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2016 ; 7
(ä): 47
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Urinary metabolomics of young Italian autistic children supports abnormal
tryptophan and purine metabolism
#MMPMID27904735
Gevi F
; Zolla L
; Gabriele S
; Persico AM
Mol Autism
2016[]; 7
(ä): 47
PMID27904735
show ga
BACKGROUND: Autism spectrum disorder (ASD) is still diagnosed through behavioral
observation, due to a lack of laboratory biomarkers, which could greatly aid
clinicians in providing earlier and more reliable diagnoses. Metabolomics on
human biofluids provides a sensitive tool to identify metabolite profiles
potentially usable as biomarkers for ASD. Initial metabolomic studies, analyzing
urines and plasma of ASD and control individuals, suggested that autistic
patients may share some metabolic abnormalities, despite several inconsistencies
stemming from differences in technology, ethnicity, age range, and definition of
"control" status. METHODS: ASD-specific urinary metabolomic patterns were
explored at an early age in 30 ASD children and 30 matched controls (age range
2-7, M:F?=?22:8) using hydrophilic interaction chromatography (HILIC)-UHPLC and
mass spectrometry, a highly sensitive, accurate, and unbiased approach.
Metabolites were then subjected to multivariate statistical analysis and grouped
by metabolic pathway. RESULTS: Urinary metabolites displaying the largest
differences between young ASD and control children belonged to the tryptophan and
purine metabolic pathways. Also, vitamin B(6), riboflavin,
phenylalanine-tyrosine-tryptophan biosynthesis, pantothenate and CoA, and
pyrimidine metabolism differed significantly. ASD children preferentially
transform tryptophan into xanthurenic acid and quinolinic acid (two catabolites
of the kynurenine pathway), at the expense of kynurenic acid and especially of
melatonin. Also, the gut microbiome contributes to altered tryptophan metabolism,
yielding increased levels of indolyl 3-acetic acid and indolyl lactate.
CONCLUSIONS: The metabolic pathways most distinctive of young Italian autistic
children largely overlap with those found in rodent models of ASD following
maternal immune activation or genetic manipulations. These results are consistent
with the proposal of a purine-driven cell danger response, accompanied by
overproduction of epileptogenic and excitotoxic quinolinic acid, large reductions
in melatonin synthesis, and gut dysbiosis. These metabolic abnormalities could
underlie several comorbidities frequently associated to ASD, such as seizures,
sleep disorders, and gastrointestinal symptoms, and could contribute to autism
severity. Their diagnostic sensitivity, disease-specificity, and interethnic
variability will merit further investigation.