УРОВЕНЬ ГЛИАДОМОРФИНОВ И КАЗОМОРФИНОВ У ДЕТЕЙ С РАССТРОЙСТВАМИ АУТИСТИЧЕСКОГО СПЕКТРА

Abstract

High frequency of detection of various disorders of the gastrointestinal tract in patients with autism spectrum disorders (ASD) formed the basis of the first attempts to prescribe diet therapy. Despite the fact that diets are not officially included in the complex of therapeutic measures for ASD, the use of gluten-free (GFD) and casein-free diets (CFD) is widespread practice. The aim of the study was to assess the level of gliadomorphins (GM) and casomorphins (CM) in the blood of children with ASD, depending on the eating style and in comparison with healthy peers. Materials and methods of research: a prospective continuous open controlled study with the participation of 230 children aged 3–15 years. The first group included 36 patients with ASD who had been observing GFD for more than 6 months; in addition, 18 children were also on CFD. Boys in the group ware 23 (64%), girls – 13 (36%). The second group included 49 children with ASD who had no dietary restrictions. Boys – 35 (71%), girls – 14 (29%). The third (control) group consisted of 145 apparently healthy children: boys – 83 (57.3%), girls – 62 (42.7%). Determination of CM and GM levels was performed on a Multiskan Go analyzer (Thermo Fisher Scientific, Finland) by enzyme-linked immunosorbent assay using Human Gliadomorphin ELISA Kit and Human Casomorphin ELISA Kit (Hycult Biotech, Netherlands). Results: more boys than girls were included in all study groups; no statistically significant differences in gender distribution were found (p=0.2). The median age values in the 1st group was 6.5 [4.0; 8.0] (3; 15) years, in the 2nd – 6.0 [4.0; 7.0] (3; 15) years, in the 3rd – 8.0 [6.0; 11.0] (3; 15) years, the differences are statistically significant (p=0.0001). The content of GM in the blood serum of children with ASD, adhering to GFD, is statistically significantly lower by 2.6 times compared with children not adhering to diet therapy – 0.61 [0.41; 0.80] (0.12; 6.42) and 1.6 [0.70; 2.38] (0.18; 4.03) ng/ml (p<0.001) and does not differ statistically significantly from the level in the control group – 0.41 ng/ml [0.31; 0.72] (0.14; 4.18) ng/ml (p>0.005). The content of CM in the blood serum of children with ASD, adhering to CFD and GFD, is also 1.25 times lower than in children not adhering to diet therapy 1.85 [1.04; 2.07] (0.16; 3.83) and 2.34 [2.11; 2.72] (0.93; 3.29) pg/ml (p<0.001) and 1.3 times lower than the level of the control group – 2.45 [2.13; 2.89] (1.22; 26.88) pg/ml (p<0.001). Conclusion: the results obtained confirm the theory/possibility of exorphin intoxication of ASD development, which may be pathogenetically significant for some patients with ASD, which must be taken into account when implementing an individual approach to prescribing GFD, CFD.