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Suprunowicz M, Tomaszek N, Urbaniak A, Zackiewicz K, Modzelewski S, Waszkiewicz N. Between Dysbiosis, Maternal Immune Activation and Autism: Is There a Common Pathway? Nutrients 2024; 16:549. [PMID: 38398873 PMCID: PMC10891846 DOI: 10.3390/nu16040549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/05/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Autism spectrum disorder (ASD) is a neuropsychiatric condition characterized by impaired social interactions and repetitive stereotyped behaviors. Growing evidence highlights an important role of the gut-brain-microbiome axis in the pathogenesis of ASD. Research indicates an abnormal composition of the gut microbiome and the potential involvement of bacterial molecules in neuroinflammation and brain development disruptions. Concurrently, attention is directed towards the role of short-chain fatty acids (SCFAs) and impaired intestinal tightness. This comprehensive review emphasizes the potential impact of maternal gut microbiota changes on the development of autism in children, especially considering maternal immune activation (MIA). The following paper evaluates the impact of the birth route on the colonization of the child with bacteria in the first weeks of life. Furthermore, it explores the role of pro-inflammatory cytokines, such as IL-6 and IL-17a and mother's obesity as potentially environmental factors of ASD. The purpose of this review is to advance our understanding of ASD pathogenesis, while also searching for the positive implications of the latest therapies, such as probiotics, prebiotics or fecal microbiota transplantation, targeting the gut microbiota and reducing inflammation. This review aims to provide valuable insights that could instruct future studies and treatments for individuals affected by ASD.
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Affiliation(s)
| | | | | | | | - Stefan Modzelewski
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland; (M.S.); (N.T.); (A.U.); (K.Z.); (N.W.)
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Cui J, Zhai Z, Wang S, Song X, Qiu T, Yu L, Zhai Q, Zhang H. The role and impact of abnormal vitamin levels in autism spectrum disorders. Food Funct 2024; 15:1099-1115. [PMID: 38221882 DOI: 10.1039/d3fo03735e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
The prevalence of autism spectrum disorder (ASD), a neurodevelopmental disorder with a predominance of social behavioral disorders, has increased dramatically in various countries in recent decades. The interplay between genetic and environmental factors is believed to underlie ASD pathogenesis. Recent analyses have shown that abnormal vitamin levels in early life are associated with an increased risk of autism. As essential substances for growth and development, vitamins have been shown to have significant benefits for the nervous and immune systems. However, it is unknown whether certain vitamin types influence the emergence or manifestation of ASD symptoms. Several studies have focused on vitamin levels in children with autism, and neurotypical children have provided different insights into the types of vitamins and their intake. Here, we review the mechanisms and significance of several vitamins (A, B, C, D, E, and K) that are closely associated with the development of ASD in order to prevent, mitigate, and treat ASD. Efforts have been made to discover and develop new indicators for nutritional assessment of children with ASD to play a greater role in the early detection of ASD and therapeutic remission after diagnosis.
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Affiliation(s)
- Jingjing Cui
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214002, China.
- Department of child health care, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hositipal of Jiangnan University, Wuxi, Jiangsu, 214002, China.
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, 214122, China.
| | - Zidan Zhai
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214002, China.
- Department of child health care, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hositipal of Jiangnan University, Wuxi, Jiangsu, 214002, China.
| | - Shumin Wang
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, 214122, China.
- School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, China.
| | - Xiaoyue Song
- Department of Toxicology, School of Public Health, Anhui Medical University/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, Anhui, China.
| | - Ting Qiu
- Department of child health care, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hositipal of Jiangnan University, Wuxi, Jiangsu, 214002, China.
| | - Leilei Yu
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, 214122, China.
| | - Qixiao Zhai
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, 214122, China.
| | - Heng Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214002, China.
- Department of child health care, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hositipal of Jiangnan University, Wuxi, Jiangsu, 214002, China.
- Department of Toxicology, School of Public Health, Anhui Medical University/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, Anhui, China.
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Gusso D, Prauchner GRK, Rieder AS, Wyse ATS. Biological Pathways Associated with Vitamins in Autism Spectrum Disorder. Neurotox Res 2023; 41:730-740. [PMID: 37864660 DOI: 10.1007/s12640-023-00674-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/18/2023] [Accepted: 10/07/2023] [Indexed: 10/23/2023]
Abstract
Autism spectrum disorder (ASD) is characterized by early-appearing social communication deficits, with genetic and environmental factors potentially playing a role in its etiology, which remains largely unknown. During pregnancy, certain deficiencies in critical nutrients are mainly associated with central nervous system impairment. The vitamin B9 (folate) is primarily related to one-carbon and methionine metabolism, participating in methyl donor generation. In addition, supplementation with folic acid (FA) is recommended by the World Health Organization (WHO) in the first three gestational months to prevent neural tube defects. Vitamin B12 is related to folate regeneration, converting it into an active form. Deficiencies in this vitamin have a negative impact on cognitive function and brain development since it is involved in myelin synthesis. Vitamin D is intimately associated with Ca2+ levels, acting in bone development and calcium-dependent signaling. This vitamin is associated with ASD at several levels since it has a relation with ASD genes and oxidative stress environment. This review carries the recent literature about the role of folate, vitamin B12, and vitamin D in ASD. In addition, we discuss the possible impact of nutrient deficiency or hypersupplementation during fetal development. On the other hand, we explore the biases of vitamin supplementation studies such as the loss of participants in retrospective studies, as well as multiple variants that are not considered in the conclusion, like dietary intake or auto-medication during pregnancy. In this regard, we aim to contribute to the discussion about the role of vitamins in ASD currency, but also in pregnancy and fetal development as well. Furthermore, stress during pregnancy can be an ASD predisposition, with cortisol as a regulator. In this view, we propose that cortisol is the bridge of susceptibility between vitamin disorders and ASD prevalence.
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Affiliation(s)
- Darlan Gusso
- Neuroprotection and Neurometabolic Diseases Laboratory (Wyse's Lab), Graduate Program in Biological Sciences: Biochemistry, Department of Biochemistry, Federal University of Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos, 2600-Anexo, Zip Code 90035003, Porto Alegre, RS, Brazil.
| | - Gustavo Ricardo Krupp Prauchner
- Neuroprotection and Neurometabolic Diseases Laboratory (Wyse's Lab), Graduate Program in Biological Sciences: Biochemistry, Department of Biochemistry, Federal University of Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos, 2600-Anexo, Zip Code 90035003, Porto Alegre, RS, Brazil
| | - Alessandra Schmitt Rieder
- Neuroprotection and Neurometabolic Diseases Laboratory (Wyse's Lab), Graduate Program in Biological Sciences: Biochemistry, Department of Biochemistry, Federal University of Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos, 2600-Anexo, Zip Code 90035003, Porto Alegre, RS, Brazil
| | - Angela T S Wyse
- Neuroprotection and Neurometabolic Diseases Laboratory (Wyse's Lab), Graduate Program in Biological Sciences: Biochemistry, Department of Biochemistry, Federal University of Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos, 2600-Anexo, Zip Code 90035003, Porto Alegre, RS, Brazil
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Önal S, Sachadyn-Król M, Kostecka M. A Review of the Nutritional Approach and the Role of Dietary Components in Children with Autism Spectrum Disorders in Light of the Latest Scientific Research. Nutrients 2023; 15:4852. [PMID: 38068711 PMCID: PMC10708497 DOI: 10.3390/nu15234852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects several areas of mental development. The onset of ASD occurs in the first few years of life, usually before the age of 3 years. Proper nutrition is important to ensure that an individual's nutrient and energy requirements are met, and it can also have a moderating effect on the progression of the disorder. A systematic database search was conducted as a narrative review to determine whether nutrition and specific diets can potentially alter gastrointestinal symptoms and neurobehavioral disorders. Databases such as Science Direct, PubMed, Scopus, Web of Science (WoS), and Google Scholar were searched to find studies published between 2000 and September 2023 on the relationship between ASD, dietary approaches, and the role of dietary components. The review may indicate that despite extensive research into dietary interventions, there is a general lack of conclusive scientific data about the effect of therapeutic diets on ASD; therefore, no definitive recommendation can be made for any specific nutritional therapy as a standard treatment for ASD. An individualized dietary approach and the dietician's role in the therapeutic team are very important elements of every therapy. Parents and caregivers should work with nutrition specialists, such as registered dietitians or healthcare providers, to design meal plans for autistic individuals, especially those who would like to implement an elimination diet.
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Affiliation(s)
- Seda Önal
- Department of Nutrition and Dietetics, Health Sciences Institute, Ankara University, 06110 Ankara, Turkey;
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Fırat University, 23200 Elazığ, Turkey
| | - Monika Sachadyn-Król
- Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
| | - Małgorzata Kostecka
- Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
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Vucak J, Matijevic J, Pivac I, Markic J. Adherence to Vitamin D Supplementation during Infancy-A Single Pediatric Primary Practice Retrospective Study. Pediatr Rep 2023; 15:660-667. [PMID: 37987284 PMCID: PMC10661251 DOI: 10.3390/pediatric15040059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/15/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023] Open
Abstract
The risk of vitamin D deficiency is high in infants. Therefore, potential vitamin D deficiency should be prophylactically treated with vitamin D supplementation. Achieving good adherence to recommended prophylactic regimens is the goal of every primary pediatrician. The aim of this paper was to establish whether Croatian infants receive recommended prophylactic doses of vitamin D regularly. We analyzed the prescription rate of vitamin D preparation during the first year of life in one pediatric primary practice. Our research has shown, for the first time in Croatia, that there is low treatment adherence. Only 7.6% of infants received the recommended doses of vitamin D. The percentage of infants in the moderately irregular adherence group was 19.3%. There was no statistical difference regarding urban or rural place of living or parents' educational level. Based on these findings, a comprehensive public health campaign is needed to improve adherence to vitamin D supplementation during infancy. Also, further studies on larger samples and on a national level are warranted.
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Affiliation(s)
- Jerko Vucak
- Primary Health Care Pediatric Practice, Sibenik 22000, Croatia;
| | - Jeronim Matijevic
- Department of Pediatrics, University Hospital of Split, Split 21000, Croatia;
| | - Ivan Pivac
- School of Medicine, University of Split, Split 21000, Croatia;
| | - Josko Markic
- Department of Pediatrics, University Hospital of Split, Split 21000, Croatia;
- School of Medicine, University of Split, Split 21000, Croatia;
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Boyd NK, Nguyen J, Khoshnood MM, Jiang T, Nguyen L, Mendez L, Spinazzi NA, Manning MA, Rafii MS, Santoro JD. Hypovitaminosis D in persons with Down syndrome and autism spectrum disorder. J Neurodev Disord 2023; 15:35. [PMID: 37880588 PMCID: PMC10599027 DOI: 10.1186/s11689-023-09503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Plasma levels of vitamin D have been reported to be low in persons with Down syndrome (DS) and existing data is limited to small and homogenous cohorts. This is of particular importance in persons with DS given the high rates of autoimmune disease in this population and the known relationship between vitamin D and immune function. This study sought to investigate vitamin D status in a multi-center cohort of individuals with DS and compare them to individuals with autism spectrum disorder (ASD) and neurotypical (NT) controls. METHODS A retrospective, multi-center review was performed. The three sites were located at latitudes of 42.361145, 37.44466, and 34.05349. Patients were identified by the International Classification of Diseases (ICD)-9 or ICD-10 codes for DS, ASD, or well-child check visits for NT individuals. The first vitamin D 25-OH level recorded in the electronic medical record (EMR) was used in this study as it was felt to be the most reflective of a natural and non-supplemented state. Vitamin D 25-OH levels below 30 ng/mL were considered deficient. RESULTS In total, 1624 individuals with DS, 5208 with ASD, and 30,775 NT controls were identified. Individuals with DS had the lowest mean level of vitamin D 25-OH at 20.67 ng/mL, compared to those with ASD (23.48 ng/mL) and NT controls (29.20 ng/mL) (p < 0.001, 95% CI: -8.97 to -6.44). A total of 399 (24.6%) individuals with DS were considered vitamin D deficient compared to 1472 (28.3%) with ASD and 12,397 (40.3%) NT controls (p < 0.001, 95% CI: -5.43 to -2.36). Individuals with DS with higher body mass index (BMI) were found to be more likely to have lower levels of vitamin D (p < 0.001, 95% CI: -0.3849 to -0.1509). Additionally, having both DS and a neurologic diagnosis increased the likelihood of having lower vitamin D levels (p < 0.001, 95% CI: -5.02 to -1.28). Individuals with DS and autoimmune disease were much more likely to have lower vitamin D levels (p < 0.001, 95% CI: -6.22 to -1.55). Similarly, a history of autoimmunity in a first-degree relative also increased the likelihood of having lower levels of vitamin D in persons with DS (p = 0.01, 95% CI: -2.45 to -0.63). CONCLUSIONS Individuals with DS were noted to have hypovitaminosis D in comparison to individuals with ASD and NT controls. Associations between vitamin D deficiency and high BMI, personal autoimmunity, and familial autoimmunity were present in individuals with DS.
