Erman Esnafoglu

Increased Serum Zonulin Levels as an Intestinal Permeability Marker in Autistic Subjects

Objective To evaluate the serum levels of zonulin, which regulates tight junctions between enterocytes and is a physiological modulator controlling intestinal permeability, in patients with autism spectrum disorders (ASDs). Study design Serum zonulin levels were determined in 32 patients with ASD and 33 healthy controls using an enzyme‐linked immunosorbent assay. The severity of ASD symptoms was assessed with the Childhood Autism Rating Scale. Results Serum zonulin levels were significantly higher in the patients with ASD (122.3 ± 98.46 ng/mL) compared with the healthy controls (41.89 ± 45.83 ng/mL). There was a positive correlation between zonulin levels and Childhood Autism Rating Scale score when all subjects were assessed (r = 0.523; P < .001). Conclusions This study suggests that zonulin, which regulates intestinal permeability, plays a role in the development of symptoms of ASD.

Vitamin B12, folic acid, homocysteine and vitamin D levels in children and adolescents with obsessive compulsive disorder

Obsessive compulsive disorder (OCD) is a complex disorder with a poorly understood aetiopathogenesis. One carbon metabolism that includes vitamin B12, folic acid and homocysteine has been investigated in many psychiatric disorders like OCD. In recent years, vitamin D has also been considered to contribute to many of these psychiatric disorders. In this study we investigated whether vitamin B12, homocysteine and vitamin D play a role in the aetiology of paediatric OCD. With this aim we compared 52 children and adolescent OCD patients with 30 healthy controls. The participants were tested for vitamin B12, folic acid, homocysteine and vitamin D levels and were evaluated with a sociodemographic form, state-trait anxiety inventory 1 and 2, Kovacs Depression Inventory and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). As a result we found significantly lower levels of vitamin B12 and vitamin D and higher levels of homocysteine in the patient group compared to control group (p values for all three scores were <0.001), whereas there was no significant difference between groups in terms of folate levels (p=0.083). This demonstrates that one carbon metabolism and vitamin D deficiency can play a role in the aetiology of OCD.

Evaluation of serum Neuron-specific enolase, S100B, myelin basic protein and glial fibrilliary acidic protein as brain specific proteins in children with autism spectrum disorder

Brain specific‐proteins are not found in other tissues and measurement non‐invasively in the blood may identify structurally and functionally damaged brain regions and identify the severity and prognosis of neuropsychiatric diseases. For this reason, we aimed to evaluate serum brain‐specific protein values as brain damage markers in children with autism spectrum disorder (ASD).

Levels of peripheral Neuregulin 1 are increased in non-medicated autism spectrum disorder patients

Though schizophrenia and autism spectrum disorders (ASD) are separate diseases, they have some common clinical manifestations and common pathogenic mechanisms. Numerous genes are associated with these conditions. Among these genes, Neuregulin-1 forms a risk for schizophrenia and some studies have shown polymorphism of this gene accompanies schizophrenia. NRG1 has a wide variety of functions, including neuronal migration, axon guidance, synaptic transmission, oligodendroglial maturation, and neurite outgrowth. To date, NRG1 levels have not been researched in ASD patients and considering the neurodevelopmental effects of NRG1, this study aimed to research the peripheral NRG1 levels in ASD patients. The study compared 32 ASD patients and 32 healthy controls. Serum NRG-1 levels were measured with ELISA. In ASD patients (mean ± SD, 10.80 ± 4.78 ng/ml), the NRG1 levels were found to be statistically significantly high compared to the health control group (mean ± SD, 6.92 ± 4.91 ng/ml) (p = 0.004). According to the results we obtained, NRG1 was shown to play a possible role in ASD pathogenesis. There is a need for advanced studies on the possible role of NRG1 in ASD patients. This study is significant as it is the first study to measure peripheral NRG1 in ASD patients.

Increased serum midkine levels in autism spectrum disorder patients

ABSTRACT Background: Midkine (MK) is a heparin binding growth factor and is involved in neurogenesis, neural development and neuroprotection. Additionally, MK may contribute to cancer development and pathogenesis of neurodegenerative disorders and schizophrenia. Considering these effects of MK, this study researched whether MK is involved in autism spectrum disorders (ASD) pathogenesis. Methods: We evaluated serum MK levels of 38 patients with ASD and 32 healthy control group. MK levels were measured with ELISA, while ASD severity was assessed with Childhood Autism Rating Scale. Results: Our data showed that the serum MK concentration in ASD patients (mean ± SD, 11.51 ± 8.53 pg/ml) is significantly higher than healthy controls (mean ± SD, 6.19 ± 3.94 pg/ml) (p = 0.007). Conclusions: According to these results, MK may play a role in ASD pathogenesis.

Decreased levels of serum fibroblast growth factor-2 in children with autism spectrum disorder

The neurodevelopment and functioning of the central nervous system, and especially the cerebral cortex, have basic importance to understand neuropsychiatric disorders like autism. Fibroblast growth factor-2 (FGF-2) plays a very important role in the development and functioning of the cortex. FGF-2 is related to developmental processes in the central nervous system such as neurogenesis, migration, differentiation and survival. This study researched the serum FGF-2 levels in children with autism spectrum disorder (ASD). With this aim, 60 ASD children and 40 healthy controls were compared. We applied a sociodemographic form and the Childhood Autism Rating Scale (CARS) to each subject with their family to assess the severity of autism. Additionally, all subjects had routine laboratory tests performed. Serum samples were studied with ELISA. The results found that serum FGF-2 levels were statistically significantly low in the patient group compared to the healthy control group (p value 0.003). Additionally there was a statistically significant negative correlation identified between serum FGF-2 levels and CARS score for all subjects (r = -0.300; p = 0.02). In conclusion, FGF-2 may contribute to the etiopathogenesis of ASD.

Hallucination and priapism associated with methylphenidate usage: Two case reports

386 risperidone treatment. The patient initially began the risperidone treatment. On the morning of the following day, 18 mg OROS-methylphenidate was taken. On the day after taking methylphenidate, an incomplete erection formed and lasted 1 day. With the patient continuing treatment, from the 2nd day, a painless full erection formed. On the 5th day, they returned to our clinic. Urologic consultation was requested, and high-flow priapism was identified. OROS-methylphenidate treatment was ended. Continuing with risperidone treatment, the patient’s priapism resolved a few days after finishing OROS-methylphenidate treatment. Routine tests did not encounter any pathology. There was no history of genital trauma.

The seroprevalence of antibodies to Toxoplasma gondii among children with autism

Objective: Although attempts have been made to explain the pathogenesis of autism spectrum disorders (ASD) with many factors such as genetic, immunological, environmental, and infectious agents, this mechanism remains for the most part unknown. Toxoplasma gondii is a parasite that is investigated in many psychiatric diseases. This work examines whether toxoplasmosis plays a role in the pathogenesis of ASD through a seroprevalence study. Method: This study is based on a comparison of 102 children with ASD and 51 healthy children. In addition to routine laboratory tests, a sociodemographic form and a childhood autism rating scale were completed and the participants’ anti-toxoplasma IgM and IgG titers were requested. Results: In 3 ASD children (2.9%) and in 1 control (2%), IgG positivity was identified. All subjects were negative for IgM. There was no statistically significant difference found between the two groups in terms of toxoplasma seropositivity. Conclusion: Our data does not confirm the involvement of toxoplasmosis in the etiopathogenesis of ASD.