Maladaptive Behavior and Gastrointestinal Disorders in Children with Autism Spectrum Disorder
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Purpose: Various gastrointestinal factors may contribute to maladaptive behavior in children with autism spectrum disorders (ASD). To determine the association between maladaptive behavior in children with ASD and gastro-intestinal symptoms such as severity, intestinal microbiota, inflammation, enterocyte damage, permeability and ab-sorption of opioid peptides. Methods: This observational cross-sectional study compared children with ASD to healthy controls, aged 2-10 years. Maladaptive behavior was classified using the Approach Withdrawal Problems Composite subtest of the Pervasive Developmental Disorder Behavior Inventory. Dependent variables were gastrointestinal symptom severity index, fecal calprotectin, urinary D-lactate, urinary lactulose/mannitol excretion, urinary intestinal fatty acids binding protein (I-FABP) and urinary opioid peptide excretion.Results: We did not find a significant difference between children with ASD with severe or mild maladaptive behavior and control subjects for gastrointestinal symptoms, fecal calprotectin, urinary D-lactate, and lactulose/mannitol ratio. Urinary opioid peptide excretion was absent in all children. Children with ASD with severe maladaptive behavior showed significantly higher urinary I-FABP levels compared to those with mild maladaptive behavior (p=0.019) and controls (p=0.015). Conclusion: In our series, maladaptive behavior in ASD children was not associated with gastrointestinal symptoms, intestinal inflammation (no difference in calprotectin), microbiota (no difference in urinary D-lactate) and intestinal permeability (no difference in lactulose/manitol ratio). ASD children with severe maladaptive behavior have sig-nificantly more enterocyte damage (increased urinary I-FABP) than ASD children with mild maladaptive behavior and normal children.
Abstract
Purpose: Various gastrointestinal factors may contribute to maladaptive behavior in children with autism spectrum disorders (ASD). To determine the association between maladaptive behavior in children with ASD and gastro-intestinal symptoms such as severity, intestinal microbiota, inflammation, enterocyte damage, permeability and ab-sorption of opioid peptides. Methods: This observational cross-sectional study compared children with ASD to healthy controls, aged 2-10 years. Maladaptive behavior was classified using the Approach Withdrawal Problems Composite subtest of the Pervasive Developmental Disorder Behavior Inventory. Dependent variables were gastrointestinal symptom severity index, fecal calprotectin, urinary D-lactate, urinary lactulose/mannitol excretion, urinary intestinal fatty acids binding protein (I-FABP) and urinary opioid peptide excretion.Results: We did not find a significant difference between children with ASD with severe or mild maladaptive behavior and control subjects for gastrointestinal symptoms, fecal calprotectin, urinary D-lactate, and lactulose/mannitol ratio. Urinary opioid peptide excretion was absent in all children. Children with ASD with severe maladaptive behavior showed significantly higher urinary I-FABP levels compared to those with mild maladaptive behavior (p=0.019) and controls (p=0.015). Conclusion: In our series, maladaptive behavior in ASD children was not associated with gastrointestinal symptoms, intestinal inflammation (no difference in calprotectin), microbiota (no difference in urinary D-lactate) and intestinal permeability (no difference in lactulose/manitol ratio). ASD children with severe maladaptive behavior have sig-nificantly more enterocyte damage (increased urinary I-FABP) than ASD children with mild maladaptive behavior and normal children.