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Affiliation(s)
- Natalie K Boyd
- Division of Neurology, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS82, Los Angeles, CA, 90027, USA
| | | | - Mellad M Khoshnood
- Division of Neurology, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS82, Los Angeles, CA, 90027, USA
| | - Timothy Jiang
- Division of Neurology, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS82, Los Angeles, CA, 90027, USA
| | - Lina Nguyen
- Division of Neurology, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS82, Los Angeles, CA, 90027, USA
| | - Lorena Mendez
- Division of Neurology, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS82, Los Angeles, CA, 90027, USA
| | - Noemi A Spinazzi
- Department of Pediatrics, Benioff Children's Hospital, University of California San Francisco, Oakland, CA, USA
| | - Melanie A Manning
- Department of Genetics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Michael S Rafii
- Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA
| | - Jonathan D Santoro
- Division of Neurology, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS82, Los Angeles, CA, 90027, USA.
- Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
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Kanellopoulos AK, Costello S, Mainardi F, Koshibu K, Deoni S, Schneider N. Dynamic Interplay between Social Brain Development and Nutrient Intake in Young Children. Nutrients 2023; 15:3754. [PMID: 37686785 PMCID: PMC10490067 DOI: 10.3390/nu15173754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Myelination of the brain structures underlying social behavior in humans is a dynamic process that parallels the emergence of social-emotional development and social skills in early life. Of the many genetic and environmental factors regulating the myelination processes, nutrition is considered as a critical and modifiable early-life factor for establishing healthy social brain networks. However, the impact of nutrition on the longitudinal development of social brain myelination remains to be fully understood. This study examined the interplay between childhood nutrient intake and social brain development across the first 5 years of life. Myelin-sensitive neuroimaging and food-intake data were analyzed in 293 children, 0.5 to 5 years of age, and explored for dynamic patterns of nutrient-social brain myelin associations. We found three data-driven age windows with specific nutrient correlation patterns, 63 individual nutrient-myelin correlations, and six nutrient combinations with a statistically significant predictive value for social brain myelination. These results provide novel insights into the impact of specific nutrient intakes on early brain development, in particular social brain regions, and suggest a critical age-sensitive opportunity to impact these brain regions for potential longer-term improvements in socio-emotional development and related executive-function and critical-thinking skills.
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Affiliation(s)
- Alexandros K. Kanellopoulos
- Brain Health Department, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, 1000 Lausanne, Switzerland
| | - Sarah Costello
- Brain Health Department, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, 1000 Lausanne, Switzerland
| | - Fabio Mainardi
- Data Science Group, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, 1000 Lausanne, Switzerland
| | - Kyoko Koshibu
- Brain Health Department, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, 1000 Lausanne, Switzerland
| | - Sean Deoni
- Advanced Baby Imaging Lab, Rhode Island Hospital, 1 Hoppin Street, Providence, RI 20903, USA
- Department of Radiology, Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02912, USA
- Spinn Neuroscience, Seattle, WA 98275, USA
| | - Nora Schneider
- Brain Health Department, Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Vers-Chez-les-Blanc, 1000 Lausanne, Switzerland
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Jiang Y, Dang W, Nie H, Kong X, Jiang Z, Guo J. Omega-3 polyunsaturated fatty acids and/or vitamin D in autism spectrum disorders: a systematic review. Front Psychiatry 2023; 14:1238973. [PMID: 37654990 PMCID: PMC10466790 DOI: 10.3389/fpsyt.2023.1238973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
This systematic review aims to offer an updated understanding of the relationship between omega-3 supplementation and/or vitamin D and autism spectrum disorders (ASD). The databases PubMed, Cochrane Library, Web of Science, EMBASE, CINAHL, Vip, CNKI, Wanfang, China Biomedical Database databases were searched using keywords, and relevant literature was hand-searched. Papers (n = 1,151) were systematically screened and deemed eligible since 2002. Twenty clinical controlled studies were included in the final review. The findings were analyzed for intervention effects focusing on the core symptoms of ASD, included social functioning, behavioral functioning, speech function and biomarkers changes. The review found that the effects of omega-3 supplementation on ASD were too weak to conclude that core symptoms were alleviated. Vitamin D supplementation improved core symptoms, particularly behavioral functioning, however, the results of the literatures included in this study were slightly mixed, we cannot directly conclude that vitamin D supplementation has a beneficial effect on a specific symptom of ASD, but the overall conclusion is that vitamin D supplementation has a positive effect on behavioral functioning in ASD. Omega-3 and vitamin D combination supplementation has a good combined effect on social and behavioral outcomes in patients with ASD.
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Affiliation(s)
- Yuwei Jiang
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Wenjun Dang
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Hong Nie
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Xiangying Kong
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Zhimei Jiang
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Jin Guo
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, Heilongjiang, China
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Ye X, Zhou Q, Ren P, Xiang W, Xiao L. The Synaptic and Circuit Functions of Vitamin D in Neurodevelopment Disorders. Neuropsychiatr Dis Treat 2023; 19:1515-1530. [PMID: 37424961 PMCID: PMC10327924 DOI: 10.2147/ndt.s407731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Vitamin D deficiency/insufficiency is a public health issue around the world. According to epidemiological studies, low vitamin D levels have been associated with an increased risk of some neurodevelopmental disorders, including autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Animal models reveal that vitamin D has a variety of impacts on the synapses and circuits in the brain. A lack of vitamin D affects the expression of synaptic proteins, as well as the synthesis and metabolism of various neurotransmitters. Depending on where vitamin D receptors (VDRs) are expressed, vitamin D may also regulate certain neuronal circuits through the endocannabinoid signaling, mTOR pathway and oxytocin signaling. While inconsistently, some data suggest that vitamin D supplementation may be able to reduce the core symptoms of ASD and ADHD. This review emphasizes vitamin D's role in the synaptic and circuit mechanisms of neurodevelopmental disorders including ASD and ADHD. Future application of vitamin D in these disorders will depend on both basic research and clinical studies, in order to make the transition from the bench to the bedside.
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Affiliation(s)
- Xiaoshan Ye
- Hainan Women and Children’s Medical Center, School of Pediatrics, Hainan Medical University, Haikou, People’s Republic of China
| | - Qionglin Zhou
- International School of Public Health and One Health, Hainan Medical University, Haikou, People’s Republic of China
| | - Pengcheng Ren
- Hainan Women and Children’s Medical Center, School of Pediatrics, Hainan Medical University, Haikou, People’s Republic of China
- National Health Commission (NHC) Key Laboratory of Control of Tropical Diseases, Hainan Medical University, Haikou, People’s Republic of China
- School of Basic Medicine and Life Science, Hainan Medical University, Haikou, People’s Republic of China
| | - Wei Xiang
- Hainan Women and Children’s Medical Center, School of Pediatrics, Hainan Medical University, Haikou, People’s Republic of China
- National Health Commission (NHC) Key Laboratory of Control of Tropical Diseases, Hainan Medical University, Haikou, People’s Republic of China
| | - Le Xiao
- Hainan Women and Children’s Medical Center, School of Pediatrics, Hainan Medical University, Haikou, People’s Republic of China
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De Marzio M, Lasky-Su J, Chu SH, Prince N, Litonjua AA, Weiss ST, Kelly RS, Glass KR. The metabolic role of vitamin D in children's neurodevelopment: a network study. bioRxiv 2023:2023.06.23.546277. [PMID: 37425858 PMCID: PMC10327084 DOI: 10.1101/2023.06.23.546277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with various proposed environmental risk factors and a rapidly increasing prevalence. Mounting evidence suggests a potential role of vitamin D deficiency in ASD pathogenesis, though causal mechanisms remain largely unknown. Here, we investigate the impact of vitamin D on child neurodevelopment through an integrative network approach that combines metabolomic profiles, clinical traits, and neurodevelopmental data from a pediatric cohort. Our results show that vitamin D deficiency is associated with changes in the metabolic networks of tryptophan, linoleic, and fatty acid metabolism. These changes correlate with distinct ASD-related outcomes, including delayed communication skills and respiratory dysfunctions. Additionally, our analysis suggests the kynurenine and serotonin sub-pathways might mediate the effect of vitamin D on early childhood communication development. Altogether, our findings provide metabolome-wide insights into the potential of vitamin D as a therapeutic option for ASD and other communication disorders.
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11
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Dong HY, Miao CY, Zhang Y, Shan L, Feng JY, Jia FY, Du L. Risk factors for developmental quotients in ASD children: A cross-sectional study. Front Psychol 2023; 14:1126622. [PMID: 36993893 PMCID: PMC10040800 DOI: 10.3389/fpsyg.2023.1126622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveTo analyze the risk factors for developmental quotients (DQs) of children with autism spectrum disorder (ASD) and to better understand the effects of screen time on neurodevelopment in children with ASD.MethodsWe retrospectively analyzed the data of 382 children with ASD, including demographic profiles; socioeconomic status; score on the Chinese parent–child interaction scale (CPCIS); screen time questionnaire; ASD symptom rating scales, including the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule Second Edition (ADOS-2); and DQs using Griffiths Development Scales–Chinese Edition. Univariate analysis was carried out to analyze the factors related to the DQs of children with ASD, and then the linear regression model was used to identify the independent influencing factors of the DQs of children with ASD.ResultsVitamin D (β = 0.180, p = 0.002), age (β = −0.283, p = 0.000) and CARS score (β = −0.347, p = 0.000) are risk factors related to DQ of locomotor in children with ASD. Vitamin D (β = 0.108, p = 0.034), CARS score (β = −0.503, p = 0.000), ADOS-2 severity score (β = −0.109, p = 0.045) and CPCIS score (β = 0.198, p = 0.000) are risk factors related to DQ of personal social skill in children with ASD. Vitamin D (β = 0.130, p = 0.018), CARS score (β = −0.469, p = 0.000), and CPCIS score (β = 0.133, p = 0.022) are risk factors related to DQ of hearing-speech in children with ASD. Vitamin D (β = 0.163, p = 0.003) and CARS score (β = −0.471, p = 0.000) are risk factors related to DQ of eye-hand coordination in children with ASD. Age (β = −0.140, p = 0.020), CARS score (β = −0.342, p = 0.000), ADOS-2 severity score (β = −0.133, p = 0.034) and CPCIS score (β = 0.193, p = 0.002) are risk factors related to DQ of performance in children with ASD. Vitamin D (β = 0.801, p = 0.000) and CPCIS score (β = 0.394, p = 0.019) are risk factors related to DQ of practical reasoning in children with ASD.ConclusionVitamin D status, the severity of autistic symptoms and parent-child interaction are risk factors for developmental quotients in children with ASD. Screen exposure time is negatively associated with DQs in children with ASD but is not an independent risk factor for DQs.
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12
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Uddin MN, Mondal T, Yao Y, Manley K, Lawrence DA. Oxidative stress and neuroimmune proteins in a mouse model of autism. Cell Stress Chaperones 2023; 28:201-217. [PMID: 36795226 PMCID: PMC10050529 DOI: 10.1007/s12192-023-01331-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
Oxidative stress including decreased antioxidant enzyme activities, elevated lipid peroxidation, and accumulation of advanced glycation end products in the blood from children with autism spectrum disorders (ASD) has been reported. The mechanisms affecting the development of ASD remain unclear; however, toxic environmental exposures leading to oxidative stress have been proposed to play a significant role. The BTBRT+Itpr3tf/J (BTBR) strain provides a model to investigate the markers of oxidation in a mouse strain exhibiting ASD-like behavioral phenotypes. In the present study, we investigated the level of oxidative stress and its effects on immune cell populations, specifically oxidative stress affecting surface thiols (R-SH), intracellular glutathione (iGSH), and expression of brain biomarkers that may contribute to the development of the ASD-like phenotypes that have been observed and reported in BTBR mice. Lower levels of cell surface R-SH were detected on multiple immune cell subpopulations from blood, spleens, and lymph nodes and for sera R-SH levels of BTBR mice compared to C57BL/6 J (B6) mice. The iGSH levels of immune cell populations were also lower in the BTBR mice. Elevated protein expression of GATA3, TGM2, AhR, EPHX2, TSLP, PTEN, IRE1α, GDF15, and metallothionein in BTBR mice is supportive of an increased level of oxidative stress in BTBR mice and may underpin the pro-inflammatory immune state that has been reported in the BTBR strain. Results of a decreased antioxidant system suggest an important oxidative stress role in the development of the BTBR ASD-like phenotype.
