatiana P Klyushnik
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | - Irina V Zhegalova
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; I.M. Sechenov First Moscow State Medical University, Malaya Trubetskaya St., 8, Moscow, 119992, Russia
| | - Andrei R Grabeklis
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia
| | | | - Alexey A Tinkov
- Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia.
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28
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Rahbar MH, Samms-Vaughan M, Lee M, Christian MA, Bressler J, Hessabi M, Grove ML, Shakespeare-Pellington S, Desai CC, Reece JA, Loveland KA, Beecher C, McLaughlin W, Boerwinkle E. Interaction between manganese and GSTP1 in relation to autism spectrum disorder while controlling for exposure to mixture of lead, mercury, arsenic, and cadmium. RESEARCH IN AUTISM SPECTRUM DISORDERS 2018; 55:50-63. [PMID: 30930959 PMCID: PMC6434704 DOI: 10.1016/j.rasd.2018.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND We previously reported a significant interactive association between polymorphisms of GSTP1 and blood manganese concentrations (BMC) with autism spectrum disorder (ASD) in Jamaican children. In this paper, we investigate the same interactive association with ASD while adjusting for the mixture of four metals (lead, mercury, cadmium, and arsenic). METHOD We used data from 163 case-control pairs of children 2-8 years of age from our autism project in Jamaica, in which we collected blood for heavy metals analysis at enrollment. To minimize potential multicollinearity between concentrations of the four metals, we generated a mixture index using generalized weighted quantile sum regression, which was used in conditional logistic regression models to control for the four metals while assessing the interactive association between GSTP1 and BMC with ASD. RESULTS Similar to the findings we reported previously, we found that in co-dominant and dominant models for GSTP1, among children with the Ile/Ile genotype, those with BMC > 12μg/L had 4.6 and 4.27 times higher odds of ASD compared to those with BMC < 12μg/L (adjusted Matched Odds Ratio (MOR) = 4.6, 95% CI: 1.21 - 17.42 and adjusted MOR = 4.27, 95% CI: 1.15 - 15.85, respectively). In the co-dominant model, for children with the Ile/Val and Val/Val genotypes, the adjusted MORs were 1.26 (95% CI: 0.32, 5.01) and 0.26 (95% CI: 0.05, 1.42), respectively. CONCLUSIONS After adjusting for the mixture of four metals, the interactive association of BMC and GSTP1 with ASD remained significant with similar magnitude of associations. Results should be interpreted cautiously.
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Affiliation(s)
- Mohammad H. Rahbar
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The
University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School,
The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences
(CCTS), The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
| | - Maureen Samms-Vaughan
- Department of Child & Adolescent Health, The University of the West Indies (UWI), Mona Campus, Kingston,
Jamaica
| | - MinJae Lee
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School,
The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences
(CCTS), The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
| | - MacKinsey A. Christian
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The
University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences
(CCTS), The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
| | - Jan Bressler
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The
University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of
Public Health, The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
| | - Manouchehr Hessabi
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences
(CCTS), The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
| | - Megan L. Grove
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The
University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of
Public Health, The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
| | | | - Charlene Coore Desai
- Department of Child & Adolescent Health, The University of the West Indies (UWI), Mona Campus, Kingston,
Jamaica
| | - Jody-Ann Reece
- Department of Child & Adolescent Health, The University of the West Indies (UWI), Mona Campus, Kingston,
Jamaica
| | - Katherine A. Loveland
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health
Science Center at Houston, Houston, Texas 77054, USA
| | - Compton Beecher
- Department of Basic Medical Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Wayne McLaughlin
- Department of Basic Medical Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
- Caribbean Genetics (CARIGEN),The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The
University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of
Public Health, The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, USA
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29
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Bjørklund G, Skalny AV, Rahman MM, Dadar M, Yassa HA, Aaseth J, Chirumbolo S, Skalnaya MG, Tinkov AA. Toxic metal(loid)-based pollutants and their possible role in autism spectrum disorder. ENVIRONMENTAL RESEARCH 2018; 166:234-250. [PMID: 29902778 DOI: 10.1016/j.envres.2018.05.020] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/18/2018] [Accepted: 05/18/2018] [Indexed: 06/08/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction, verbal and non-verbal communication, and stereotypic behaviors. Many studies support a significant relationship between many different environmental factors in ASD etiology. These factors include increased daily exposure to various toxic metal-based environmental pollutants, which represent a cause for concern in public health. This article reviews the most relevant toxic metals, commonly found, environmental pollutants, i.e., lead (Pb), mercury (Hg), aluminum (Al), and the metalloid arsenic (As). Additionally, it discusses how pollutants can be a possible pathogenetic cause of ASD through various mechanisms including neuroinflammation in different regions of the brain, fundamentally occurring through elevation of the proinflammatory profile of cytokines and aberrant expression of nuclear factor kappa B (NF-κB). Due to the worldwide increase in toxic environmental pollution, studies on the role of pollutants in neurodevelopmental disorders, including direct effects on the developing brain and the subjects' genetic susceptibility and polymorphism, are of utmost importance to achieve the best therapeutic approach and preventive strategies.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | - Anatoly V Skalny
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; Yaroslavl State University, Yaroslavl, Russia; All-Russian Research Institute of Medicinal and Aromatic Plants, Moscow, Russia
| | - Md Mostafizur Rahman
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, Bangladesh; Graduate School of Environmental Science, Hokkaido University, Japan
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Heba A Yassa
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Jan Aaseth
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Salvatore Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | | | - Alexey A Tinkov
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; Yaroslavl State University, Yaroslavl, Russia
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Dickerson AS, Rotem RS, Christian MA, Nguyen VT, Specht AJ. Potential Sex Differences Relative to Autism Spectrum Disorder and Metals. Curr Environ Health Rep 2018; 4:405-414. [PMID: 28988324 DOI: 10.1007/s40572-017-0164-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW This study aims to summarize the current body of literature on the relationship between various toxic metals exposures (i.e., aluminum, antimony, arsenic, beryllium, cadmium, chromium, lead, manganese, and nickel) and autism spectrum disorder (ASD), with a focus on potential sex differences in these associations. RECENT FINDINGS Sex differences in ASD diagnosis and mutagenic effects of toxic exposures indicate that sex differences may play a major part in the causal relationship of any potential associations seen; however, we were only able to find three studies that reported on sex differences in observed associations with toxic metals exposure and ASD. We also found several studies investigating associations between ASD and metals exposures, including 11 on aluminum, 6 on antimony, 15 on arsenic, 5 on beryllium, 17 on cadmium, 11 on chromium, 25 on lead, 14 on manganese, and 13 on nickel with markers of exposure in hair, urine, blood, teeth, fingernails, and air pollution. Results for each metal were conflicting, but studies on cadmium and lead yielded the highest proportion of studies with positive results (72% and 36%, respectively). Based on our examination of existing literature, the current evidence warrants a considerable need for evaluations of sex differences in future studies assessing the association between metals exposures and ASD. Additionally, failure to account for potential sex differences could result in bias and misinterpretation of exposure-disease relationships.
