A prospective assessment of porphyrins in autistic disorders: A potential marker for heavy metal exposure
A prospective assessment of porphyrins in autistic disorders: A potential marker for heavy metal exposure
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DOI：
10.1007/bf03033334
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发表时间：
2006-08-01
影响因子：
3.7
通讯作者：
Geier, Mark R.
中科院分区：
文献类型：
--
作者：
Geier, David A.;Geier, Mark R.
最近，在一大群法国儿童中，自闭症与一种表明汞中毒的尿卟啉模式有关。慢性病研究所的IRB批准了本研究。共有37名连续的美国自闭症谱系障碍(ASDS)患者(7岁)(《精神疾病诊断和统计手册》，第四版-DSM IV)出生于1983-1998年，提交给美国遗传中心进行门诊遗传评估，他们被前瞻性地检查了尿前列腺素水平(LabCorp，Inc.)2005年6月至2006年6月。对每个患者进行了成像和实验室测试，以排除导致ASD的其他原因。作为对照，检查了年龄、性别和种族匹配的神经典型ASD兄弟姐妹。在自闭症严重程度和尿辅酶A增加之间观察到明显的剂量-反应效应。与对照组相比，非螯合性自闭症患者(2.25倍，83%的患者水平高于对照均值>；2SD)和非螯合性自闭症患者(2倍，58%的患者水平高于对照均值>；2SD)，而非非螯合性广泛性发育迟缓(PDD-NOS)或阿斯伯格病(1.4倍，46%的患者水平高于对照均值)的中位数钴比例显著增加。在非螯合性ASD患者中观察到的中位数共比例卟啉水平显著高于螯合性ASD患者(1.7倍)。在自闭症患者中，应常规进行卟啉的临床检测，潜在的自闭症治疗应考虑监测卟啉水平。应该进行更多的研究，以评估汞暴露在某些自闭症中的潜在作用。
Autism was recently associated with a urinary porphyrin pattern indicative of mercury toxicity in a large cohort of French children. The IRB of the Institute for Chronic Illnesses approved the present study. A total of 37 consecutive American patients (>= 7 years-old) with autism spectrum disorders (ASDs) (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-DSM IV), born from 1983-1998, that presented to the Genetic Centers of America for outpatient genetic evaluations were prospectively examined for urinary prophryin levels (LabCorp, Inc.) from June 2005-June 2006. Imaging and laboratory testing were conducted on each patient to rule-out other causal factors for their ASDs. As controls, age-, sex-, and race-matched neurotypical ASD siblings were examined. An apparent dose-response effect was observed between autism severity and increased urinary coproporphyrins. Patients with non-chelated autism (2.25-fold, 83% had levels > 2 SD above the control mean) and non-chelated ASDs (2-fold, 58% had levels > 2 SD above the control mean), but not patients with non-chelated pervasive developmental delay-not otherwise specified (PDD-NOS) or Asperger's disorder (1.4-fold, 46% had levels > 2 SD above the control mean), had significantly increased median coproporphyrin levels versus controls. A significant increase (1.7-fold) in median coproporphyrin levels was observed among non-chelated ASD patients versus chelated ASD patients. Porphyrins should be routinely clinically measured in ASDs, and potential ASD treatments should consider monitoring porphyrin levels. Additional research should be conducted to evaluate the potential role for mercury exposure in some ASDs.