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Affiliation(s)
- Mohammad Nizam Uddin
- Wadsworth Center, New York State Department of Health, Center for Medical Science, 150 New Scotland Avenue, Albany, NY, 12208, USA
| | - Tapan Mondal
- Wadsworth Center, New York State Department of Health, Center for Medical Science, 150 New Scotland Avenue, Albany, NY, 12208, USA
| | - Yunyi Yao
- Wadsworth Center, New York State Department of Health, Center for Medical Science, 150 New Scotland Avenue, Albany, NY, 12208, USA
| | - Kevin Manley
- Wadsworth Center, New York State Department of Health, Center for Medical Science, 150 New Scotland Avenue, Albany, NY, 12208, USA
| | - David A Lawrence
- Wadsworth Center, New York State Department of Health, Center for Medical Science, 150 New Scotland Avenue, Albany, NY, 12208, USA.
- University at Albany School of Public Health, Rensselaer, NY, USA.
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13
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Asfour MH, Abd El-Alim SH, Kassem AA, Salama A, Gouda AS, Nazim WS, Nashaat NH, Hemimi M, Abdel Meguid N. Vitamin D 3-Loaded Nanoemulsions as a Potential Drug Delivery System for Autistic Children: Formulation Development, Safety, and Pharmacokinetic Studies. AAPS PharmSciTech 2023; 24:58. [PMID: 36759398 DOI: 10.1208/s12249-023-02501-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/27/2022] [Indexed: 02/11/2023] Open
Abstract
The aim of the current study is the development of a vitamin D3 (VD3)-loaded nanoemulsion (NE) formulation to improve VD3 oral bioavailability for management of vitamin D inadequacy in autistic children. Eight NE formulations were prepared by high-speed homogenization followed by ultrasonication. Four vegetable oils were employed along with two concentrations of Span 20 as the emulsifier. Glycerol, fructose, and mango flavor were included as viscosity modifier, sweetening, and flavoring agents, respectively. The prepared VD3-loaded NE formulations exhibited high drug content (> 98%), droplet size (DS) ranging from 61.15 to 129.8 nm with narrow size distribution, zeta potential values between - 9.83 and - 19.22 mV, and acceptable pH values (4.59-5.89). Storage stability showed that NE formulations underwent coalescence and phase separation during 6 months at room temperature, whereas at refrigerated conditions, formulations showed slight creaming. The optimum formulation (VD3-NE6) revealed a non-significant DS growth at refrigerated conditions and spherical morphology under transmission electron microscopy. VD3-NE6 did not produce any toxic effects to rats treated orally for 3 months, where normal blood picture and kidney and liver functions were observed compared to control rats. Also, serum calcium, oxidative stress, and apoptosis biomarkers remained within normal levels, indicating the safety of the optimum formulation. Furthermore, evaluation of VD3-NE6 oral bioavailability depicted a significant increase in AUC0-72 and Cmax with decreased Tmax compared to plain VD3. The optimum formulation demonstrated improved stability, safety, and oral bioavailability indicating the potential for successful management of vitamin D deficiency in autistic children.
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Affiliation(s)
- Marwa Hasanein Asfour
- Pharmaceutical Technology Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Sameh Hosam Abd El-Alim
- Pharmaceutical Technology Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt.
| | - Ahmed Alaa Kassem
- Pharmaceutical Technology Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Abeer Salama
- Pharmacology Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Amr Sobhi Gouda
- Biochemical Genetics Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Walaa Samy Nazim
- Biochemical Genetics Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Neveen Hassan Nashaat
- Research On Children With Special Needs Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Maha Hemimi
- Research On Children With Special Needs Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
| | - Nagwa Abdel Meguid
- Research On Children With Special Needs Department, National Research Centre, El-Buhouth St., Dokki, 12622, Cairo, Egypt
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Qi X, Yang T, Chen J, Dai Y, Chen L, Wu L, Hao Y, Li L, Zhang J, Ke X, Yi M, Hong Q, Chen J, Fang S, Wang Y, Wang Q, Jin C, Jia F, Li T. Vitamin D status is primarily associated with core symptoms in children with autism spectrum disorder: A multicenter study in China. Psychiatry Res 2022; 317:114807. [PMID: 36063750 DOI: 10.1016/j.psychres.2022.114807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We aimed to investigate the relationship between vitamin D status and core symptoms and neurodevelopmental levels in children with ASD with a multicenter survey. METHODS We enrolled 1321 ASD children and 1279 typically developing (TD) children aged 2-7 years from 13 cities in China. ASD symptoms were assessed with the Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS), and neurodevelopmental levels were evaluated with the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016). RESULTS Children with ASD had lower serum 25(OH)D levels than TD children. Serum 25(OH)D levels were negatively associated with CARS and communication warning behavior of CNBS-R2016 scores, and were not associated with the development quotients of ASD children. ASD Children were grouped based on the quartiles for 25(OH)D levels in the controls, and children in the first to third quartiles had higher SRS social communication and/or CARS and communication warning behavior of CNBS-R2016 scores than those in the fourth quartile. CONCLUSIONS Serum 25(OH)D levels were primarily associated with core symptoms in children with ASD, and individuals with relatively lower 25(OH)D levels displayed worse autistic symptomatology. More research is needed to determine whether vitamin D supplements would be a useful treatment for ASD.
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Zhang Z, Liu J, Jiang G, Yu H. Vitamin D receptor gene variants and serum vitamin D in childhood autism spectrum disorder. Mol Biol Rep 2022. [PMID: 35953654 DOI: 10.1007/s11033-022-07829-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/28/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE This study aimed to examine the correlation between polymorphisms in vitamin D receptor (VDR) gene and serum vitamin D, and to determine their role in predicting childhood Autism Spectrum Disorder (ASD). METHODS Children with ASD and age- and gender- matched healthy controls were recruited from the Chinese Han population. Their serum 25(OH) vitamin D was measured using competitive chemiluminescent immunoassays. The TaqMan probe approach was applied to analyze the common VDR SNPs rs731236 (Taq1), rs11568820 (Cdx2), rs1544410 (BsmI), and rs228570 (FokI). Both linear and logistic regressions were applied in data analysis. RESULTS A total of 269 children with ASD and 320 healthy controls were recruited. Children with ASD had significantly lower levels of serum vitamin D and a significantly higher rate of vitamin D deficiency (< 20 ng/ml) compared to healthy controls (67.7% vs 34.1%). All these examined VDR SNPs were not correlated with serum vitamin D concentrations or vitamin D deficiency. Logistic regression analysis revealed that rs731236 and serum vitamin D were associated with childhood ASD. The area under the receiver operating characteristic (ROC) curve was 0.7285 for serum vitamin D. Children with both T/C genotype of rs731236 and vitamin D deficiency had a higher risk of being diagnosed with ASD. CONCLUSION All examined common VDR SNPs are not correlated with serum vitamin D concentrations or vitamin D deficiency. The combination of T/C phenotype of rs731236 and vitamin D deficiency are associated with a higher risk of childhood ASD. Vitamin D is a promising target in the prevention and treatment of this disease.
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Wang J, Huang H, Liu C, Zhang Y, Wang W, Zou Z, Yang L, He X, Wu J, Ma J, Liu Y. Research Progress on the Role of Vitamin D in Autism Spectrum Disorder. Front Behav Neurosci 2022; 16:859151. [PMID: 35619598 PMCID: PMC9128593 DOI: 10.3389/fnbeh.2022.859151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can lead to severe social behavioral difficulties, which mainly manifests as social communication and interaction disorders; narrow interests; and repetitive, stereotyped behaviors. In recent years, the prevalence of ASD has increased annually, and it has evolved from a rare disease to one with a high incidence among childhood developmental disorders. The pathogenesis of ASD is considered to be the interaction of genetic and environmental factors. There is increasing evidence that vitamin D deficiency in pregnancy and early childhood can lead to the occurrence of ASD. Studies have demonstrated that vitamin D intervention can significantly improve the symptoms of ASD, but the underlying mechanism is still unclear. Therefore, exploring the neuroprotective mechanism of vitamin D against ASD is a huge challenge currently being worked on by current basic and clinical researchers, a task which is of great significance for the clinical promotion and optimization of vitamin D in the treatment of ASD. To further clarify the relationship between vitamin D and ASD, this review summarizes the correlation between vitamin D level and ASD, the effects of vitamin D supplementation on ASD, the possible mechanism of vitamin D involved in ASD, and insights from ASD animal models.
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Affiliation(s)
- Jing Wang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Haoyu Huang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Chunming Liu
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Yangping Zhang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Wenjuan Wang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Zhuo Zou
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Lei Yang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Xuemei He
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Jinting Wu
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Jing Ma
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
- *Correspondence: Jing Ma,
| | - Yun Liu
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
- *Correspondence: Jing Ma,
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17
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Mansur JL, Oliveri B, Giacoia E, Fusaro D, Costanzo PR. Vitamin D: Before, during and after Pregnancy: Effect on Neonates and Children. Nutrients 2022; 14:1900. [PMID: 35565867 PMCID: PMC9105305 DOI: 10.3390/nu14091900] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 02/06/2023] Open
Abstract
A worldwide high prevalence of vitamin D (VD) deficiency has become of growing concern because of potential adverse effects on human health, including pregnant women and their offsprings. Beyond its classical function as a regulator of calcium and phosphate metabolism, together with its fundamental role in bone health in every stage of life, its deficiency has been associated to multiple adverse health effects. The classic effects of VD deficiency in pregnancy and neonates have been late hypocalcemia and nutritional rickets. Nevertheless, recent studies have linked VD to fertility and 25(OH)D with several clinical conditions in pregnancy: preeclampsia, gestational diabetes, higher incidence of cesarean section and preterm birth, while in infants, the clinical conditions are low birth weight, lower bone mass and possible relationship with the development of such diseases as bronchiolitis, asthma, type 1 diabetes, multiple sclerosis and autism included as VD non-classical actions. The supplementation with Vitamin D and achievement of optimal levels reduce maternal-fetal and newborn complications. Supplementation in children with VD deficiency reduces the risk of respiratory infections and possibly autoimmune diseases and autism. This review emphasizes the roles of Vitamin D deficiency and the consequences of intervention from preconception to infancy.
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18
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Muñoz A, Grant WB. Vitamin D and Cancer: An Historical Overview of the Epidemiology and Mechanisms. Nutrients 2022; 14:nu14071448. [PMID: 35406059 PMCID: PMC9003337 DOI: 10.3390/nu14071448] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 02/07/2023] Open
Abstract
This is a narrative review of the evidence supporting vitamin D’s anticancer actions. The first section reviews the findings from ecological studies of cancer with respect to indices of solar radiation, which found a reduced risk of incidence and mortality for approximately 23 types of cancer. Meta-analyses of observational studies reported the inverse correlations of serum 25-hydroxyvitamin D [25(OH)D] with the incidence of 12 types of cancer. Case-control studies with a 25(OH)D concentration measured near the time of cancer diagnosis are stronger than nested case-control and cohort studies as long follow-up times reduce the correlations due to changes in 25(OH)D with time. There is no evidence that undiagnosed cancer reduces 25(OH)D concentrations unless the cancer is at a very advanced stage. Meta-analyses of cancer incidence with respect to dietary intake have had limited success due to the low amount of vitamin D in most diets. An analysis of 25(OH)D-cancer incidence rates suggests that achieving 80 ng/mL vs. 10 ng/mL would reduce cancer incidence rates by 70 ± 10%. Clinical trials have provided limited support for the UVB-vitamin D-cancer hypothesis due to poor design and execution. In recent decades, many experimental studies in cultured cells and animal models have described a wide range of anticancer effects of vitamin D compounds. This paper will review studies showing the inhibition of tumor cell proliferation, dedifferentiation, and invasion together with the sensitization to proapoptotic agents. Moreover, 1,25-(OH)2D3 and other vitamin D receptor agonists modulate the biology of several types of stromal cells such as fibroblasts, endothelial and immune cells in a way that interferes the apparition of metastases. In sum, the available mechanistic data support the global protective action of vitamin D against several important types of cancer.