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Affiliation(s)
- Aisha S Dickerson
- Departments of Epidemiology and Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA. .,Environmental and Occupation Medicine and Epidemiology Division of the Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Street, Landmark Center L3-125, Boston, MA, USA.
| | - Ran S Rotem
- Department Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
| | - MacKinsey A Christian
- Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, and Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Vy T Nguyen
- Department Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
| | - Aaron J Specht
- Department Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
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Li H, Li H, Li Y, Liu Y, Zhao Z. Blood Mercury, Arsenic, Cadmium, and Lead in Children with Autism Spectrum Disorder. Biol Trace Elem Res 2018; 181:31-37. [PMID: 28480499 DOI: 10.1007/s12011-017-1002-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 03/17/2017] [Indexed: 12/15/2022]
Abstract
Environmental factors have been implicated in the etiology of autism spectrum disorder (ASD); however, the role of heavy metals has not been fully defined. This study investigated whether blood levels of mercury, arsenic, cadmium, and lead of children with ASD significantly differ from those of age- and sex-matched controls. One hundred eighty unrelated children with ASD and 184 healthy controls were recruited. Data showed that the children with ASD had significantly (p < 0.001) higher levels of mercury and arsenic and a lower level of cadmium. The levels of lead did not differ significantly between the groups. The results of this study are consistent with numerous previous studies, supporting an important role for heavy metal exposure, particularly mercury, in the etiology of ASD. It is desirable to continue future research into the relationship between ASD and heavy metal exposure.
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Affiliation(s)
- Huamei Li
- Children's Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Hui Li
- Laboratory of Neuroinflammation, StVincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW, Australia
| | - Yun Li
- Children's Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Yujie Liu
- Children's Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Zhengyan Zhao
- Children's Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
- Department of Pediatric Health Care, Children's Hospital of Zhejiang University School of Medicine, 57 Zhuganxiang Road, Hangzhou, People's Republic of China, 310003.
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Skalny AV, Simashkova NV, Skalnaya MG, Klyushnik TP, Chernova LN, Tinkov AA. Mercury and autism spectrum disorders. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:75-79. [DOI: 10.17116/jnevro20181185275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Jafari T, Rostampour N, Fallah AA, Hesami A. The association between mercury levels and autism spectrum disorders: A systematic review and meta-analysis. J Trace Elem Med Biol 2017; 44:289-297. [PMID: 28965590 DOI: 10.1016/j.jtemb.2017.09.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/30/2017] [Accepted: 09/01/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS The relationship between mercury and autism spectrum disorders (ASD) has always been a topic of controversy among researchers. This study aimed to assess the relationship between ASD and mercury levels in hair, urine, blood, red blood cells (RBC), and brain through a meta-analysis. METHODS A systematic search was performed in several databases including PubMed, ISI Web of Science, Cochrane register of controlled trials, Google Scholar, Scopus, and MagIran until June 2017. Case-control studies evaluating concentration of total mercury in different tissues of ASD patients and comparing them to the healthy subjects (control group) were identified. Necessary data were extracted and random effects model was used to calculate overall effect and its 95% corresponding confidence interval (CI) from the effect sizes. RESULTS A total of 44 studies were identified that met the necessary criteria for meta-analysis. The mercury level in whole blood (Hedges=0.43, 95% CI: 0.12, 0.74, P=0.007), RBC (Hedges=1.61, 95% CI: 0.83, 2.38, P<0.001), and brain (0.61ng/g, 95% CI, 0.02, 1.19, P=0.043) was significantly higher in ASD patients than healthy subjects, whereas mercury level in hair (-0.14mg/g, 95% CI: -0.28, -0.01, P=0.039) was significantly lower in ASD patients than healthy subjects. The mercury level in urine was not significantly different between ASD patients and healthy subjects (0.51mg/g creatinine, 95% CI: -0.14, 1.16, P=0.121). CONCLUSIONS Results of the current meta-analysis revealed that mercury is an important causal factor in the etiology of ASD. It seems that the detoxification and excretory mechanisms are impaired in ASD patients which lead to accumulation of mercury in the body. Future additional studies on mercury levels in different tissues of ASD patients should be undertaken.
