Otizm spektrum bozukluğu tanısı alan çocuklarda kan zonulin düzeyleri, inflamatuar süreçler ve nöronal değişikliklerin değerlendirilmesi
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Otizm Spektrum Bozukluğu (OSB), sosyal iletişim ve etkileşimde bozulmayla giden nörogelişimsel bir bozukluktur. Sebebi henüz net bilinmemekle birlikte, etiyolojisinde genetik ve çevresel faktörlerin rol oynadığı öne sürülmektedir. Son yıllarda, çevresel faktörlerden immün-inflamatuar sistemin de bu hastalıkta rolünün olabileceği vurgulanmaktadır. Bu çalışmada, OSB tanısı almış hastalarda bağırsak geçirgenliğinin, besin antijenlerine ve bakteri duvarına karşı oluşan antikor düzeylerinin, inflamatuar süreçlerin ve nöron hasarlarına ait değişikliklilerin değerlendirilmesi ve kontrol grubuyla karşılaştırılması amaçlanmıştır. Yöntem: Çalışmaya DSM-5 tanı kriterlerine göre OSB tanısı konulan 3-12 yaş aralığında 35 hasta ve 35 sağlıklı çocuk dahil edilmiştir. Tüm katılımcıların boy ve kiloları ölçülmüş ve araştırma grubuna Çocukluk Otizmi Derecelendirme Ölçeği (ÇODÖ) uygulanmıştır. Ayrıca ebeveynlerle birlikte Sosyodemografik Veri Formu (SDVF) ve Gelişim Değerlendirme Formu (GDF) doldurulmuştur. OSB ve kontrol gruplarından venöz kan örnekleri alınarak, serum zonulin, anti-gliadin IgA-IgG, anti-LPS IgG, IL6, TNF-alfa, TGF-B, S100B ve NSE seviyeleri enzim benzeri immüno-sorbent testi (ELISA) ile ölçülmüştür. Bulgular: Serum zonulin seviyeleri OSB grubunda anlamlı olarak daha düşük saptanmıştır. İnflamatuar faktörlerden IL-6 ve TGF-? seviyeleri çalışma grubunda anlamlı olarak yüksektir. Serum Antigliadin Ig-A, Antigliadin Ig-G, Anti-LPS Ig-G ve TNF-? değerlerinde her iki grup arasında istatistiksel olarak anlamlı farklılık bulunmamıştır. Yine NSE ve S100B seviyeleri OSB ve kontrol grupları arasında benzer bulunmuştur. ÇODÖ'nün entelektüel düzeyi değerlendiren 14. alt ölçeği ile Anti-LPS, IL-6, TGF-Beta, S100B değerleri arasında pozitif bir korelasyon gözlendi. Ek olarak, zonulin ile IL-6, Anti-LPS, TNF-alfa, TGF-Beta, NSE, S100B arasında pozitif bir ilişki saptanmıştır. Sonuç: Bu çalışmada OSB'de bağırsak geçirgenliğinin bir göstergesi olan zonulin düzeyleri kontrollere göre daha düşük bulunmuştur. Ancak gıda antijenlerine veya bakteri duvarına karşı antikor seviyeleri kontrol grubu ile benzer bulunmuştur. Ayrıca OSB'de inflamatuvar sürecin arttığı gösterilse de nöronal hasarı gösteren parametrelerde herhangi bir değişiklik saptanmamıştır. Bu sonuçlar zonulin düzeylerinin, özellikle komorbid GIS bozuklukları dışlandığında, otizmli hastalarda düşük olabileceğini ve bunun inflamatuar süreçlerle ilişkili olabileceğini göstermektedir. Ancak bu bulguların desteklenmesi için daha büyük örneklemli izlem çalışmalarının yapılmasına ihtiyaç vardır. Anahtar Kelimeler: Otizm; zonulin; inflamasyon; nöronal hasar
Aim: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with impaired social communication and interaction. Although the cause is not yet known, it has been suggested that genetic and environmental factors play a role in its etiology. In recent years, it has been emphasized that the immune-inflammatory system, one of the environmental factors, may also play a role in this disease. In this study, it was aimed to evaluate intestinal permeability, antibody levels against food antigens and bacterial wall, inflammatory processes and changes in neuron damage in patients diagnosed with ASD and to compare them with the control group. Method: 35 patients who were diagnosed with ASD according to DSM-5 diagnostic criteria and 35 healthy children between the ages of 3-12 were included in the study. The height and weight of all the participants were measured and Childhood Autism Rating Scale (CARS) was applied to the study group. In addition, the Sociodemographic Data Form (SDF) and the Development Assessment Form (DAF) were filled with the parents. Venous blood samples were taken from ASD and control groups, serum zonulin, anti-gliadin IgA-IgG, anti-LPS IgG, IL6, TNF-alpha, TGF-B, S100B and NSE levels were measured by enzyme-like immuno-sorbent test (ELISA). Results: Serum zonulin levels were significantly lower in the ASD group. IL-6 and TGF-? levels among inflammatory factors were significantly higher in the study group. No statistically significant difference was observed between the two groups in terms of serum Antigliadin Ig-A, Antigliadin Ig-G, Anti-LPS Ig-G and TNF-? values. Again, NSE and S100B levels were similar between ASD and control groups. A positive correlation was observed between the 14th subscale of CARS, evaluating the intellectual level, and the values of Anti-LPS, IL-6, TGF-Beta, S100B. In addition, a positive relationship was found between zonulin and IL-6, Anti-LPS, TNF-alpha, TGF-Beta, NSE, S100B. Conclusion: In this study, zonulin levels, which is an indicator of intestinal permeability in ASB, were found to be lower than controls. However, antibody levels against food antigens or bacterial wall were similar to the control group. In addition, although it has been shown that the inflammatory process increases in ASD, no change in neuronal damage indicators was detected. These results indicate that zonulin levels may be low in patients with autism, especially when comorbid GIS disorders are excluded, and this may be associated with inflammatory processes. However, larger sample size follow-up studies are needed to support these findings. Keywords: Autism; zonulin; inflammation; neuronal damage
Aim: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with impaired social communication and interaction. Although the cause is not yet known, it has been suggested that genetic and environmental factors play a role in its etiology. In recent years, it has been emphasized that the immune-inflammatory system, one of the environmental factors, may also play a role in this disease. In this study, it was aimed to evaluate intestinal permeability, antibody levels against food antigens and bacterial wall, inflammatory processes and changes in neuron damage in patients diagnosed with ASD and to compare them with the control group. Method: 35 patients who were diagnosed with ASD according to DSM-5 diagnostic criteria and 35 healthy children between the ages of 3-12 were included in the study. The height and weight of all the participants were measured and Childhood Autism Rating Scale (CARS) was applied to the study group. In addition, the Sociodemographic Data Form (SDF) and the Development Assessment Form (DAF) were filled with the parents. Venous blood samples were taken from ASD and control groups, serum zonulin, anti-gliadin IgA-IgG, anti-LPS IgG, IL6, TNF-alpha, TGF-B, S100B and NSE levels were measured by enzyme-like immuno-sorbent test (ELISA). Results: Serum zonulin levels were significantly lower in the ASD group. IL-6 and TGF-? levels among inflammatory factors were significantly higher in the study group. No statistically significant difference was observed between the two groups in terms of serum Antigliadin Ig-A, Antigliadin Ig-G, Anti-LPS Ig-G and TNF-? values. Again, NSE and S100B levels were similar between ASD and control groups. A positive correlation was observed between the 14th subscale of CARS, evaluating the intellectual level, and the values of Anti-LPS, IL-6, TGF-Beta, S100B. In addition, a positive relationship was found between zonulin and IL-6, Anti-LPS, TNF-alpha, TGF-Beta, NSE, S100B. Conclusion: In this study, zonulin levels, which is an indicator of intestinal permeability in ASB, were found to be lower than controls. However, antibody levels against food antigens or bacterial wall were similar to the control group. In addition, although it has been shown that the inflammatory process increases in ASD, no change in neuronal damage indicators was detected. These results indicate that zonulin levels may be low in patients with autism, especially when comorbid GIS disorders are excluded, and this may be associated with inflammatory processes. However, larger sample size follow-up studies are needed to support these findings. Keywords: Autism; zonulin; inflammation; neuronal damage
Açıklama
Anahtar Kelimeler
Psikiyatri, Psychiatry