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Affiliation(s)
- Alberto Muñoz
- Instituto de Investigaciones Biomédicas “Alberto Sols”, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, CIBERONC and IdiPAZ, 28029 Madrid, Spain;
| | - William B. Grant
- Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
- Correspondence: ; Tel.: +14-15-409-1980
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Tian J, Gao X, Yang L. Repetitive Restricted Behaviors in Autism Spectrum Disorder: From Mechanism to Development of Therapeutics. Front Neurosci 2022; 16:780407. [PMID: 35310097 PMCID: PMC8924045 DOI: 10.3389/fnins.2022.780407] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/09/2022] [Indexed: 01/28/2023] Open
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by deficits in social communication, social interaction, and repetitive restricted behaviors (RRBs). It is usually detected in early childhood. RRBs are behavioral patterns characterized by repetition, inflexibility, invariance, inappropriateness, and frequent lack of obvious function or specific purpose. To date, the classification of RRBs is contentious. Understanding the potential mechanisms of RRBs in children with ASD, such as neural connectivity disorders and abnormal immune functions, will contribute to finding new therapeutic targets. Although behavioral intervention remains the most effective and safe strategy for RRBs treatment, some promising drugs and new treatment options (e.g., supplementary and cell therapy) have shown positive effects on RRBs in recent studies. In this review, we summarize the latest advances of RRBs from mechanistic to therapeutic approaches and propose potential future directions in research on RRBs.
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Nogay NH, Nahikian-Nelms M. Effects of nutritional interventions in children and adolescents with autism spectrum disorder: an overview based on a literature review. Int J Dev Disabil 2022; 69:811-824. [PMID: 37885847 PMCID: PMC10599198 DOI: 10.1080/20473869.2022.2036921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/27/2022] [Indexed: 10/28/2023]
Abstract
Background: Nutrition is important in autism spectrum disorder (ASD). Because nutritional problems of children with ASD can lead to nutritional deficiencies and this can also directly or indirectly affect symptoms related to autism. We investigated the effect of diet and supplementation treatments on gastrointestinal, behavioral or sleep problems based on the results of literature review. Methods: We generated four questions based on literature. We carried out title and abstract-based search using the Web of Science database. Of 4580 abstracts were identified, 192 papers were reviewed and 55 papers precisely meeting the inclusion criteria. Results: The studies examining the effects of vitamins, minerals, probiotics, and other supplements on ASD symptoms had different dosages, different treatment durations, small sample sizes and used different scales for evaluation. The results of the studies of the effectiveness of Gluten-Free and Casein-Free (GFCF) and ketogenic diet to reduce gastrointestinal, behavioral and sleeping problems in children and adolescents were contradictory. Conclusions: It is not possible to suggest the GFCF and/or ketogenic diet, vitamins, minerals and probiotics to individual with ASD based on the available evidence. By planning a sufficient and balanced diet, it should be aimed to prevent nutrient deficiency and to ensure growth in accordance with the age in children with ASD.
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Affiliation(s)
- Nalan Hakime Nogay
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Erciyes University, Kayseri, Turkey
| | - Marcia Nahikian-Nelms
- School of Health and Rehabilitation Sciences, College of Medicine, the Ohio State University, Columbus, OH, USA
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21
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Balandeh E, Karimian M, Behjati M, Mohammadi AH. Serum Vitamins and Homocysteine Levels in Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis. Neuropsychobiology 2022; 80:502-515. [PMID: 33744893 DOI: 10.1159/000514075] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/21/2020] [Indexed: 11/19/2022]
Abstract
Vitamin and homocysteine (Hcy) alternations have been associated with psychiatric disorders. The aim of this meta-analysis was to assess the association of serum vitamin and Hcy levels with obsessive-compulsive disorder (OCD). Following PRISMA protocol, we used the databases including Scopus, PubMed, Google Scholar, and Web of Science with no time restriction. Data were pooled using a random-effects model and/or fixed-effects model to estimate the standard mean difference (SMD) for evaluation of the strength of association analyses. Our data showed a significant reduction in vitamin B12 (SMD = -0.58, 95% CI = -1.08 to -0.08, p = 0.02, I2 = 65%; pheterogeneity = 0.06), vitamin E (SMD = -0.89, 95% CI = -1.23 to -0.56, p < 0.00001, I2 = 23%; pheterogeneity = 0.26), and vitamin C (SMD = -1.40, 95% CI = -2.44 to -0.36, p = 0.008, I2 = 92%; pheterogeneity < 0.0001) in OCD patients. In addition, the findings showed significantly higher levels of Hcy (SMD = 1.11, 95% CI = [0.48, 1.75], p = 0.0006, I2 = 73%; ph = 0.02) in patients compared to controls. Also, our data showed that vitamin B9 and D levels are not associated with OCD (vitamin B9: SMD = -0.23, 95% CI = -1.01 to 0.55, p = 0.56, I2 = 88%; pheterogeneity < 0.0001; vitamin D: SMD = -0.63, 95% CI = -1.41 to 0.15, p = 0.11, I2 = 88%; pheterogeneity = 0.0002). Our findings support significant impacts of Hcy and vitamin B12, E, and C levels in OCD pathogenesis. This will be important for prevention and treatment of OCD. However, further studies are recommended to elucidate more accurate conclusions.
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Affiliation(s)
- Ebrahim Balandeh
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Karimian
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Mohaddeseh Behjati
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Mohammadi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran, .,Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran,
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22
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Wang B, Dong H, Li H, Yue X, Xie L. A Probable Way Vitamin D Affects Autism Spectrum Disorder: The Nitric Oxide Signaling Pathway. Front Psychiatry 2022; 13:908895. [PMID: 35722582 PMCID: PMC9199365 DOI: 10.3389/fpsyt.2022.908895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Vitamin D (VD) deficiency during pregnancy and early brain development is an important environmental risk factor for autism spectrum disorder (ASD). Its specific mechanism of action is still unclear. However, one study on the correlation between metabolomics and VD levels in children with ASD has found that the whole-blood arginine (Arg) levels of children with ASD are significantly negatively correlated with serum VD levels, suggesting that the effect of VD on ASD may be related to the signaling pathway involving Arg. Arg is a precursor of nitric oxide (NO), and changes in its levels most directly affect NO levels and signal transduction pathways. NO, a biologically active free radical, is both a neurotransmitter and a neuromodulator in the central nervous system and is related to the pathogeneses of various neurological diseases. The NO signaling pathway is not only affected by VD levels but also closely related to ASD through a series of mechanisms, such as neurotransmitter imbalance, immune disorders, and oxidative stress. Therefore, the effect of VD on ASD may be achieved via regulation of the NO signaling pathway. The current review discusses the relationship among VD, NO, and ASD as suggested by a large body of evidence in the literature in an effort to provide clues for researchers on the pathogenesis of ASD and the mechanism of VD's impact on ASD.
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Affiliation(s)
- Bing Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China.,Department of Developmental and Behavioral Pediatrics, First Affiliated Hospital of Jilin University, Changchun, China
| | - HanYu Dong
- Department of Developmental and Behavioral Pediatrics, First Affiliated Hospital of Jilin University, Changchun, China
| | - HongHua Li
- Department of Developmental and Behavioral Pediatrics, First Affiliated Hospital of Jilin University, Changchun, China
| | - XiaoJing Yue
- Department of Developmental and Behavioral Pediatrics, First Affiliated Hospital of Jilin University, Changchun, China
| | - Lin Xie
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
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Kittana M, Ahmadani A, Stojanovska L, Attlee A. The Role of Vitamin D Supplementation in Children with Autism Spectrum Disorder: A Narrative Review. Nutrients 2021; 14:26. [PMID: 35010901 DOI: 10.3390/nu14010026] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 12/18/2022] Open
Abstract
Children with autism spectrum disorder (ASD) present with persistent deficits in both social communication and interactions, along with the presence of restricted and repetitive behaviors, resulting in significant impairment in significant areas of functioning. Children with ASD consistently reported significantly lower vitamin D levels than typically developing children. Moreover, vitamin D deficiency was found to be strongly correlated with ASD severity. Theoretically, vitamin D can affect neurodevelopment in children with ASD through its anti-inflammatory properties, stimulating the production of neurotrophins, decreasing the risk of seizures, and regulating glutathione and serotonin levels. A Title/Abstract specific search for publications on Vitamin D supplementation trials up to June 2021 was performed using two databases: PubMed and Cochrane Library. Twelve experimental studies were included in the synthesis of this review. Children with ASD reported a high prevalence of vitamin D deficiency or insufficiency. In general, it was observed that improved vitamin D status significantly reduced the ASD severity, however, this effect was not consistently different between the treatment and control groups. The variations in vitamin D dose protocols and the presence of concurrent interventions might provide an explanation for the variability of results. The age of the child for introducing vitamin D intervention was identified as a possible factor determining the effectiveness of the treatment. Common limitations included a small number of participants and a short duration of follow-ups in the selected studies. Long-term, well-designed randomized controlled trials are warranted to confirm the effect of vitamin D on severity in children with ASD.
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Tuovinen S, Räikkönen K, Holmlund-Suila E, Hauta-alus H, Helve O, Rosendahl J, Enlund-Cerullo M, Kajantie E, Valkama S, Viljakainen H, Mäkitie O, Andersson S, Heinonen K. Effect of High-Dose vs Standard-Dose Vitamin D Supplementation on Neurodevelopment of Healthy Term Infants: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2124493. [PMID: 34495336 PMCID: PMC8427371 DOI: 10.1001/jamanetworkopen.2021.24493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/02/2021] [Indexed: 01/04/2023] Open
Abstract
Importance Vitamin D may be important for neurodevelopment. The optimal daily dose of vitamin D for early brain development is not known. Objectives To test whether a higher (1200 IU) vs standard (400 IU) dose of vitamin D3 has beneficial effects on neurodevelopment in the first 2 years of life and whether serum 25-hydroxyvitamin D concentration is associated with neurodevelopment. Design, Setting, and Participants This double-blind, interventional randomized clinical trial involved healthy infants born full-term between January 1, 2013, and June 30, 2014, at a maternity hospital in Helsinki, Finland, at the 60th northern latitude. Two-year follow-up was conducted by May 30, 2016. Data analysis was by the intention-to-treat principle. Data were analyzed from November 1, 2020, to May 31, 2021. Interventions Randomization of 404 infants to receive 400 IU of oral vitamin D3 supplementation daily and 397 infants to receive 1200 IU of oral vitamin D3 supplementation daily from 2 weeks to 24 months of age. Main Outcomes and Measures Primary outcomes were child total developmental milestone scores at 12 and 24 months of age measured using the Ages and Stages Questionnaire (total score is calculated as a mean of the 5 subscale scores: total score range, 0-60, where 0 indicates delay in all developmental domains and 60 indicates that the child can master all age-specific skills) as well as externalizing, internalizing, and dysregulation problems and competencies scores at 24 months measured using the Infant-Toddler Social and Emotional Assessment (range 0-2, where 0 indicates no problems or no competencies and 2 indicates a high level of problems or a high level of competencies; variables were standardized to the mean [SD] of 0 [1]). Secondary outcomes were specific skills, problems, and competencies derived from these questionnaires. Results Of the 987 families recruited, 495 children were randomly assigned to receive 400 IU of vitamin D3, and 492 children were randomly assigned to receive 1200 IU of vitamin D3. A total of 801 families participated in the follow-up at 12 and/or 24 months, with 404 children (207 girls [51.2%]) in the 400-IU group and 397 children (198 girls [49.9%]) in the 1200-IU group. All children were of Northern European ethnicity. No differences were found between the 400-IU group and the 1200-IU group in the mean (SD) adjusted Ages and Stages Questionnaire total score at 12 months (45.0 [7.1] vs 46.2 [7.9]; mean difference [MD], 1.17 [95% CI, -0.06 to 2.38]) or 24 months (50.9 [5.3] vs 51.5 [5.5]; MD, 0.48 [95% CI, -0.40 to 1.36]). No differences were found between the 400-IU group and the 1200-IU group at 24 months in the mean (SD) adjusted Infant-Toddler Social and Emotional Assessment externalizing domain score (-0.07 [1.00] vs 0.07 [0.98]; MD, 0.15 [95% CI, -0.01 to 0.31]), internalizing domain score (0.04 [1.06] vs -0.02 [0.98]; MD, -0.07 [95% CI, -0.24 to 0.1.0]), dysregulation domain score (-0.00 [1.04] vs 0.02 [0.96]; MD, 0.02 [95% CI, -0.14 to 0.18]), or competencies score (-0.02 [1.02] vs 0.01 [1.02]; MD, 0.03 [95% CI, -0.13 to 0.20]). The 1200-IU group did have a higher risk in the adjusted model of scoring 1.5 SDs or more on the externalizing domain score (odds ratio, 2.33 [95% CI, 1.19-4.56]; P = .01). Levels of serum 25-hydroxyvitamin D were not associated with the primary outcomes. Conclusions and Relevance Higher-than-standard vitamin D3 doses provide no systematic benefits for child neurodevelopment up to 2 years of age. However, the potential disadvantageous effects of higher doses could not be fully excluded; even if minimal, the potential nonbeneficial effects of higher-than-standard doses warrant further studies in which both safety and benefits should be evaluated. Trial Registration ClinicalTrials.gov Identifier: NCT01723852.