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Affiliation(s)
- Tina Jafari
- Clinical Biochemistry Research Center, Shahrekord University of Medical Sciences, Sharhekord, Iran; Department of Biochemistry and Nutrition, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Noushin Rostampour
- Department of Pediatrics, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Aziz A Fallah
- Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord 34141, Iran
| | - Afshin Hesami
- Clinical Biochemistry Research Center, Shahrekord University of Medical Sciences, Sharhekord, Iran
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Saghazadeh A, Rezaei N. Systematic review and meta-analysis links autism and toxic metals and highlights the impact of country development status: Higher blood and erythrocyte levels for mercury and lead, and higher hair antimony, cadmium, lead, and mercury. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:340-368. [PMID: 28716727 DOI: 10.1016/j.pnpbp.2017.07.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder that affects cognitive and higher cognitive functions. Increasing prevalence of ASD and high rates of related comorbidities has caused serious health loss and placed an onerous burden on the supporting families, caregivers, and health care services. Heavy metals are among environmental factors that may contribute to ASD. However, due to inconsistencies across studies, it is still hard to explain the association between ASD and toxic metals. Therefore the objective of this study was to investigate the difference in heavy metal measures between patients with ASD and control subjects. METHODS We included observational studies that measured levels of toxic metals (antimony, arsenic, cadmium, lead, manganese, mercury, nickel, silver, and thallium) in different specimens (whole blood, plasma, serum, red cells, hair and urine) for patients with ASD and for controls. The main electronic medical database (PubMed and Scopus) were searched from inception through October 2016. RESULTS 52 studies were eligible to be included in the present systematic review, of which 48 studies were included in the meta-analyses. The hair concentrations of antimony (standardized mean difference (SMD)=0.24; 95% confidence interval (CI): 0.03 to 0.45) and lead (SMD=0.60; 95% confidence interval (CI): 0.17 to 1.03) in ASD patients were significantly higher than those of control subjects. ASD patients had higher erythrocyte levels of lead (SMD=1.55, CI: 0.2 to 2.89) and mercury (SMD=1.56, CI: 0.42 to 2.70). There were significantly higher blood lead levels in ASD patients (SMD=0.43, CI: 0.02 to 0.85). Sensitivity analyses showed that ASD patients in developed but not in developing countries have lower hair concentrations of cadmium (SMD=-0.29, CI: -0.46 to -0.12). Also, such analyses indicated that ASD patients in developing but not in developed lands have higher hair concentrations of lead (SMD=1.58, CI: 0.80 to 2.36) and mercury (SMD=0.77, CI: 0.31 to 1.23). These findings were confirmed by meta-regression analyses indicating that development status of countries significantly influences the overall effect size of mean difference for hair arsenic, cadmium, lead, and mercury between patients with ASD and controls. CONCLUSION The findings help highlighting the role of toxic metals as environmental factors in the etiology of ASD, especially in developing lands. While there are environmental factors other than toxic metals that greatly contribute to the etiology of ASD in developed lands. It would be, thus, expected that classification of ASD includes etiological entities of ASD on the basis of implication of industrial pollutants (developed vs. developing ASD).
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Affiliation(s)
- Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; MetaCognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Boston, MA, USA.
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Skalny AV, Simashkova NV, Klyushnik TP, Grabeklis AR, Radysh IV, Skalnaya MG, Nikonorov AA, Tinkov AA. Assessment of serum trace elements and electrolytes in children with childhood and atypical autism. J Trace Elem Med Biol 2017; 43:9-14. [PMID: 27707611 DOI: 10.1016/j.jtemb.2016.09.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/02/2016] [Accepted: 09/28/2016] [Indexed: 11/24/2022]
Abstract
The existing data demonstrate a significant interrelation between ASD and essential and toxic trace elements status of the organism. However, data on trace element homeostasis in particular ASD forms are insufficient. Therefore, the objective of the present study was to assess the level of trace elements and electrolytes in serum of children with childhood and atypical autism. A total of 48 children with ASD (24 with childhood and 24 with atypical autism) and age- and sex-adjusted controls were examined. Serum trace elements and electrolytes were assessed using inductively-coupled plasma mass spectrometry. The obtained data demonstrate that children with ASD unspecified are characterized by significantly lower Ni, Cr, and Se levels as compared to the age- and sex-matched controls. At the same time, significantly decreased serum Ni and Se concentrations were detected in patients with childhood autism. In turn, children with atypical autism were characterized by more variable serum trace element spectrum. In particular, atypical autism is associated with lower serum Al, As, Ni, Cr, Mn, and Se levels in comparison to the control values. Moreover, Al and Mn concentration in this group was also lower than that in childhood autism patients. Generally, the obtained data demonstrate lower levels of both essential and toxic trace elements in atypical autism group, being indicative of profound alteration of trace elements metabolism. However, further detailed metabolic studies are required to reveal critical differences in metabolic pathways being responsible for difference in trace element status and clinical course of the disease.
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Affiliation(s)
- Anatoly V Skalny
- All-Russian Research Institute of Medicinal and Aromatic Plants, Moscow, Russia; Orenburg State University, Orenburg, Russia; Yaroslavl State University, Yaroslavl, Russia; RUDN University, Moscow, Russia.
| | - Natalia V Simashkova
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | - Tatiana P Klyushnik
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | | | | | | | - Alexandr A Nikonorov
- Orenburg State University, Orenburg, Russia; Orenburg State Medical University, Orenburg, Russia
| | - Alexey A Tinkov
- Orenburg State University, Orenburg, Russia; Yaroslavl State University, Yaroslavl, Russia; RUDN University, Moscow, Russia; Orenburg State Medical University, Orenburg, Russia
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El-Ansary A, Bjørklund G, Tinkov AA, Skalny AV, Al Dera H. Relationship between selenium, lead, and mercury in red blood cells of Saudi autistic children. Metab Brain Dis 2017; 32:1073-1080. [PMID: 28326463 DOI: 10.1007/s11011-017-9996-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/15/2017] [Indexed: 12/22/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause significant social, communication and behavioral challenges. Environmental contribution to ASD is due in large part to the sensitivity of the developing brain to external exposures such as lead (Pb), and mercury (Hg) as toxic heavy metals or due to a poor detoxification ability as the phenotype of this disorder. Selenium (Se) as an antioxidant element that counteracts the neurotoxicity of Hg, and Pb, presumably through the formation of nontoxic complexes. In the present study, Pb, Hg, and Se were measured in red blood cells (RBCs) of 35 children with ASD and 30 age- and gender-matched healthy control children using atomic absorption spectrometry. Receiver Operating Characteristics (ROC) analysis of the obtained data was performed to measure the predictive value of their absolute and relative concentrations. The obtained data demonstrates a significant elevation of Hg and Pb together with a significant decrease in the Se levels in RBCs of patients with ASD when compared to the healthy controls. The ratios of Se to both Pb and Hg were remarkably altered, being indicative of heavy metal neurotoxicity in patients with ASD. In conclusion, the present study indicates the importance of Se for prevention and/or therapy of heavy metal neurotoxicity.