참고문헌 (33)
- Steyaert JG, "What's new in autism?", Eur J Pediatr, 167, pp.1091~1101 (2008)
- Autism and Developmental Disabilities Monitoring Network Surveillance Year 2008 Principal Investigators, "Prevalence of autism spectrum disorders--Autism and Developmental Disabilities Monitoring Network, 14sites, United States, 2008", MMWR Surveill Summ, 61, pp.1~19 (2012)
- Stilp RL, "Genetic variance for autism screening items in an unselected sample of toddler-age twins", J Am Acad Child Adolesc Psychiatry, 49, pp.267~276 (2010)
- Hertz-Picciotto I, "The CHARGE study: an epidemiologic investigation of genetic and environmental factors contributing to autism", Environ Health Perspect, 114, pp.1119~1125 (2006)
- Currenti SA, "Understanding and determining the etiology of autism", Cell Mol Neurobiol, 30, pp.161~171 (2010)
- Smith RA, "Are there more bowel symptoms in children with autism compared to normal children and children with other developmental and neurological disorders?: A case control study", Autism, 13, pp.343~355 (2009)
- Gorrindo P, "Gastrointestinal dysfunction in autism:parental report, clinical evaluation, and associated factors", Autism Res, 5, pp.101~108 (2012)
- Ibrahim SH, "Incidence of gastrointestinal symptoms in children with autism: a population-based study", Pediatrics, 124, pp.680~686 (2009)
- Mouridsen SE, "A longitudinal study of gastrointestinal diseases in individuals diagnosed with infantile autism as children", Child Care Health Dev, 36, pp.437~443 (2010)
- Reichelt KL, "Can the pathophysiology of autism be explained by the nature of the discovered urine peptides?", Nutr Neurosci, 6, pp.19~28 (2003)
- Chaidez V, "Gastrointestinal problems in children with autism, developmental delays or typical development", J Autism Dev Disord, 44, pp.1117~1127 (2014)
- Wang LW, "The prevalence of gastrointestinal problems in children across the United States with autism spectrum disorders from families with multiple affected members", J Dev Behav Pediatr, 32, pp.351~360 (2011)
- Kemperman RF, "Brief report: normal intestinal permeability at elevated platelet serotonin levels in a subgroup of children with pervasive developmental disorders in Curaçao (The Netherlands antilles)", J Autism Dev Disord, 38, pp.401~406 (2008)
- Handen BL, "A double-blind, placebo-controlled trial of oral human immunoglobulin for gastrointestinal dysfunction in children with autistic disorder", J Autism Dev Disord, 39, pp.796~805 (2009)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders IV-TR" (2000), American Psychiatric Association
- Cohen IL, "PDD behavior inventory. Professional manual" (2005), Psychological Assessment Resources, Inc
- "Clinical Growth Chart:United States" (2000)[URL]
- Sjarif DR, "Textbook of pediatric nutrition and metabolic diseases", pp.36~48 (2011), Indonesian Pediatric Society
- Waterlow JC., "Classification and definition of protein-calorie malnutrition", Br Med J, 3, pp.566~569 (1972)
- Vreugdenhil AC, "Additional value of serum I-FABP levels for evaluating celiac disease activity in children", Scand J Gastroenterol, 46, pp.1435~1441 (2011)
- Grootjans J, "Non-invasive assessment of barrier integrity and function of the human gut", World J Gastrointest Surg, 2, pp.61~69 (2010)
- Dettmer K, "Autism and urinary exogenous neuropeptides:development of an on-line SPE-HPLC-tandem mass spectrometry method to test the opioid excess theory", Anal Bioanal Chem, 388, pp.1643~1651 (2007)
- Jackson PB, "Further evidence that the rs1858830C variant in the promoter region of the MET gene is associated with autistic disorder", Autism Res, 2, pp.232~236 (2009)
- Campbell DB, "Distinct genetic risk based on association of MET in families with co-occurring autism and gastrointestinal conditions", Pediatrics, 123, pp.1018~1024 (2009)
- Savino F, "High faecal calprotectin levels in healthy, exclusively breast-fed infants", Neonatology, 97, pp.299~304 (2010)
- Prell C, "Comparison of three tests for faecal calprotectin in children and young adults: a retrospective monocentric study", BMJ Open, 4, pp.e004558~ (2014)
- Fernell E, "No evidence for a clear link between active intestinal inflammation and autism based on analyses of faecal calprotectin and rectal nitric oxide", Acta Paediatr, 96, pp.1076~1079 (2007)
- Buie T, "Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report", Pediatrics, 125(Suppl 1), pp.S1~18 (2010)
- de Magistris L, "Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives", J Pediatr Gastroenterol Nutr, 51, pp.418~424 (2010)
- Gondalia SV, "Molecular characterisation of gastrointestinal microbiota of children with autism (with and without gastrointestinal dysfunction) and their neurotypical siblings", Autism Res, 5, pp.419~427 (2012)
- Boaz RT, "Intestinal permeability in normally nourished and malnourished children with and without diarrhea", Indian Pediatr, 50, pp.152~153 (2013)
- Cass H, "Absence of urinary opioid peptides in children with autism", Arch Dis Child, 93, pp.745~750 (2008)
- MacFabe DF, "Enteric short-chain fatty acids: microbial messengers of metabolism, mitochondria, and mind:implications in autism spectrum disorders", Microb Ecol Health Dis, 26, pp.28177~ (2015)