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Affiliation(s)
- Soile Tuovinen
- Psychology/Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elisa Holmlund-Suila
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Helena Hauta-alus
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology, and Ophthalmology, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Otto Helve
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Rosendahl
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Maria Enlund-Cerullo
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Eero Kajantie
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology, and Ophthalmology, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
| | - Saara Valkama
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | | | - Outi Mäkitie
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Center for Molecular Medicine, Karolinska Institutet and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Sture Andersson
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Kati Heinonen
- Psychology/Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Narzisi A, Masi G, Grossi E. Nutrition and Autism Spectrum Disorder: Between False Myths and Real Research-Based Opportunities. Nutrients 2021; 13:nu13062068. [PMID: 34204187 PMCID: PMC8234602 DOI: 10.3390/nu13062068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 02/05/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is a multicomplex disorder characterized by an umbrella of specific issues in the areas of social communication, restricted interests, and repetitive behaviors [...].
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Affiliation(s)
- Antonio Narzisi
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56018 Pisa, Italy;
- Correspondence:
| | - Gabriele Masi
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56018 Pisa, Italy;
| | - Enzo Grossi
- Villa Santa Maria Foundation, Tavernerio, 22038 Como, Italy;
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Higazi AM, Kamel HM, Abdel-Naeem EA, Abdullah NM, Mahrous DM, Osman AM. Expression analysis of selected genes involved in tryptophan metabolic pathways in Egyptian children with Autism Spectrum Disorder and learning disabilities. Sci Rep 2021; 11:6931. [PMID: 33767242 PMCID: PMC7994393 DOI: 10.1038/s41598-021-86162-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 03/07/2021] [Indexed: 01/31/2023] Open
Abstract
Autism Spectrum Disorder (ASD) and learning disabilities are neurodevelopmental disabilities characterized by dramatically increasing incidence rates, yet the exact etiology for these disabilities is not identified. Impairment in tryptophan metabolism has been suggested to participate in the pathogenesis of ASD, however, further validation of its involvement is required. Additionally, its role in learning disabilities is still uninvestigated. Our objective was to evaluate some aspects of tryptophan metabolism in ASD children (N = 45) compared to children with learning disabilities (N = 44) and healthy controls (N = 40) by measuring the expression levels of the MAOA, HAAO and AADAT genes using real-time RT-qPCR. We also aimed to correlate the expression patterns of these genes with parental ages at the time of childbirth, levels of serum iron, and vitamin D3 and zinc/copper ratio, as possible risk factors for ASD. Results demonstrated a significant decrease in the expression of the selected genes within ASD children (p < 0.001) relative to children with learning disabilities and healthy controls, which significantly associated with the levels of our targeted risk factors (p < 0.05) and negatively correlated to ASD scoring (p < 0.001). In conclusion, this study suggests that the expression of the MAOA, HAAO and AADAT genes may underpin the pathophysiology of ASD.
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Affiliation(s)
- Aliaa M. Higazi
- grid.411806.a0000 0000 8999 4945Clinical and Molecular Chemistry Unit, Department of Clinical and Chemical Pathology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Hanan M. Kamel
- grid.411806.a0000 0000 8999 4945Clinical and Molecular Chemistry Unit, Department of Clinical and Chemical Pathology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Emad A. Abdel-Naeem
- grid.411806.a0000 0000 8999 4945Immunology Unit, Department of Clinical and Chemical Pathology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Noha M. Abdullah
- grid.411806.a0000 0000 8999 4945Clinical and Molecular Chemistry Unit, Department of Clinical and Chemical Pathology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Doaa M. Mahrous
- grid.411806.a0000 0000 8999 4945Department of Pediatrics, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ashraf M. Osman
- grid.411806.a0000 0000 8999 4945Clinical and Molecular Chemistry Unit, Department of Clinical and Chemical Pathology, Faculty of Medicine, Minia University, Minia, Egypt
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Chen L, Shi XJ, Liu H, Mao X, Gui LN, Wang H, Cheng Y. Oxidative stress marker aberrations in children with autism spectrum disorder: a systematic review and meta-analysis of 87 studies (N = 9109). Transl Psychiatry 2021; 11:15. [PMID: 33414386 PMCID: PMC7791110 DOI: 10.1038/s41398-020-01135-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022] Open
Abstract
There is increasing awareness that oxidative stress may be implicated in the pathophysiology of autism spectrum disorder (ASD). Here we aimed to investigate blood oxidative stress marker profile in ASD children by a meta-analysis. Two independent investigators systematically searched Web of Science, PubMed, and Cochrane Library and extracted data from 87 studies with 4928 ASD children and 4181 healthy control (HC) children. The meta-analysis showed that blood concentrations of oxidative glutathione (GSSG), malondialdehyde, homocysteine, S-adenosylhomocysteine, nitric oxide, and copper were higher in children with ASD than that of HC children. In contrast, blood reduced glutathione (GSH), total glutathione (tGSH), GSH/GSSG, tGSH/GSSG, methionine, cysteine, vitamin B9, vitamin D, vitamin B12, vitamin E, S-adenosylmethionine/S-adenosylhomocysteine, and calcium concentrations were significantly reduced in children with ASD relative to HC children. However, there were no significance differences between ASD children and HC children for the other 17 potential markers. Heterogeneities among studies were found for most markers, and meta-regressions indicated that age and publication year may influence the meta-analysis results. These results therefore clarified blood oxidative stress profile in children with ASD, strengthening clinical evidence of increased oxidative stress implicating in pathogenesis of ASD. Additionally, given the consistent and large effective size, glutathione metabolism biomarkers have the potential to inform early diagnosis of ASD.
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Affiliation(s)
- Lei Chen
- grid.411077.40000 0004 0369 0529Key Laboratory of Ethnomedicine of Ministry of Education, Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Xiao-Jie Shi
- grid.411077.40000 0004 0369 0529Key Laboratory of Ethnomedicine of Ministry of Education, Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Hua Liu
- grid.411077.40000 0004 0369 0529Key Laboratory of Ethnomedicine of Ministry of Education, Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Xiao Mao
- NHC Key Laboratory of Birth Defects Research, Prevention and Treatment (Hunan Provincial Maternal and Child Health Care Hospital), Hunan, China
| | - Lue-Ning Gui
- grid.411077.40000 0004 0369 0529Key Laboratory of Ethnomedicine of Ministry of Education, Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Hua Wang
- NHC Key Laboratory of Birth Defects Research, Prevention and Treatment (Hunan Provincial Maternal and Child Health Care Hospital), Hunan, China
| | - Yong Cheng
- Key Laboratory of Ethnomedicine of Ministry of Education, Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China. .,NHC Key Laboratory of Birth Defects Research, Prevention and Treatment (Hunan Provincial Maternal and Child Health Care Hospital), Hunan, China.
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28
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Silva MRM, Barros WMA, da Silva ML, da Silva JML, Souza APDS, da Silva ABJ, Fernandes MSDS, de Souza SL, Souza VDON. Relationship between vitamin D deficiency and psychophysiological variables: a systematic review of the literature. Clinics (Sao Paulo) 2021; 76:e3155. [PMID: 34755759 PMCID: PMC8552952 DOI: 10.6061/clinics/2021/e3155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/09/2021] [Indexed: 11/24/2022] Open
Abstract
Vitamin D is a fat-soluble vitamin that plays a role not only in calcium homeostasis, but also in several other functions, including cell growth and immune functions, and is considered a neurosteroid. Vitamin D deficiency is highly prevalent worldwide and has been suggested to be associated with an increased risk of emotional disorders. Therefore, the association between vitamin D levels and psychophysiological disorders, such as depression, anxiety, and mood, has been investigated. To list these variables, a bibliographical literature research was conducted in the MEDLINE/PubMed, Web of Science, Scopus, Science Direct and PsycINFO databases, between November and December 2020, with no year limits of publication. The studies involved humans aged between 18 and 59 years without associated diseases. This review presents evidence of the main variables involved in this association, main tools used to verify these variables, and methods used to verify circulating vitamin D levels in populations. Most studies have indicated that the main psychophysiological variables involved with vitamin D levels are depression and anxiety followed by mood, and an association has been observed between increased serum vitamin D levels and reduction in symptoms of depression, anxiety, and mood, and there is a heterogeneity of methods for assessing vitamin D. More studies are clearly needed to improve our understanding of their role in modulating the psychophysiological aspects of vitamin D levels.
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Affiliation(s)
- Mariluce Rodrigues Marques Silva
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Centro de Ciencias da Saude, Universidade Federal de Pernambuco, Recife, PE, BR
- Centro Integrado de Tecnologias em Neurociencia (CITENC), Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
| | - Waleska Maria Almeida Barros
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Centro de Ciencias da Saude, Universidade Federal de Pernambuco, Recife, PE, BR
- Centro Integrado de Tecnologias em Neurociencia (CITENC), Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
- Departamento de Fisioterapia, Centro de Ciencias da Saude, Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
| | - Mayara Luclécia da Silva
- Centro Integrado de Tecnologias em Neurociencia (CITENC), Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
- Departamento de Fisioterapia, Centro de Ciencias da Saude, Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
| | - José Maurício Lucas da Silva
- Centro Integrado de Tecnologias em Neurociencia (CITENC), Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
- Departamento de Fisioterapia, Centro de Ciencias da Saude, Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
| | - Ana Patrícia da Silva Souza
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Centro de Ciencias da Saude, Universidade Federal de Pernambuco, Recife, PE, BR
- Centro Integrado de Tecnologias em Neurociencia (CITENC), Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
| | - Ana Beatriz Januário da Silva
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Centro de Ciencias da Saude, Universidade Federal de Pernambuco, Recife, PE, BR
- Centro Integrado de Tecnologias em Neurociencia (CITENC), Centro Universitario Osman Lins (UNIFACOL), Vitoria de Santo Antao, PE, BR
| | - Matheus Santos de Sousa Fernandes
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Centro de Ciencias da Saude, Universidade Federal de Pernambuco, Recife, PE, BR
| | - Sandra Lopes de Souza
- Programa de Pos-graduacao em Neuropsiquiatria e Ciencias do Comportamento, Centro de Ciencias da Saude, Universidade Federal de Pernambuco, Recife, PE, BR
| | - Viviane de Oliveira Nogueira Souza
- Nucleo de Nutricao, Centro Academico de Vitoria (CAV), Universidade Federal de Pernambuco, Vitoria de Santo Antao, PE, BR
- Programa de Pos-graduacao em Nutricao, Atividade Fisica e Plasticidade Fenotipica, Centro Academico de Vitoria, Universidade Federal de Pernambuco, Vitoria de Santo Antao, PE, BR
- Corresponding author. E-mail:
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Shan L, Dong H, Wang T, Feng J, Jia F. Screen Time, Age and Sunshine Duration Rather Than Outdoor Activity Time Are Related to Nutritional Vitamin D Status in Children With ASD. Front Pediatr 2021; 9:806981. [PMID: 35096715 PMCID: PMC8793674 DOI: 10.3389/fped.2021.806981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to investigate the possible association among vitamin D, screen time and other factors that might affect the concentration of vitamin D in children with autism spectrum disorder (ASD). Methods: In total, 306 children with ASD were recruited, and data, including their age, sex, height, weight, screen time, time of outdoor activity, ASD symptoms [including Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS) and Autism Diagnostic Observation Schedule-Second Edition (ADOS-2)] and vitamin D concentrations, were collected. A multiple linear regression model was used to analyze the factors related to the vitamin D concentration. Results: A multiple linear regression analysis showed that screen time (β = -0.122, P = 0.032), age (β = -0.233, P < 0.001), and blood collection month (reflecting sunshine duration) (β = 0.177, P = 0.004) were statistically significant. The vitamin D concentration in the children with ASD was negatively correlated with screen time and age and positively correlated with sunshine duration. Conclusion: The vitamin D levels in children with ASD are related to electronic screen time, age and sunshine duration. Since age and season are uncontrollable, identifying the length of screen time in children with ASD could provide a basis for the clinical management of their vitamin D nutritional status.