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Affiliation(s)
- Afaf El-Ansary
- Central Laboratory, Center for Female Scientific and Medical Colleges, King Saud University, Riyadh, Saudi Arabia
- Autism Research and Treatment Center, Riyadh, Saudi Arabia
- Medicinal Chemistry Department, National Research Centre, Dokki, Cairo, Egypt
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610, Mo i Rana, Norway.
| | - Alexey A Tinkov
- Orenburg State University, Orenburg, Russia
- Orenburg State Medical University, Orenburg, Russia
- Yaroslavl State University, Yaroslavl, Russia
| | - Anatoly V Skalny
- Orenburg State Medical University, Orenburg, Russia
- Yaroslavl State University, Yaroslavl, Russia
- RUDN University, Moscow, Russia
- All-Russian Research Institute of Medicinal and Aromatic Plants, Moscow, Russia
| | - Hussain Al Dera
- Basic Medical Science Department, College of Medicine, King Saud bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
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Skalny AV, Simashkova NV, Klyushnik TP, Grabeklis AR, Radysh IV, Skalnaya MG, Tinkov AA. Analysis of Hair Trace Elements in Children with Autism Spectrum Disorders and Communication Disorders. Biol Trace Elem Res 2017; 177:215-223. [PMID: 27785740 DOI: 10.1007/s12011-016-0878-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/14/2016] [Indexed: 12/24/2022]
Abstract
The primary objective of the present study is analysis of hair trace elements content in children with communication disorder (CD) and autism spectrum disorder (ASD). A total of 99 children from control, CD, and ASD groups (n = 33) were examined. All children were additionally divided into two subgroups according to age. Hair levels of trace elements were assessed using inductively coupled plasma mass spectrometry. The difference was considered significant at p < 0.01. The obtained data demonstrate that children with CD are characterized by significantly increased hair lithium (Li) (96 %; p = 0.008), selenium (Se) (66 %; p < 0.001), arsenic (As) (96 %; p = 0.005), beryllium (Be) (150 %; p < 0.001), and cadmium (Cd) (72 %; p = 0.007) content, being higher than the respective control values. In the ASD group, hair copper (Cu), iodine (I), and Be levels tended to be lower than the control values. In turn, the scalp hair content of Se significantly exceeded the control values (33 %; p = 0.004), whereas the level of iron (Fe) and aluminum (Al) tended to increase. After gradation for age, the most prominent differences in children with CD were detected in the elder group (5-8 years), whereas in the case of ASD-in the younger group (3-4 years old). Taking into account the role of hair as excretory mechanism for certain elements including the toxic ones, it can be proposed that children suffering from ASD are characterized by more profound alteration of metal handling and excretion in comparison to CD.
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Affiliation(s)
- Anatoly V Skalny
- All-Russian Research Institute of Medicinal and Aromatic Plants, Moscow, Russia.
- Orenburg State University, Orenburg, Russia.
- Yaroslavl State University, Yaroslavl, Russia.
- RUDN University, Moscow, Russia.
| | - Natalia V Simashkova
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | - Tatiana P Klyushnik
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | | | | | | | - Alexey A Tinkov
- Orenburg State University, Orenburg, Russia
- Yaroslavl State University, Yaroslavl, Russia
- RUDN University, Moscow, Russia
- Orenburg State Medical University, Orenburg, Russia
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Karimi P, Kamali E, Mousavi SM, Karahmadi M. Environmental factors influencing the risk of autism. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2017; 22:27. [PMID: 28413424 PMCID: PMC5377970 DOI: 10.4103/1735-1995.200272] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/06/2016] [Accepted: 11/30/2016] [Indexed: 12/16/2022]
Abstract
Autism is a developmental disability with age of onset in childhood (under 3 years old), which is characterized by definite impairments in social interactions, abnormalities in speech, and stereotyped pattern of behaviors. Due to the progress of autism in recent decades, a wide range of studies have been done to identify the etiological factors of autism. It has been found that genetic and environmental factors are both involved in autism pathogenesis. Hence, in this review article, a set of environmental factors involved in the occurrence of autism has been collected, and finally, some practical recommendations for reduction of the risk of this devastating disease in children are represented.
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Affiliation(s)
- Padideh Karimi
- Division of Genetics, Department of Biology, Faculty of Science, Tarbiat Modares University, Tehran, Iran
| | - Elahe Kamali
- Division of Genetics, Department of Biology, Faculty of Science, Isfahan University, Isfahan, Iran
| | - Seyyed Mohammad Mousavi
- Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Genetic and Identification Lab, Legal Medicine Center, Isfahan, Iran
| | - Mojgan Karahmadi
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Noor Hospital, Isfahan, Iran
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Sivanesan S, Tan A, Jeyaraj R, Lam J, Gole M, Hardan A, Ashkan K, Rajadas J. Pharmaceuticals and Stem Cells in Autism Spectrum Disorders: Wishful Thinking? World Neurosurg 2017; 98:659-672. [DOI: 10.1016/j.wneu.2016.09.100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/24/2016] [Accepted: 09/26/2016] [Indexed: 12/21/2022]
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Skalny AV, Simashkova NV, Klyushnik TP, Grabeklis AR, Bjørklund G, Skalnaya MG, Nikonorov AA, Tinkov AA. Hair toxic and essential trace elements in children with autism spectrum disorder. Metab Brain Dis 2017; 32:195-202. [PMID: 27581303 DOI: 10.1007/s11011-016-9899-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 08/19/2016] [Indexed: 02/08/2023]
Abstract
The objective of the study was to investigate hair trace elements content in children suffering from autism spectrum disorder (ASD). A total of 74 ASD children and 74 sex- and age-matched controls divided into two age groups (2-4 and 5-9 years) were investigated. Hair trace elements content was assessed using inductively coupled plasma mass spectrometry. A general cohort of ASD children was characterized by 29 %, 41 %, and 24 % lower hair levels of chromium (Cr), iodine (I), and vanadium (V), respectively, whereas the level of selenium (Se) exceeded the respective control values by 31 %. In ASD children aged 2-4 years hair Cr, I and V content was 68 %, 36 % and 41 % lower than in the controls. Older ASD children were characterized by 45 % increase in hair Se levels. In a general cohort of ASD children hair beryllium (Be) and tin (Sn) levels were 50 % and 34 % lower than the control values. In the first age group (2-4 years) of ASD children 34 %, 42 %, and 73 % lower levels of arsenic (As), boron (B), and Be were detected. In the second age group of ASD children only a nearly significant 25 % decrease in hair lead (Pb) was detected. Surprisingly, no significant group difference in hair mercury (Hg), zinc (Zn), and copper (Cu) content was detected. Generally, the results of the present study demonstrate that children with ASD are characterized by lower values in hair of not only essential but also toxic trace elements.
