Abstract

BackgroundAutism spectrum disorder (ASD) is characterized by impairments in social communication and restricted or repetitive behaviors or interests. ASD is now diagnosed in more than one out of 100 children and is biased towards males by a ratio of at least 4:1. Many possible explanations and potential causative factors have been reported, such as genetics, sex, and environmental factors, although the detailed mechanisms of ASD remain unclear.MethodsThe dams were exposed through oral contraceptives to either vehicle control (VEH) alone, levonorgestrel (LNG) alone, ethinyl estradiol (EE) alone, or a combination of LNG/EE for 21 days during their pregnancy. The subsequent 10-week-old offspring were used for autism-like behavior testing, and the limbic tissues were isolated for analysis. In another experimental group, 8-week-old male offspring were treated by infusion of ERβ overexpression/knockdown lentivirus in the amygdala, and the offspring were analyzed after 2 weeks.ResultsWe show that prenatal exposure of either LNG alone or a LNG/EE combination, but not EE alone, results in suppression of ERβ (estrogen receptor β) and its target genes in the amygdala with autism-like behavior in male offspring, while there is a much smaller effect on female offspring. However, we find that there is no effect on the hippocampus and hypothalamus. Further investigation shows that ERβ suppression is due to LNG-mediated altered methylation on the ERβ promoter and results in tissue damage with oxidative stress and the dysfunction of mitochondria and fatty acid metabolism, which subsequently triggers autism-like behavior. Overexpression of ERβ in the amygdala completely restores LNG-induced ERβ suppression and autism-like behaviors in offspring, while ERβ knockdown mimics this effect, indicating that ERβ expression in the amygdala plays an important role in autism-like behavior development.ConclusionsWe conclude that prenatal levonorgestrel exposure induces autism-like behavior in offspring through ERβ suppression in the amygdala. To our knowledge, this is the first time the potential effect of oral contraceptives on the contribution of autism-like behavior in offspring has been discovered.

Highlights

  • Autism spectrum disorder (ASD) is characterized by impairments in social communication and restricted or repetitive behaviors or interests

  • We found that treatment of either LNG alone or LNG/ethinyl estradiol (EE) combination significantly suppressed the expression of Estrogen receptor β (ERβ), Mitochondrial superoxide dismutase (SOD2), and estrogen-related receptor α (ERRα) in male offspring, and EE alone had no effect

  • The results showed that protein levels of ERβ and its target genes SOD2 and ERRα were suppressed significantly in male offspring by treatment of LNG alone and LNG/EE combination, and EE alone had no effect

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Summary

Introduction

Autism spectrum disorder (ASD) is characterized by impairments in social communication and restricted or repetitive behaviors or interests. ASD is diagnosed in more than one out of 100 children and is biased towards males by a ratio of at least 4:1. Many possible explanations and potential causative factors have been reported, such as genetics, sex, and environmental factors, the detailed mechanisms of ASD remain unclear. The detailed mechanism of ASD remains unclear [3], and many possible explanations and potential causative factors have been reported. A three-hit theory, which includes the combination of genetic/epigenetic, environmental, and sex factors for the mechanism of ASD, has been widely accepted [4]. ASD is biased towards males by a ratio of at least 4:1, suggesting that fetal or perinatal exposure to elevated male hormones may increase susceptibility towards autism [5,6,7]. There is a hypothesis that estrogen, especially ethinyl estradiol (EE) from COC (combined oral contraceptives), may play a role in ASD development [8], current literatures have not reached a conclusion [9]

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