Autism Risk, Prenatal Environmental Exposures, and Pathophysiologic Markers

描述（由申请人提供）：尽管对自闭症谱系障碍（ASD）的非遗传原因知之甚少，但目前，对这种情况的病因学中的环境因素的严格调查很少。该提案扩展了由NIEHS资助的加州大学戴维斯分校儿童环境健康中心（CCEH）发起的流行病学项目，该项目被称为“MARBLES”（婴儿自闭症风险标志物-学习早期迹象）。MARBLES已经招募了近200名孕妇，这些孕妇已经有一个患有ASD的孩子，因此分娩婴儿的风险很高，这些婴儿也会患上ASD。在R 01中，我们将招募另外250名孕妇，并跟踪她们的妊娠和孩子。通过纵向收集1）广泛的行为，医学和暴露数据，2）母亲和孩子的生物标本，3）从出生到三岁的详细心理测量评估，MARBLES创建了一个解决病因学问题和寻找早期病理生理标志物的基础设施。感兴趣的接触是家用产品中常见的两类化合物，具有已知的神经或神经发育毒性：拟除虫菊酯农药和多溴二苯醚（阻燃剂）。首先，我们将评估自我报告的暴露，内部剂量的测量和毒理学衍生的生物有效剂量的估计，一方面，与ASD或其他神经行为发育障碍的风险的关联。其次，我们将检查暴露或剂量估计值是否与异常免疫反应或线粒体功能障碍的标志物相关，以及这些标志物是否可预测临床确认的3岁儿童发育状况。因此，该项目从黑箱流行病学典型的宏观层面关联开始，改进剂量估计，然后更深入地探索环境暴露可能改变神经发育并导致临床结果的机制。这种综合方法是由一个跨学科的团队，汇集了分子和基础研究，流行病学人口为基础的方法，和临床科学。如果我们的假设得到支持，这将是基于常用家用产品中化合物的前瞻性测量的自闭症风险较高的第一个证据，也是第一个确定可改变的风险因素的证据之一。因此，研究结果将为在个人行为和社会层面上进行预防打开大门，例如，可能通过教育、产品标签和/或监管行动。研究结果还可能导致有针对性的干预措施，以改变儿童的发展轨迹。总的来说，我们希望这项研究能够刺激该领域的范式转变，朝着更加多因素和机械驱动的研究议程发展，更加关注环境暴露和跨学科方法的发展。

DESCRIPTION (provided by applicant): Despite the fact that little is known about non-genetic causes of autism spectrum disorders (ASD), currently, few rigorous investigations of environmental factors in the etiology of this condition are underway. This proposal extends the epidemiology project initiated under the NIEHS-funded UC Davis Center for Children's Environmental Health (CCEH) known as "MARBLES" (Markers of Autism Risk in Babies - Learning Early Signs). MARBLES has enrolled close to 200 pregnant women who already have a child with ASD and therefore are at high risk for delivering an infant who will also develop ASD. In this R01, we will recruit an additional 250 pregnant mothers and follow their pregnancy and their child. Through longitudinal collection of 1) extensive behavioral, medical, and exposure data, 2) biologic specimens from the mother and child, and 3) detailed psychometric assessments from birth to three years of age, MARBLES has created an infrastructure for addressing etiologic questions and searching for early pathophysiologic markers. The exposures of interest are two classes of compounds common in household products, and having known neuro- or neurodevelopmental toxicity: pyrethroid pesticides and polybrominated diphenyl ethers (flame retardants). First, we will assess associations of self-reported exposure, measurements of internal dose, and toxicologically-derived estimates of biologically effective dose, on the one hand, with risk for ASD or other impairments in neurobehavioral development on the other. Secondly, we will examine whether the exposure or dose estimates are associated with markers of aberrant immune responses or mitochondrial dysfunction and whether these markers predict clinically confirmed child developmental status at three years of age. Thus, this project begins with the macro-level associations typical of black-box epidemiology, refines the estimates of dose, and then explores more deeply into the mechanisms by which environmental exposures might alter neurodevelopment and lead to clinical outcomes. This integrated approach is made possible by an interdisciplinary team that brings together molecular and basic research, epidemiologic population-based approaches, and clinical sciences. If our hypotheses are supported, this will be the first evidence of higher autism risk based on prospective measurements of compounds in commonly used household products, and one of the first to identify modifiable risk factors. The results will thereby open the door to prevention at the individual behavioral and societal level, e.g., potentially through education, product labeling, and/or regulatory action. Results may also lead to targeted interventions to alter children's developmental trajectory. Overall, we expect this study to stimulate a paradigm shift in the field, towards a more multifactorial and mechanistically driven research agenda, with significantly more attention to environmental exposures and the development of inter-disciplinary approaches.