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Affiliation(s)
- Anatoly V Skalny
- All-Russian Research Institute of Medicinal and Aromatic Plants, Moscow, Russia.
- Orenburg State University, Orenburg, Russia.
- Yaroslavl State University, Yaroslavl, Russia.
- RUDN University, Moscow, Russia.
| | - Natalia V Simashkova
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | - Tatiana P Klyushnik
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow, Russia
| | | | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | - Margarita G Skalnaya
- RUDN University, Moscow, Russia
- Russian Society of Trace Elements in Medicine, Moscow, Russia
| | - Alexandr A Nikonorov
- Orenburg State University, Orenburg, Russia
- Department of Biochemistry, Orenburg State Medical University, Orenburg, Russia
| | - Alexey A Tinkov
- Orenburg State University, Orenburg, Russia
- Yaroslavl State University, Yaroslavl, Russia
- RUDN University, Moscow, Russia
- Department of Biochemistry, Orenburg State Medical University, Orenburg, Russia
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Adams J, Howsmon DP, Kruger U, Geis E, Gehn E, Fimbres V, Pollard E, Mitchell J, Ingram J, Hellmers R, Quig D, Hahn J. Significant Association of Urinary Toxic Metals and Autism-Related Symptoms-A Nonlinear Statistical Analysis with Cross Validation. PLoS One 2017; 12:e0169526. [PMID: 28068407 PMCID: PMC5222512 DOI: 10.1371/journal.pone.0169526] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 11/16/2016] [Indexed: 01/25/2023] Open
Abstract
Introduction A number of previous studies examined a possible association of toxic metals and autism, and over half of those studies suggest that toxic metal levels are different in individuals with Autism Spectrum Disorders (ASD). Additionally, several studies found that those levels correlate with the severity of ASD. Methods In order to further investigate these points, this paper performs the most detailed statistical analysis to date of a data set in this field. First morning urine samples were collected from 67 children and adults with ASD and 50 neurotypical controls of similar age and gender. The samples were analyzed to determine the levels of 10 urinary toxic metals (UTM). Autism-related symptoms were assessed with eleven behavioral measures. Statistical analysis was used to distinguish participants on the ASD spectrum and neurotypical participants based upon the UTM data alone. The analysis also included examining the association of autism severity with toxic metal excretion data using linear and nonlinear analysis. “Leave-one-out” cross-validation was used to ensure statistical independence of results. Results and Discussion Average excretion levels of several toxic metals (lead, tin, thallium, antimony) were significantly higher in the ASD group. However, ASD classification using univariate statistics proved difficult due to large variability, but nonlinear multivariate statistical analysis significantly improved ASD classification with Type I/II errors of 15% and 18%, respectively. These results clearly indicate that the urinary toxic metal excretion profiles of participants in the ASD group were significantly different from those of the neurotypical participants. Similarly, nonlinear methods determined a significantly stronger association between the behavioral measures and toxic metal excretion. The association was strongest for the Aberrant Behavior Checklist (including subscales on Irritability, Stereotypy, Hyperactivity, and Inappropriate Speech), but significant associations were found for UTM with all eleven autism-related assessments with cross-validation R2 values ranging from 0.12–0.48.
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Affiliation(s)
- James Adams
- Arizona State University, Tempe, AZ, United States of America
- * E-mail:
| | - Daniel P. Howsmon
- Rensselaer Polytechnic Institute, Troy, NY, United States of America
| | - Uwe Kruger
- Rensselaer Polytechnic Institute, Troy, NY, United States of America
| | - Elizabeth Geis
- Arizona State University, Tempe, AZ, United States of America
| | - Eva Gehn
- Arizona State University, Tempe, AZ, United States of America
| | - Valeria Fimbres
- Arizona State University, Tempe, AZ, United States of America
| | - Elena Pollard
- Arizona State University, Tempe, AZ, United States of America
| | - Jessica Mitchell
- Southwest College of Naturopathic Medicine, Tempe, AZ, United States of America
| | - Julie Ingram
- Arizona State University, Tempe, AZ, United States of America
| | - Robert Hellmers
- Arizona Allergy Associates, Phoenix, AZ, United States of America
| | - David Quig
- Doctor’s Data, St. Charles, IL, United States of America
| | - Juergen Hahn
- Rensselaer Polytechnic Institute, Troy, NY, United States of America
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Domingues VF, Nasuti C, Piangerelli M, Correia-Sá L, Ghezzo A, Marini M, Abruzzo PM, Visconti P, Giustozzi M, Rossi G, Gabbianelli R. Pyrethroid Pesticide Metabolite in Urine and Microelements in Hair of Children Affected by Autism Spectrum Disorders: A Preliminary Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:388. [PMID: 27482573 PMCID: PMC4847050 DOI: 10.3390/ijerph13040388] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The number of children affected by Autism Spectrum Disorders (ASD) is dramatically increasing as well as the studies aimed at understanding the risk factors associated with the development of ASD. Since the etiology of ASD is partly genetic and partly environmental, factors (i.e., heavy metals, pesticides) as well as lifestyle seem to have a key role in the development of the disease. ASD and Control (CTR) children, aged 5–12 years, were compared. Gas chromatography coupled with trap mass detector was used to measure the level of 3-PBA, the main pyrethroid metabolite in urine in a group of ASD patients, while optical emission spectrometry analysis was employed to estimate the level of metals and microelements in hair in a different group of ASD children. The presence of 3-PBA in urine seems to be independent of age in ASD children, while a positive correlation between 3-PBA and age was observed in the control group of the same age range. Urine concentration of 3-BPA in ASD children had higher values than in the control group, which were marginally significant (p = 0.054). Mg results were significantly decreased in ASD with respect to controls, while V, S, Zn, and Ca/Mg were marginally increased, without reaching statistical significance. Results of Principal Component (PC) analysis of metals and microelements in hair were not associated with either age or health status. In conclusion, 3-PBA in urine and Mg in hair were changed in ASD children relative to control ones.