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Affiliation(s)
- Ling Shan
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Hanyu Dong
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Tiantian Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Junyan Feng
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Feiyong Jia
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
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Wang Z, Ding R, Wang J. The Association between Vitamin D Status and Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis. Nutrients 2020; 13:E86. [PMID: 33383952 PMCID: PMC7824115 DOI: 10.3390/nu13010086] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/21/2020] [Accepted: 12/25/2020] [Indexed: 12/22/2022] Open
Abstract
The association between vitamin D status and autism spectrum disorder (ASD) is well-investigated but remains to be elucidated. We quantitatively combined relevant studies to estimate whether vitamin D status was related to ASD in this work. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched to include eligible studies. A random-effects model was applied to pool overall estimates of vitamin D concentration or odds ratio (OR) for ASD. In total, 34 publications involving 20,580 participants were identified in this present study. Meta-analysis of 24 case-control studies demonstrated that children and adolescents with ASD had significantly lower vitamin D concentration than that of the control group (mean difference (MD): -7.46 ng/mL, 95% confidence interval (CI): -10.26; -4.66 ng/mL, p < 0.0001, I2 = 98%). Quantitative integration of 10 case-control studies reporting OR revealed that lower vitamin D was associated with higher risk of ASD (OR: 5.23, 95% CI: 3.13; 8.73, p < 0.0001, I2 = 78.2%). Analysis of 15 case-control studies barring data from previous meta-analysis reached a similar result with that of the meta-analysis of 24 case-control studies (MD: -6.2, 95% CI: -9.62; -2.78, p = 0.0004, I2 = 96.8%), which confirmed the association. Furthermore, meta-analysis of maternal and neonatal vitamin D showed a trend of decreased early-life vitamin D concentration in the ASD group (MD: -3.15, 95% CI: -6.57; 0.26, p = 0.07, I2 = 99%). Meta-analysis of prospective studies suggested that children with reduced maternal or neonatal vitamin D had 54% higher likelihood of developing ASD (OR: 1.54, 95% CI: 1.12; 2.10, p = 0.0071, I2 = 81.2%). These analyses indicated that vitamin D status was related to the risk of ASD. The detection and appropriate intervention of vitamin D deficiency in ASD patients and pregnant and lactating women have clinical and public significance.
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Affiliation(s)
- Zuqun Wang
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
| | - Rui Ding
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
| | - Juan Wang
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
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Kern JK, Geier DA, Mehta JA, Homme KG, Geier MR. Mercury as a hapten: A review of the role of toxicant-induced brain autoantibodies in autism and possible treatment considerations. J Trace Elem Med Biol 2020; 62:126504. [PMID: 32534375 DOI: 10.1016/j.jtemb.2020.126504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/28/2020] [Accepted: 03/18/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Mercury has many direct and well-recognized neurotoxic effects. However, its immune effects causing secondary neurotoxicity are less well-recognized. Mercury exposure can induce immunologic changes in the brain indicative of autoimmune dysfunction, including the production of highly specific brain autoantibodies. Mercury, and in particular, Thimerosal, can combine with a larger carrier, such as an endogenous protein, thereby acting as a hapten, and this new molecule can then elicit the production of antibodies. METHODS A comprehensive search using PubMed and Google Scholar for original studies and reviews related to autism, mercury, autoantibodies, autoimmune dysfunction, and haptens was undertaken. All articles providing relevant information from 1985 to date were examined. Twenty-three studies were identified showing autoantibodies in the brains of individuals diagnosed with autism and all were included and discussed in this review. RESULTS Research shows mercury exposure can result in an autoimmune reaction that may be causal or contributory to autism, especially in children with a family history of autoimmunity. The autoimmune pathogenesis in autism is demonstrated by the presence of brain autoantibodies (neuroantibodies), which include autoantibodies to: (1) human neuronal progenitor cells; (2) myelin basic protein (MBP); (3) neuron-axon filament protein (NAFP); (4) brain endothelial cells; (5) serotonin receptors; (6) glial fibrillary acidic protein (GFAP); (7) brain derived neurotrophic factor (BDNF); (8) myelin associated glycoprotein (MAG); and (9) various brain proteins in the cerebellum, hypothalamus, prefrontal cortex, cingulate gyrus, caudate putamen, cerebral cortex and caudate nucleus. CONCLUSION Recent evidence suggests a relationship between mercury exposure and brain autoantibodies in individuals diagnosed with autism. Moreover, brain autoantibody levels in autism are found to correlate with both autism severity and blood mercury levels. Treatments to reduce mercury levels and/or brain autoantibody formation should be considered in autism.
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Affiliation(s)
- 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.
| | - David A Geier
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA; CoMeD, Inc., Silver Spring, MD, USA
| | - Jyutika A Mehta
- Texas Woman's University, Department of Communication Sciences and Disorders, Denton, TX, USA
| | - Kristin G Homme
- CoMeD, Inc., Silver Spring, MD, USA; International Academy of Oral Medicine and Toxicology, Champions Gate, FL, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA; CoMeD, Inc., Silver Spring, MD, USA
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Sotgiu S, Manca S, Gagliano A, Minutolo A, Melis MC, Pisuttu G, Scoppola C, Bolognesi E, Clerici M, Guerini FR, Carta A. Immune regulation of neurodevelopment at the mother-foetus interface: the case of autism. Clin Transl Immunology 2020; 9:e1211. [PMID: 33209302 PMCID: PMC7662086 DOI: 10.1002/cti2.1211] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by deficits in social communication and stereotypical behaviours. ASD’s aetiology remains mostly unclear, because of a complex interaction between genetic and environmental factors. Recently, a strong consensus has developed around ASD’s immune‐mediated pathophysiology, which is the subject of this review. For many years, neuroimmunological studies tried to understand ASD as a prototypical antibody‐ or cell‐mediated disease. Other findings indicated the importance of autoimmune mechanisms such as familial and individual autoimmunity, adaptive immune abnormalities and the influence of infections during gestation. However, recent studies have challenged the idea that autism may be a classical autoimmune disease. Modern neurodevelopmental immunology shows the double‐edged nature of many immune effectors, which can be either beneficial or detrimental depending on tissue homeostasis, stressors, neurodevelopmental stage, inherited and de novo gene mutations and other variables. Nowadays, mother–child interactions in the prenatal environment appear to be crucial for the occurrence of ASD. Studies of animal maternal–foetal immune interaction are being fruitfully carried out using different combinations of type and timing of infection, of maternal immune response and foetal vulnerability and of resilience factors to hostile events. The derailed neuroimmune crosstalk through the placenta initiates and maintains a chronic foetal neuroglial activation, eventually causing the alteration of neurogenesis, migration, synapse formation and pruning. The importance of pregnancy can also allow early immune interventions, which can significantly reduce the increasing risk of ASD and its heavy social burden.
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Affiliation(s)
- Stefano Sotgiu
- Unit of Child Neuropsychiatry Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | - Salvatorica Manca
- Unità Operativa di Neuropsichiatria Infanzia e Adolescenza (UONPIA) ASSL Sassari Sassari Italy
| | - Antonella Gagliano
- Child & Adolescent Neuropsychiatry Unit Department of Biomedical Sciences University of Cagliari Cagliari Italy
| | - Alessandra Minutolo
- Child & Adolescent Neuropsychiatry Unit Department of Biomedical Sciences University of Cagliari Cagliari Italy
| | - Maria Clotilde Melis
- Unit of Child Neuropsychiatry Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | - Giulia Pisuttu
- Unit of Child Neuropsychiatry Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | - Chiara Scoppola
- Unit of Child Neuropsychiatry Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
| | | | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi - ONLUS Milan Italy.,Department of Pathophysiology and Transplantation University of Milano Milan Italy
| | | | - Alessandra Carta
- Unit of Child Neuropsychiatry Department of Medical Surgical and Experimental Sciences University of Sassari Sassari Italy
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Shuai B, Jin H, Lin Y, Duan R, Zhao N, Li Z, Mao J, Luo Y, Shi M. Safety and efficacy of complementary and alternative medicine in the treatment of autism spectrum disorder: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e23128. [PMID: 33157993 PMCID: PMC7647561 DOI: 10.1097/md.0000000000023128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The purpose of this study is to evaluate the efficacy and safety of complementary and alternative medicine in the treatment of autism spectrum disorder. METHODS AND ANALYSIS We will electronically search Pubmed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trial, China National Knowledge Infrastructure, China Biomedical Literature Database, China Science Journal Database, and Wan-fang Database from their inception. Also, we will manually retrieve other resources, including reference lists of identified publications, conference articles, and gray literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to complementary and alternative medicine treating autism spectrum disorder will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data were synthesized by using a fixed-effect model or random-effect model depend on the heterogeneity test. The Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) scores will be the primary outcomes. The scores of the Autism Treatment Evaluation Checklist and the Ritvo-Freeman Real Life Rating Scale will also be assessed as secondary outcomes. RevMan V.5.3 statistical software will be used for meta-analysis, and the level of evidence will be assessed by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Continuous data will be expressed in the form of weighted mean difference or standardized mean difference with 95% confidence intervals (CIs), whereas dichotomous data will be expressed in the form of relative risk with 95% CIs. ETHICS AND DISSEMINATION The protocol of this systematic review does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences. SYSTEMATIC REVIEW REGISTRATION OSF Registries, DOI: 10.17605/OSF.IO/ HA97R (https://osf.io/ha97r).
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Riccio MP, Catone G, Siracusano R, Occhiati L, Bernardo P, Sarnataro E, Corrado G, Bravaccio C. Vitamin D deficiency is not related to eating habits in children with Autistic Spectrum Disorder. AIMS Public Health 2020; 7:792-803. [PMID: 33294482 PMCID: PMC7719555 DOI: 10.3934/publichealth.2020061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/09/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND AIMS Autism Spectrum Disorder (ASD) is characterized by the impairment of communication and social interaction and by repetitive, restricted and stereotyped interests. ASD is often accompanied by comorbidities; eating disorders are frequent and imply important nutritional deficits (i.e. deficiencies of vitamins, minerals and fatty acids). Vitamin D has a critical role in neurodevelopment and serum levels in ASD are reported inadequate. A useful reference for setting up a correct diet in childhood is the food pyramid, which is inspired by the Mediterranean Diet (MD). The MD guarantees an intake of nutrients, considered optimal to maintain an adequate nutritional status. The aim of this study is to explore serum levels of Vitamin D and food habits (through MD adherence) in a sample of children with ASD and evaluate a possible correlation between these factors. METHODS study participants include 91 children 47 presenting ASD and 44 healthy typically-developing (TD) subjects, as control group. We evaluated serum level of Vitamin D in both group; anthropometric parameters (weight, height, body mass index-BMI-and growth percentile) and MD adherence have been explored, in order to investigate the correlation among those data and level of Vitamin D in children with ASD. Lastly, the association between Vitamin D levels and severity of ASD symptoms has been analysed. RESULTS AND CONCLUSION 74% of ASD group presented blood levels of Vitamin D under 30 ng/ml (normal range 30-100 ng/ml). The analysis performed showed that the two groups were significant different regards Vitamin D levels (t = 2.24, p < 0.05), according to literature. 31.9% of children with ASD presented a condition of overweight and 12.6% a condition of obesity. Adherence to the MD was low in 25.5% of cases. No significant statistical correlation has been found between Vitamin D serum levels, anthropometric parameters and the adherence to MD in the ASD group.
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Affiliation(s)
- Maria Pia Riccio
- Department of Translational Medical Science, Child and Adolescent Neuropsychiatry, University Federico II of Naples, Italy
| | - Gennaro Catone
- Department of Educational, Psychological and Communication Sciences. Suor Orsola Benincasa University, Italy
| | - Rosamaria Siracusano
- Department of Translational Medical Science, Child and Adolescent Neuropsychiatry, University Federico II of Naples, Italy
| | - Luisa Occhiati
- Department of Translational Medical Science, Section of Pediatrics, University Federico II of Naples, Italy
| | - Pia Bernardo
- Department of Pediatric Neurosciences, Unit of Neuropsychiatry, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Emilia Sarnataro
- Department of Translational Medical Science, Child and Adolescent Neuropsychiatry, University Federico II of Naples, Italy
| | - Giuseppina Corrado
- Department of Translational Medical Science, Child and Adolescent Neuropsychiatry, University Federico II of Naples, Italy
| | - Carmela Bravaccio
- Department of Translational Medical Science, Child and Adolescent Neuropsychiatry, University Federico II of Naples, Italy
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Abstract
Several lines of evidence from family history studies, immunogenetics, maternal immune activation, neuroinflammation, and systemic inflammation support an immune subtype of autism spectrum disorder (ASD). Current Food and Drug Administration-approved medications for ASD do not address the underlying pathophysiology of ASD, have not consistently been shown to address the core symptoms of ASD, and are currently only approved for treating irritability in children and adolescents. In this article, we review the immune modulatory effects of the 2 currently Food and Drug Administration-approved treatments for ASD. We then provide an overview of current data on emerging treatments for ASD from multiple fields of medicine with immune modulatory effects. Although further research is needed to more clearly establish the efficacy and safety of immune modulatory treatments, early data on repurposing medications used to treat systemic inflammation for ASD demonstrate potential benefit and further research is warranted.
