Role of Paracetamol in the Pathogenesis of Autism Spectrum Disorder: A Growing Perspective

Abstract

Autism spectrum disorder (ASD) affecting one in every 59 newborns with significant surge in the prevalence rates over last few decades has complex underlying pathophysiological mechanism which is not fully understood. We hypothesize that such association might be associated with paracetamol-induced alterations in cytokine levels, oxidative stress and dysregulation of neurotransmission, especially dopaminergic pathways. Additionally, disruption of prostaglandin synthesis following paracetamol administration has considerable impact over neurodevelopment. We performed literature review by searching our topic of interest on three databases including PubMed, Embase and the Cochrane library by utilizing keywords. Recent large scale nationwide birth cohort studies implicate link between paracetamol use during pregnancy, most commonly utilized anti-pyretic and analgesic medication at that period, and risk of autism in infants. Alterations at cytokine and prostaglandin levels, elevated oxidative stress and impairment of neurotransmission may have role in ASD pathogenesis, though, it has not been demonstrated in human studies. There is clear need for future comprehensive molecular and clinical studies to investigate the association between paracetamol use in pregnancy and ASD risk. This study is significant by investigating the role of paracetamol use in upward projection in ASD prevalence and providing a hypothetical underlying mechanism for the association between paracetamol use and ASD risk.