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Affiliation(s)
- Valentina F. Domingues
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, 4200-072 Porto, Portugal; (V.F.D.); (L.C.-S.)
| | - Cinzia Nasuti
- School of Pharmacy, University of Camerino, 62032 Camerino, Italy;
| | - Marco Piangerelli
- Computer Science Division, School of Science and Technology, University of Camerino, 62032 Camerino, Italy;
| | - Luísa Correia-Sá
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, 4200-072 Porto, Portugal; (V.F.D.); (L.C.-S.)
| | - Alessandro Ghezzo
- DIMES, School of Medicine, Università di Bologna, 40126 Bologna, Italy and Don Carlo Gnocchi Foundation ONLUS, 20162 Milan, Italy; (A.G.); (M.M.); (P.M.A.)
| | - Marina Marini
- DIMES, School of Medicine, Università di Bologna, 40126 Bologna, Italy and Don Carlo Gnocchi Foundation ONLUS, 20162 Milan, Italy; (A.G.); (M.M.); (P.M.A.)
| | - Provvidenza M. Abruzzo
- DIMES, School of Medicine, Università di Bologna, 40126 Bologna, Italy and Don Carlo Gnocchi Foundation ONLUS, 20162 Milan, Italy; (A.G.); (M.M.); (P.M.A.)
| | - Paola Visconti
- IRCCS Institute of Neurological Sciences-Bologna, 40126 Bologna, Italy;
| | | | - Gerardo Rossi
- Laboratorio NovEra srl, 62012 Civitanova Marche, Italy; (M.G.); (G.R.)
| | - Rosita Gabbianelli
- School of Pharmacy, University of Camerino, 62032 Camerino, Italy;
- Correspondence: ; Tel.: +39-737-403208
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Mostafa GA, Bjørklund G, Urbina MA, Al-Ayadhi LY. The positive association between elevated blood lead levels and brain-specific autoantibodies in autistic children from low lead-polluted areas. Metab Brain Dis 2016; 31:1047-54. [PMID: 27250967 DOI: 10.1007/s11011-016-9836-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 05/16/2016] [Indexed: 12/31/2022]
Abstract
The underlying pathogenic mechanism in autoimmune disorders is the formation of autoantibodies. In children with autism spectrum disorder (ASD), it has been documented increased levels of brain-specific autoantibodies. Furthermore, lead (Pb) has been identified as one of the main neurotoxicants acting as environmental triggers for ASD as it induces neuroinflammation and autoimmunity. The present study is the first to explore a potential relationship between the levels of blood lead (BPb) and seropositivity of anti-ribosomal P protein antibodies in ASD children. Levels of BPb and serum anti-ribosomal P protein antibodies were measured in 60 children with ASD and 60 healthy control matched children, aged between 5 and 12 years, recruited from low Pb-polluted areas. The levels of BPb were significantly higher in ASD children than in healthy control children (P < 0.001). Patients with ASD had significantly higher frequency of increased BPb levels ≥10 μg/dL (43.3 %) than healthy control children (13.3 %; P < 0.001). There were significant and positive correlations between the levels of BPb, and the values of Childhood Autism Rating Scale (CARS) (P < 0.01) and IQ in children with ASD (P < 0.001). Patients with ASD showing increased levels of BPb had significantly higher frequency of seropositivity of anti-ribosomal P antibodies (92.3 %) than patients with normal BPb levels (32.3 %; P < 0.001). The findings of the present study suggest that increased levels of BPb in some children with ASD may trigger the production of serum anti-ribosomal P antibodies. Further research is warranted to determine if the production of brain autoantibodies is triggered by environmental Pb exposure in children with ASD. The possible therapeutic role of Pb chelators in ASD children should also be studied.