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Affiliation(s)
- Robyn P Thom
- Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Christopher J McDougle
- Massachusetts General Hospital, Boston, MA; Lurie Center for Autism, Lexington, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.
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36
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Li B, Xu Y, Zhang X, Zhang L, Wu Y, Wang X, Zhu C. The effect of vitamin D supplementation in treatment of children with autism spectrum disorder: a systematic review and meta-analysis of randomized controlled trials. Nutr Neurosci 2020; 25:835-845. [PMID: 32893747 DOI: 10.1080/1028415x.2020.1815332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Bingbing Li
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Yiran Xu
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Xiaoli Zhang
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Lingling Zhang
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Yanan Wu
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Xiaoyang Wang
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
- Center of Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Changlian Zhu
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
- Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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37
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Li YJ, Zhang X, Li YM. Antineuroinflammatory therapy: potential treatment for autism spectrum disorder by inhibiting glial activation and restoring synaptic function. CNS Spectr 2020; 25:493-501. [PMID: 31659946 DOI: 10.1017/S1092852919001603] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is characterized by deficits in social interactions and perseverative and stereotypical behavior. Growing evidence points toward a critical role for synaptic dysfunction in the onset of ASD, and synaptic function is influenced by glial cells. Considering the evidence that neuroinflammation in ASD is mediated by glial cells, one hypothesis is that reactive glial cells, under inflammatory conditions, contribute to the loss of synaptic functions and trigger ASD. Ongoing pharmacological treatments for ASD, including oxytocin, vitamin D, sulforaphane, and resveratrol, are promising and are shown to lead to improvements in behavioral performance in ASD. More importantly, their pharmacological mechanisms are closely related to anti-inflammation and synaptic protection. We focus this review on the hypothesis that synaptic dysfunction caused by reactive glial cells would lead to ASD, and discuss the potentials of antineuroinflammatory therapy for ASD.
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38
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Abstract
The gut microbiome regulates a relationship with the brain known as the gut–microbiota–brain (GMB) axis. This interaction is influenced by immune cells, microbial metabolites and neurotransmitters. Recent findings show gut dysbiosis is prevalent in autism spectrum disorder (ASD) as well as attention deficit hyperactivity disorder (ADHD). There are previously established negative correlations among vitamin D, vitamin D receptor (VDR) levels and severity of ASD as well as ADHD. Both vitamin D and VDR are known to regulate homeostasis in the brain and the intestinal microbiome. This review summarizes the growing relationship between vitamin D/VDR signalling and the GMB axis in ASD and ADHD. We focus on current publications and summarize the progress of GMB in neurodevelopmental disorders, describe effects and mechanisms of vitamin D/VDR in regulating the microbiome and synoptically highlight the potential applications of targeting vitamin D/VDR signalling in neurodevelopment disorders.
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Affiliation(s)
- Destiny Ogbu
- Division of Gastroenterology and Hepatology, Medicine, University of Illinois at Chicago, Chicago 60612, IL, USA
| | - Eric Xia
- Division of Gastroenterology and Hepatology, Medicine, University of Illinois at Chicago, Chicago 60612, IL, USA.,Marian University College of Osteopathic Medicine, Indianapolis, IN, USA
| | - Jun Sun
- Division of Gastroenterology and Hepatology, Medicine, University of Illinois at Chicago, Chicago 60612, IL, USA.,UIC Cancer Center, Chicago, IL, USA
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Robea MA, Luca AC, Ciobica A. Relationship between Vitamin Deficiencies and Co-Occurring Symptoms in Autism Spectrum Disorder. ACTA ACUST UNITED AC 2020; 56:E245. [PMID: 32443822 DOI: 10.3390/medicina56050245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023]
Abstract
Recently, connections have been made between feeding and eating problems and autism spectrum disorder (ASD) and between autism pathophysiology and diet issues. These could explain some of the mechanisms which have not yet been discovered or are not sufficiently characterized. Moreover, there is an increased awareness for micronutrients in ASD due to the presence of gastrointestinal (GI) problems that can be related to feeding issues. For example, levels of vitamins B1, B6, B12, A and D are often reported to be low in ASD children. Thus, in the present mini review we focused on describing the impact of some vitamins deficiencies and their relevance in ASD patients.
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Siracusano M, Riccioni A, Abate R, Benvenuto A, Curatolo P, Mazzone L. Vitamin D Deficiency and Autism Spectrum Disorder. Curr Pharm Des 2020; 26:2460-2474. [PMID: 32294031 DOI: 10.2174/1381612826666200415174311] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/08/2020] [Indexed: 12/24/2022]
Abstract
Vitamin D is a neurosteroid hormone crucially involved in neurodevelopment. Neural cell proliferation, neurotransmission, oxidative stress and immune function represent the main mechanisms mediated by vitamin D in the Central Nervous System. Therefore, its deficiency during pregnancy and early childhood may significantly impact on a developing brain, leading to possible adverse neuropsychological outcomes including Autism Spectrum Disorder (ASD). Significant vitamin D deficiency is described within children affected by ASD and in pregnant mothers whose offspring will later develop ASD, suggesting a possible role of the hormone as a contributing risk factor in the etiopathogenesis of ASD. We reviewed the actual literature on the potential contributing role of prenatal and early postnatal vitamin D deficiency in ASD etiopathogenesis, at both genetic and environmental levels, and the possible effect of vitamin D supplementation in autistic children. Conflicting but promising results emerged on the topic. Further Randomized Controlled Trials studies carried out during pregnancy and early infancy are necessary for better understanding the possible contribution of vitamin D deficiency in the etiopathogenesis of autism and the potential efficacy of the hormone supplementation in the improvement of ASD core symptoms.
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Affiliation(s)
- Martina Siracusano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,PHD Student in Experimental Medicine- Neuroscience, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila AQ, Italy
| | - Assia Riccioni
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Roberta Abate
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Arianna Benvenuto
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Paolo Curatolo
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Luigi Mazzone
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
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Marotta R, Risoleo MC, Messina G, Parisi L, Carotenuto M, Vetri L, Roccella M. The Neurochemistry of Autism. Brain Sci 2020; 10:E163. [PMID: 32182969 PMCID: PMC7139720 DOI: 10.3390/brainsci10030163] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/04/2020] [Accepted: 03/10/2020] [Indexed: 12/12/2022] Open
Abstract
Autism spectrum disorder (ASD) refers to complex neurobehavioral and neurodevelopmental conditions characterized by impaired social interaction and communication, restricted and repetitive patterns of behavior or interests, and altered sensory processing. Environmental, immunological, genetic, and epigenetic factors are implicated in the pathophysiology of autism and provoke the occurrence of neuroanatomical and neurochemical events relatively early in the development of the central nervous system. Many neurochemical pathways are involved in determining ASD; however, how these complex networks interact and cause the onset of the core symptoms of autism remains unclear. Further studies on neurochemical alterations in autism are necessary to clarify the early neurodevelopmental variations behind the enormous heterogeneity of autism spectrum disorder, and therefore lead to new approaches for the treatment and prevention of autism. In this review, we aim to delineate the state-of-the-art main research findings about the neurochemical alterations in autism etiology, and focuses on gamma aminobutyric acid (GABA) and glutamate, serotonin, dopamine, N-acetyl aspartate, oxytocin and arginine-vasopressin, melatonin, vitamin D, orexin, endogenous opioids, and acetylcholine. We also aim to suggest a possible related therapeutic approach that could improve the quality of ASD interventions. Over one hundred references were collected through electronic database searching in Medline and EMBASE (Ovid), Scopus (Elsevier), ERIC (Proquest), PubMed, and the Web of Science (ISI).
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Affiliation(s)
- Rosa Marotta
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro 88100, Italy; (R.M.); (M.C.R.)
| | - Maria C. Risoleo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro 88100, Italy; (R.M.); (M.C.R.)
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli 80138, Italy;
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71100, Italy;
| | - Lucia Parisi
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, Palermo 90128, Italy; (L.P.); (M.R.)
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli 80138, Italy;
| | - Luigi Vetri
- Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo 90127, Italy
| | - Michele Roccella
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, Palermo 90128, Italy; (L.P.); (M.R.)
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Jaureguiberry MS, Venturino A. Nutritional and environmental contributions to Autism Spectrum Disorders: Focus on nutrigenomics as complementary therapy. INT J VITAM NUTR RES 2020; 92:248-266. [PMID: 32065556 DOI: 10.1024/0300-9831/a000630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The prevalence of autism spectrum disorders (ASD) has risen sharply in the last 30 years, posing a major public health concern and a big emotional and financial challenge for families. While the underlying causes remain to be fully elucidated, evidence shows moderate genetic heritability contribution, but heavy environmental influence. Over the last decades, modern lifestyle has deeply changed our eating, rest, and exercise habits, while exposure to air, water, and food chemical pollution has increased due to indiscriminate use of pesticides, food additives, adjuvants, and antibiotics. The result is a drastic change in the quality of our energy source input, and an overload for antioxidant and detoxification pathways that compromises normal metabolism and homeostasis. Current research shows high prevalence of food selectivity and/or food allergy among children with autism, resulting in essential micronutrient deficits that may trigger or aggravate physical and cognitive symptoms. Nutrigenomics is an emerging discipline that focuses on genotype-micronutrient interaction, and a useful approach to tailor low risk, personalized interventions through diet and micronutrient supplementation. Here, we review available literature addressing the role of micronutrients in the symptomatology of ASD, the metabolic pathways involved, and their therapeutic relevance. Personalized and supervised supplementation according to individual needs is suggested as a complement of traditional therapies to improve outcome both for children with autism and their families.
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Affiliation(s)
- María S Jaureguiberry
- Centro de Investigaciones en Toxicología Ambiental y Agrobiotecnología del Comahue-CITAAC, Universidad Nacional del Comahue-CONICET, Neuquén, Argentina
| | - Andrés Venturino
- Centro de Investigaciones en Toxicología Ambiental y Agrobiotecnología del Comahue-CITAAC, Universidad Nacional del Comahue-CONICET, Neuquén, Argentina
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Abstract
Autism spectrum disorder is a neurodevelopmental disorder characterized by reduced social interactions, impaired communications, and stereotypic and repetitive behavior with different degrees of severity. The etiology of autism spectrum disorder is unknown, although the interaction of genetic and environmental factors is believed to play a fundamental role in the process. The main aim of this narrative review is to discuss the current knowledge about the interrelationships between vitamin D deficiency during pregnancy and autism spectrum disorder development. Literature analysis showed that vitamin D supplementation during pregnancy plays a role in conditioning the development and function of the nervous system. Studies carried out in vitro and in experimental animals have shown that vitamin D deficiency can be associated with structural and functional abnormalities of the nervous system that can be observed in autism spectrum disorder patients. Moreover, it has been reported that vitamin D deficiency during pregnancy could be a risk factor for autism spectrum disorder development in the offspring, that children with autism spectrum disorder have significantly lower serum levels of vitamin D than normal children and that supplementation of vitamin D in autism spectrum disorder children is associated with a reduction in psychiatric manifestations. However, the data currently available do not adequately support the hypothesis that vitamin D may be a factor which contribute to the etiology of autism spectrum disorder. The effects of vitamin D supplementation during pregnancy should be better studied to establish whether and when fetal vulnerability is highest and if vitamin D supplementation is able to reduce the risk of structural and functional alterations of the nervous system and autism spectrum disorder development. The role of vitamin D after birth must be better defined to evaluate if vitamin D administration is potentially effective in reducing autism spectrum disorder manifestations.
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Affiliation(s)
| | - Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
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44
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Abstract
:
Autism spectrum disorder (ASD) is a pervasive developmental disorder with heterogeneous etiology.
Vitamin D can function as a fat-soluble vitamin as well as a hormone, and can exert its effect through both genomic
and non-genomic mechanisms. In the last decades, several studies have examined the relationship between
vitamin D levels and ASD. These studies demonstrated that low vitamin D status in early development has been
hypothesized as an environmental risk factor for ASD. Both in vivo and in vitro studies have demonstrated that
vitamin D deficiency in early life can alter brain development, dysregulates neurotransmitter balance in the brain,
decreases body and brain antioxidant ability, and alters the immune system in ways that resemble pathological
features commonly seen in ASD. In this review, we focused on the association between vitamin D and ASD. In
addition, the above-mentioned mechanisms of action that link vitamin D deficiency with ASD were also discussed.
