Sulforaphane treatment of autism spectrum disorder (ASD)

Kanwaljit Singh et al., Proc Natl Acad Sci U S A. 2014 Oct 28; 111(43): 15550–15555.

Autism spectrum disorder (ASD), encompassing impaired communication and social interaction, and repetitive stereotypic behaviour and language, affects 1–2% of predominantly male individuals and is an enormous medical and economic problem for which there is no documented, mechanism-based treatment. In a placebo-controlled, randomised, double-blind clinical trial, daily oral administration for 18 wk of the phytochemical sulforaphane (derived from broccoli sprouts) to 29 young men with ASD substantially (and reversibly) improved behaviour compared with 15 placebo recipients. Behaviour was quantified by both parents/caregivers and physicians by three widely accepted measures. Sulforaphane, which showed negligible toxicity, was selected because it up-regulates genes that protect aerobic cells against oxidative stress, inflammation, and DNA-damage, all of which are prominent and possibly mechanistic characteristics of ASD.

Increasing Prevalence, Changes in Diagnostic Criteria, and Nutritional Risk Factors for Autism Spectrum Disorders

Yasmin H. Neggers, ISRN Nutrition, Volume 2014, Article ID 514026.

The frequency of autism spectrum disorders (ASD) diagnoses has been increasing for decades, but researchers cannot agree on whether the trend is a result of increased awareness, improved detection, expanding definition, or an actual increase in incidence or a combination of these factors. Though both genetic and multiple environmental risk factors have been studied extensively, many potentially modifiable risk factors including nutritional and immune function related risk factors such as vitamin D, folic acid, and metabolic syndrome have not received sufficient attention. Several recent studies have put forward hypotheses to explain the mechanism of association between both folic acid and vitamin D and autism. A continuous rise in the prevalence of autism in the USA has coincided with a significant enhancement of maternal folate status with FDA mandated folic acid fortification of certain foods starting in 1998. There is also a growing body of research that suggests that vitamin D status either in utero or early in life may be a risk for autism. In this communication, controversies regarding increase in estimate of prevalence, implications of changes in definition, and possible association between some modifiable nutritional risk factors such as folic acid and vitamin D and ASD will be discussed.

The Brain-Gut-Microbiome Axis: What Role Does it Play in Autism Spectrum Disorder?

Ruth Ann Luna et al., Current Developmental Disorders Reports, March 2016, Volume 3, Issue 1, pp 75–81

The brain-gut-microbiome axis refers to the interactions between the central nervous system, gastrointestinal (GI) system, and microorganisms that live in the gastrointestinal tract. Exploring these interactions provides a rationale for why gastrointestinal disorders commonly occur in children with autism spectrum disorders (ASD). Signs of altered brain-gut interactions that are closely associated with functional GI disorders (FGIDs) commonly occur in children with ASD. Studies of microbiome in ASD suggest that changes in the gut microbiome may be associated with ASD and with GI disorders in children with ASD. Further studies into the brain-gut-microbiome axis could lead to new techniques for identifying GI disorders in children with ASD and novel therapies for treating ASD behaviour.

Microbiome and nutrition in autism spectrum disorder: current knowledge and research needs

K Berding et al. Nutr Rev 74 (12), 723-736. 12 2016.

 

Gastrointestinal discomfort is commonly reported in children with ASD. Here, the current evidence base regarding the gut environment and nutritional status of children with ASD is reviewed. Potential underlying mechanisms of the microbiota-gut-brain axis in ASD and the interplay between nutrition, microbiota, and ASD symptoms are also reviewed. Future studies investigating the microbiota in the context of dietary intake are needed to increase understanding of the interplay between diet and the gut microbiota in ASD and to identify potential dietary, probiotic, or prebiotic intervention strategies.

Biomarker-Guided Interventions of Clinically Relevant Conditions Associated with Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder

Bradstreet JJ et al., Altern Med Rev. 2010 Apr;15(1):15-32.

This article reviews the medical literature and discusses the authors clinical experience using various biomarkers for measuring oxidative stress, methylation capacity and transsulfuration, immune function, gastrointestinal problems, and toxic metal burden. These biomarkers provide useful guides for selection, efficacy, and sufficiency of biomedical interventions. The use of these biomarkers is of great importance in young children with ADHD or individuals of any age with ASD, because typically they cannot adequately communicate regarding their symptoms.

Gut Microbes and the Brain: Paradigm Shift in Neuroscience

EA. Mayer et al., Journal of Neuroscience 12 November 2014, 34 (46) 15490-15496.

The discovery of the size and complexity of the human microbiome has resulted in an ongoing reevaluation of many concepts of health and disease, including diseases affecting the CNS. A growing body of preclinical literature has demonstrated bidirectional signalling between the brain and the gut microbiome, involving multiple neurocrine and endocrine signalling mechanisms. While psychological and physical stressors can affect the composition and metabolic activity of the gut microbiota, experimental changes to the gut microbiome can affect emotional behaviour and related brain systems. These findings have resulted in speculation that alterations in the gut microbiome may play a pathophysiological role in human brain diseases, including autism spectrum disorder, anxiety, depression, and chronic pain. Ongoing large-scale population-based studies of the gut microbiome and brain imaging studies looking at the effect of gut microbiome modulation on brain responses to emotion-related stimuli are seeking to validate these speculations. This article is a summary of emerging topics covered in a symposium and is not meant to be a comprehensive review of the subject.

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