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Affiliation(s)
- Gehan Ahmed Mostafa
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
- Department of Physiology, Autism Research and Treatment Center, AL-Amodi Autism Research Chair, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | - Mauricio A Urbina
- Departamento de Zoología, Facultad de Ciencias Naturales y Oceanográficas, Universidad de Concepción, Casilla 160-C, Concepción, Chile
| | - Laila Yousef Al-Ayadhi
- Department of Physiology, Autism Research and Treatment Center, AL-Amodi Autism Research Chair, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
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Ornoy A, Weinstein-Fudim L, Ergaz Z. Genetic Syndromes, Maternal Diseases and Antenatal Factors Associated with Autism Spectrum Disorders (ASD). Front Neurosci 2016; 10:316. [PMID: 27458336 PMCID: PMC4933715 DOI: 10.3389/fnins.2016.00316] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/22/2016] [Indexed: 01/29/2023] Open
Abstract
Autism spectrum disorder (ASD) affecting about 1% of all children is associated, in addition to complex genetic factors, with a variety of prenatal, perinatal, and postnatal etiologies. In addition, ASD is often an important clinical presentation of some well-known genetic syndromes in human. We discuss these syndromes as well as the role of the more important prenatal factors affecting the fetus throughout pregnancy which may also be associated with ASD. Among the genetic disorders we find Fragile X, Rett syndrome, tuberous sclerosis, Timothy syndrome, Phelan-McDermid syndrome, Hamartoma tumor syndrome, Prader-Willi and Angelman syndromes, and a few others. Among the maternal diseases in pregnancy associated with ASD are diabetes mellitus (PGDM and/or GDM), some maternal autoimmune diseases like antiphospholipid syndrome (APLS) with anti-β2GP1 IgG antibodies and thyroid disease with anti-thyroid peroxidase (TPO) antibodies, preeclampsia and some other autoimmune diseases with IgG antibodies that might affect fetal brain development. Other related factors are maternal infections (rubella and CMV with fetal brain injuries, and possibly Influenza with fever), prolonged fever and maternal inflammation, especially with changes in a variety of inflammatory cytokines and antibodies that cross the placenta and affect the fetal brain. Among the drugs are valproic acid, thalidomide, misoprostol, and possibly SSRIs. β2-adrenergic receptor agonists and paracetamol have also lately been associated with increased rate of ASD but the data is too preliminary and inconclusive. Associations were also described with ethanol, cocaine, and possibly heavy metals, heavy smoking, and folic acid deficiency. Recent studies show that heavy exposure to pesticides and air pollution, especially particulate matter < 2.5 and 10 μm in diameter (PM2.5 and PM10) during pregnancy is also associated with ASD. Finally, we have to remember that many of the associations mentioned in this review are only partially proven, and not all are "clean" of different confounding factors. The associations described in this review emphasize again how little we know about the etiology and pathogenesis of ASD. It is obvious that we need more epidemiologic data to establish many of these associations, but if proven, they might be promising avenues for prevention.
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Affiliation(s)
- Asher Ornoy
- Laboratory of Teratology, Department of Medical Neurobiology, Hadassah Medical School, Hebrew University Jerusalem, Israel
| | - Liza Weinstein-Fudim
- Laboratory of Teratology, Department of Medical Neurobiology, Hadassah Medical School, Hebrew University Jerusalem, Israel
| | - Zivanit Ergaz
- Laboratory of Teratology, Department of Medical Neurobiology, Hadassah Medical School, Hebrew UniversityJerusalem, Israel; Department of Neonatology, Hadassah-Hebrew University Medical CenterJerusalem, Israel
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Dickerson AS, Rahbar MH, Bakian AV, Bilder DA, Harrington RA, Pettygrove S, Kirby RS, Durkin MS, Han I, Moyé LA, Pearson DA, Wingate MS, Zahorodny WM. Autism spectrum disorder prevalence and associations with air concentrations of lead, mercury, and arsenic. ENVIRONMENTAL MONITORING AND ASSESSMENT 2016; 188:407. [PMID: 27301968 DOI: 10.1007/s10661-016-5405-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/02/2016] [Indexed: 06/06/2023]
Abstract
Lead, mercury, and arsenic are neurotoxicants with known effects on neurodevelopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder apparent by early childhood. Using data on 4486 children with ASD residing in 2489 census tracts in five sites of the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network, we used multi-level negative binomial models to investigate if ambient lead, mercury, and arsenic concentrations, as measured by the US Environmental Protection Agency National-Scale Air Toxics Assessment (EPA-NATA), were associated with ASD prevalence. In unadjusted analyses, ambient metal concentrations were negatively associated with ASD prevalence. After adjusting for confounding factors, tracts with air concentrations of lead in the highest quartile had significantly higher ASD prevalence than tracts with lead concentrations in the lowest quartile (prevalence ratio (PR) = 1.36; 95 '% CI: 1.18, 1.57). In addition, tracts with mercury concentrations above the 75th percentile (>1.7 ng/m(3)) and arsenic concentrations below the 75th percentile (≤0.13 ng/m(3)) had a significantly higher ASD prevalence (adjusted RR = 1.20; 95 % CI: 1.03, 1.40) compared to tracts with arsenic, lead, and mercury concentrations below the 75th percentile. Our results suggest a possible association between ambient lead concentrations and ASD prevalence and demonstrate that exposure to multiple metals may have synergistic effects on ASD prevalence.
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Affiliation(s)
- Aisha S Dickerson
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building Suite 1100.05, Houston, TX, 77030, USA.
| | - Mohammad H Rahbar
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building Suite 1100.05, Houston, TX, 77030, USA
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
- Division of Epidemiology, Human Genetics, and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Amanda V Bakian
- Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Deborah A Bilder
- Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Rebecca A Harrington
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Sydney Pettygrove
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA
| | - Russell S Kirby
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, 33612, USA
| | - Maureen S Durkin
- Waisman Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA
| | - Inkyu Han
- Division of Epidemiology, Human Genetics, and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Lemuel A Moyé
- Division of Biostatistics, University of Texas School of Public Health at Houston, Houston, TX, 77030, USA
| | - Deborah A Pearson
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical School, Houston, TX, 77054, USA
| | - Martha Slay Wingate
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 35205, USA
| | - Walter M Zahorodny
- Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
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Kim KN, Kwon HJ, Hong YC. Low-level lead exposure and autistic behaviors in school-age children. Neurotoxicology 2016; 53:193-200. [PMID: 26877220 DOI: 10.1016/j.neuro.2016.02.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 01/07/2016] [Accepted: 02/08/2016] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The association between lead exposure and autism spectrum disorder is inconclusive. We hypothesized an association between higher blood lead concentrations and more autistic behaviors, including impaired social interactions and communication, stereotypical behaviors, and restricted interests, among school-age children. METHODS Data from 2473 Korean children aged 7-8years who had no prior history of developmental disorders were analyzed. Two follow-up surveys were conducted biennially until the children reached 11-12years of age. Blood lead concentrations were measured at every survey, and autistic behaviors were evaluated at 11-12years of age using the Autism Spectrum Screening Questionnaire (ASSQ) and Social Responsiveness Scale (SRS). The associations of blood lead concentration with ASSQ and SRS scores were analyzed using negative binomial, logistic, and linear regression models. RESULTS Blood lead concentrations at 7-8years of age (geometric mean: 1.64μg/dL), but not at 9-10 and 11-12years of age, were associated with more autistic behaviors at 11-12years of age, according to the ASSQ (β=0.151; 95% confidence interval [CI]: 0.061, 0.242) and SRS (β=2.489; 95% CI: 1.378, 3.600). SRS subscale analysis also revealed associations between blood lead concentrations and social awareness, cognition, communication, motivation, and mannerisms. CONCLUSION Even low blood lead concentrations at 7-8years of age are associated with more autistic behaviors at 11-12years of age, underscoring the need for continued efforts to reduce lead exposure.