Finally, clinical trials of vitamin D supplementation treatment of ASD have also been discussed.
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Affiliation(s)
- Loai Alzghoul
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
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Feng JY, Li HH, Wang B, Shan L, Jia FY. Successive clinical application of vitamin D and bumetanide in children with autism spectrum disorder: A case report. Medicine (Baltimore) 2020; 99:e18661. [PMID: 31914053 PMCID: PMC6959878 DOI: 10.1097/md.0000000000018661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 11/09/2019] [Accepted: 12/04/2019] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Autism spectrum disorder (ASD) is a common neurodevelopmental disorder caused by complex interactions between genetic and environmental factors. Recent studies suggest that Vitamin D3 or bumetanide therapy may improve the core symptoms of ASD in some individuals. However, there are no guidelines that provide clinicians with evidence-based treatment regimens for the use of these therapies in ASD. PATIENT CONCERNS A 30-month-old female was referred to our department because she did not respond when her name was called. DIAGNOSIS The patient was diagnosed with ASD by a team of autism experts according to American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. INTERVENTIONS The patient was administered Vitamin D3 150,000 IU intramuscularly once a month and Vitamin D3 800 IU orally each day. After 6 months, Vitamin D3 supplementation was discontinued because of lack of effectiveness. Subsequently, oral bumetanide 0.5 mg twice daily was initiated. OUTCOMES The patient's symptoms remained unchanged after 6 months of Vitamin D3 supplementation, and her serum 25 (OH) D levels had reached 52.4 ng/mL. At the parent's request, Vitamin D3 supplementation was discontinued because of lack of effectiveness. Thereafter, bumetanide was initiated. After 1 month of bumetanide, the patient's Childhood Autism Rating Scale score was 26, which is below the cutoff score for ASD. This case report suggests that Vitamin D3 and bumetanide target different mechanisms in the pathogenesis of ASD. LESSONS Based on these observations, we discuss three possible scenarios for Vitamin D3 supplementation and propose that bumetanide should be initiated if Vitamin D3 supplementation is ineffective (identifier ChiCTR-CCC-13004498).
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Affiliation(s)
- Jun-Yan Feng
- Department of Developmental and Behavior Pediatrics, The First Hospital of Jilin University
| | - Hong-Hua Li
- Department of Developmental and Behavior Pediatrics, The First Hospital of Jilin University
| | - Bing Wang
- Department of Developmental and Behavior Pediatrics, The First Hospital of Jilin University
| | - Ling Shan
- Department of Developmental and Behavior Pediatrics, The First Hospital of Jilin University
| | - Fei-Yong Jia
- Department of Developmental and Behavior Pediatrics, The First Hospital of Jilin University
- Neurological Research Center of First Hospital of Jilin University, Changchun, China
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Jia F, Shan L, Wang B, Li H, Feng J, Xu Z, Saad K. Fluctuations in clinical symptoms with changes in serum 25(OH) vitamin D levels in autistic children: Three cases report. Nutr Neurosci 2019; 22:863-866. [PMID: 29629638 DOI: 10.1080/1028415x.2018.1458421] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder caused by complicated interactions between genetic and environmental factors. Clinical trials, including case reports, case-control studies, and a double-blinded randomized clinical study, have suggested that high-dose vitamin D3 regimens may ameliorate the core symptoms of ASD. Vitamin D3 supplementation was effective in about three-quarters of children with ASD. To further investigate the relationship between vitamin D and ASD symptoms in vitamin D-responsive autistic children, changes in symptoms were assessed in three children with ASD who were given vitamin D3 supplementation followed by a long interruption. The core symptoms of ASD were remarkably improved during the vitamin D3 supplementation period when serum 25-hydroxyvitamin D [25(OH)]D levels reached over 40.0 ng/mL. However, symptoms reappeared after the supplementation was stopped, when serum 25(OH)D levels fell below 30.0 ng/mL but were again improved with re-administration of vitamin D3 after the interruption, when serum 25(OH)D levels exceeded 40.0 ng/mL. Overall, these results showed that the core symptoms of ASD fluctuated in severity with changes in serum 25(OH)D levels in children, indicating that maintaining a responsive 25(OH)D level is important for treating ASD. Maintaining a serum 25(OH)D level between 40.0 and 100.0 ng/ml may be optimal for producing therapeutic effects in vitamin D-responsive individuals with ASD.
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Affiliation(s)
- Feiyong Jia
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
- Institute of Pediatrics of First Hospital of Jilin University, Changchun 130021, People's Republic of China
- Neurological Research Center of First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Ling Shan
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Bing Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Honghua Li
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Junyan Feng
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
| | - Zhida Xu
- Department of Psychiatry, University Medical Center Utrecht, Netherlands
| | - Khaled Saad
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun 130021, People's Republic of China
- Pediatric Department, Faculty of Medicine, Assiut University, Assiut, Egypt
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Pistollato F, Forbes-Hernández TY, Calderón Iglesias R, Ruiz R, Elexpuru Zabaleta M, Cianciosi D, Giampieri F, Battino M. Pharmacological, non-pharmacological and stem cell therapies for the management of autism spectrum disorders: A focus on human studies. Pharmacol Res 2020; 152:104579. [PMID: 31790820 DOI: 10.1016/j.phrs.2019.104579] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/13/2019] [Accepted: 11/27/2019] [Indexed: 01/03/2023]
Abstract
In the last decade, the prevalence of autism spectrum disorders (ASD) has dramatically escalated worldwide. Currently available drugs mainly target some co-occurring symptoms of ASD, but are not effective on the core symptoms, namely impairments in communication and social interaction, and the presence of restricted and repetitive behaviors. On the other hand, transplantation of hematopoietic and mesenchymal stem cells in ASD children has been shown promising to stimulate the recruitment, proliferation, and differentiation of tissue-residing native stem cells, reducing inflammation, and improving some ASD symptoms. Moreover, several comorbidities have also been associated with ASD, such as immune dysregulation, gastrointestinal issues and gut microbiota dysbiosis. Non-pharmacological approaches, such as dietary supplementations with certain vitamins, omega-3 polyunsaturated fatty acids, probiotics, some phytochemicals (e.g., luteolin and sulforaphane), or overall diet interventions (e.g., gluten free and casein free diets) have been considered for the reduction of such comorbidities and the management of ASD. Here, interventional studies describing pharmacological and non-pharmacological treatments in ASD children and adolescents, along with stem cell-based therapies, are reviewed.
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Ribeiro R, Nicoli JR, Santos G, Lima-Santos J. Impact of vitamin deficiency on microbiota composition and immunomodulation: relevance to autistic spectrum disorders. Nutr Neurosci 2019; 24:601-613. [PMID: 31506005 DOI: 10.1080/1028415x.2019.1660485] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVES Inappropriate vitamin supply is a public health problem and is related to abnormalities in brain development, immune response and, more recently, in changes of gut microbial composition. It is known that low levels of vitamin in early life are linked to increased susceptibility to neurodevelopmental disorders, such as Autism Spectrum Disorders (ASD). Unfortunately, the possible peripheral influences of vitamin deficiency that leads to alterations in the gut microbiota-immune-brain axis, one important modulator of the ASD pathology, remain unclear. This narrative review discusses how the impact of vitamin deficiency results in changes in the immune regulation and in the gut microbiota composition, trying to understand how these changes may contribute for the development and severity of ASD. METHODS The papers were selected using Pubmed and other databases. This review discusses the following topics: (1) vitamin deficiency in alterations of central nervous system in autism, (2) the impact of low levels of vitamins in immunomodulation and how it can favor imbalance in gut microbiota composition and gastrointestinal (GI) disturbances, (3) gut microbiota imbalance/inflammation associated with the ASD pathophysiology, and (4) possible evidences of the role of vitamin deficiency in dysfunctional gut microbiota-immune-brain axis in ASD. RESULTS Studies indicate that hypovitaminosis A, B12, D, and K have been co-related with the ASD neuropathology. Furthermore, it was shown that low levels of these vitamins favor the Th1/Th17 environment in the gut, as well as the growth of enteropathogens linked to GI disorders. DISCUSSION GI disorders and alterations in the gut microbiota-immune-brain axis seems to be linked with ASD severity. Although unclear, hypovitaminosis appears to regulate peripherally the ASD pathophysiology by modulating the gut microbiota-immune-brain axis, however, more research is still necessary to confirm this hypothesis.
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Affiliation(s)
- Roberta Ribeiro
- Departament of Biologic Sciences, State University of Santa Cruz, Ilheus, Brazil
| | - Jacques Robert Nicoli
- Departament of Microbiology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Gesivaldo Santos
- Departament of Biologic Sciences, State University of the Southwest of Bahia, Jequie, Brazil
| | - Jane Lima-Santos
- Departament of Biologic Sciences, State University of Santa Cruz, Ilheus, Brazil
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Mazahery H, Conlon CA, Beck KL, Mugridge O, Kruger MC, Stonehouse W, Camargo CA Jr, Meyer BJ, Tsang B, Jones B, von Hurst PR. A Randomised-Controlled Trial of Vitamin D and Omega-3 Long Chain Polyunsaturated Fatty Acids in the Treatment of Core Symptoms of Autism Spectrum Disorder in Children. J Autism Dev Disord 2019; 49:1778-94. [PMID: 30607782 DOI: 10.1007/s10803-018-3860-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We evaluated the efficacy of vitamin D (VID), omega-3 long chain polyunsaturated fatty acids (omega-3 LCPUFA, OM), or both (VIDOM) on core symptoms of ASD. New Zealand children with ASD (n = 73; aged 2.5-8.0 years) received daily 2000 IU vitamin D3, 722 mg docosahexaenoic acid, both, or placebo. Outcome measures were Social Responsiveness Scale (SRS) and Sensory Processing Measure (SPM). Of 42 outcome measures comparisons (interventions vs. placebo), two showed greater improvements (P = 0.03, OM and VIDOM for SRS-social awareness) and four showed trends for greater improvements (P < 0.1, VIDOM for SRS-social communicative functioning, OM for SRS-total, VIDOM for SPM-taste/smell and OM for SPM-balance/motion). Omega-3 LCPUFA with and without vitamin D may improve some core symptoms of ASD but no definitive conclusions can be made.
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Feng JY, Li HH, Shan L, Wang B, Jia FY, DU L. [Clinical effect of vitamin D 3 combined with the Early Start Denver Model in the treatment of autism spectrum disorder in toddlers]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:337-341. [PMID: 31014425 PMCID: PMC7389219 DOI: 10.7499/j.issn.1008-8830.2019.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/14/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To study the clinical effect of vitamin D3 (VitD3) combined with the Early Start Denver Model (ESDM) in the treatment of autism spectrum disorder (ASD) in toddlers. METHODS A total of 102 toddlers with ASD, aged 1 to 3 years, were enrolled. According to the wishes of their parents, they were divided into conventional rehabilitation, ESDM and ESDM+VitD3 groups. Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS) were used evaluate behavior problems before treatment and after 3 months of treatment. RESULTS The conventional rehabilitation group had significant reductions in the total score and the scores on somatic movement and self-care subscales of the ABC scale after 3 months of treatment (P<0.05). After 3 months of treatment, the ESDM group had significant reductions in the total score and the scores on somatic movement, self-care, social interaction and language subscales of the ABC scale (P<0.05), as well as a significant reduction in the total score of the CARS (P<0.05). After 3 months of treatment, the ESDM+VitD3 group had a significant increase in the level of 25(OH)D and significant reductions in the total score and the scores on self-care, sensation, social interaction and language subscales of the ABC scale (P<0.05), as well as a significant reduction in the total score of the CARS (P<0.05). The ESDM group had a significantly greater reduction in the score on social interaction subscale than the conventional rehabilitation group (P<0.05). The ESDM+VitD3 group had a significantly greater reduction in the score on social interaction subscale than the other two groups (P<0.05). CONCLUSIONS ESDM can effectively improve the clinical symptoms of toddlers with ASD, with a significantly better clinical effect in improving social interaction and somatic movement than conventional rehabilitation. ESDM combined with VitD3 has a significantly better clinical effect in improving social communication skills and may be one of the best strategies for improving the clinical symptoms of toddlers with ASD.
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Affiliation(s)
- Jun-Yan Feng
- Department of Developmental-Behavioral Pediatrics, First Hospital of Jilin University, Changchun 130021, China.
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