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Affiliation(s)
- Kyoung-Nam Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine and Public Health, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Environmental Medicine, Medical Research Center, Seoul, Republic of Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Amtul Z. Neural plasticity and memory: molecular mechanism. Rev Neurosci 2015; 26:253-68. [PMID: 25995328 DOI: 10.1515/revneuro-2014-0075] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 12/14/2014] [Indexed: 11/15/2022]
Abstract
Deciphering the cellular and molecular mechanisms of memory has been an important topic encompassing the learning and memory domain besides the neurodegenerative disorders. Synapses accumulate cognitive information from life-lasting alterations of their molecular and structural composition. Current memory storage models identify posttranslational modification imperative for short-term information storage and mRNA translation for long-term information storage. However, the precise account of these modifications has not been summarized at the individual synapse level. Therefore, herein we describe the spatiotemporal reorganization of synaptic plasticity at the dendritic spine level to elucidate the mechanism through which synaptic substructures are remodeled; though at the molecular level, such mechanisms are still quite unclear. It has thus been concluded that the existing mechanisms do not entirely elaborate memory storage processes. Further efforts are therefore encouraged to delineate the mechanism of neuronal connectivity at the chemical level as well, including inter- or intramolecular bonding patterns at the synaptic level, which may be a permissive and vital step of memory storage.
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Mohamed FEB, Zaky EA, El-Sayed AB, Elhossieny RM, Zahra SS, Salah Eldin W, Youssef WY, Khaled RA, Youssef AM. Assessment of Hair Aluminum, Lead, and Mercury in a Sample of Autistic Egyptian Children: Environmental Risk Factors of Heavy Metals in Autism. Behav Neurol 2015; 2015:545674. [PMID: 26508811 PMCID: PMC4609793 DOI: 10.1155/2015/545674] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/24/2015] [Accepted: 09/02/2015] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND AIMS The etiological factors involved in the etiology of autism remain elusive and controversial, but both genetic and environmental factors have been implicated. The aim of this study was to assess the levels and possible environmental risk factors and sources of exposure to mercury, lead, and aluminum in children with autism spectrum disorder (ASD) as compared to their matched controls. METHODS One hundred ASD children were studied in comparison to 100 controls. All participants were subjected to clinical evaluation and measurement of mercury, lead, and aluminum through hair analysis which reflects past exposure. RESULTS The mean Levels of mercury, lead, and aluminum in hair of the autistic patients were significantly higher than controls. Mercury, lead, and aluminum levels were positively correlated with maternal fish consumptions, living nearby gasoline stations, and the usage of aluminum pans, respectively. CONCLUSION Levels of mercury, lead, and aluminum in the hair of autistic children are higher than controls. Environmental exposure to these toxic heavy metals, at key times in development, may play a causal role in autism.
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Affiliation(s)
| | - Eman Ahmed Zaky
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | - Sally Soliman Zahra
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Wong CT, Wais J, Crawford DA. Prenatal exposure to common environmental factors affects brain lipids and increases risk of developing autism spectrum disorders. Eur J Neurosci 2015. [DOI: 10.1111/ejn.13028] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Christine T. Wong
- School of Kinesiology and Health Science; York University; Toronto ON Canada M3J 1P3
- Neuroscience Graduate Diploma Program; York University; Toronto ON Canada M3J 1P3
| | - Joshua Wais
- School of Kinesiology and Health Science; York University; Toronto ON Canada M3J 1P3
| | - Dorota A. Crawford
- School of Kinesiology and Health Science; York University; Toronto ON Canada M3J 1P3
- Neuroscience Graduate Diploma Program; York University; Toronto ON Canada M3J 1P3
- Department of Biology; York University; Toronto ON Canada M3J 1P3
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Kern JK, Geier DA, Sykes LK, Geier MR, Deth RC. Are ASD and ADHD a Continuum? A Comparison of Pathophysiological Similarities Between the Disorders. J Atten Disord 2015; 19:805-27. [PMID: 23074304 DOI: 10.1177/1087054712459886] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The objective of this study was to review and compare the similarities between autism spectrum disorder (ASD) and ADHD with regard to symptomatology, neurological deficits, metabolic and endocrine-related conditions, and brain pathology. METHOD A comprehensive review of the relevant research literature was carried out. RESULTS A number of important similarities between ASD and ADHD were identified, including recent increases in prevalence, male-biased incidence, shared involvement of sensory processing, motor and impulse control, abnormal patterns of neural connectivity, and sleep disturbances. Studies suggest involvement of androgen metabolism, impaired methylation, and heavy metal toxicity as possible contributing factors for both disorders. CONCLUSION ASD and ADHD share a number of features and pathophysiological conditions, which suggests that the two disorders may be a continuum and have a common origin.
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Affiliation(s)
- Janet K Kern
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA University of Texas Southwestern Medical Center at Dallas, TX, USA
| | - David A Geier
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA
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