Toda Yoshihiro, Mori Kenji, Hashimoto Toshiaki, Miyazaki Masahito, Nozaki Satoshi, Watanabe Yasuyoshi, Kuroda Yasuhiro, Kagami Shoji
Department of Pediatrics, School of Medicine, University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima-shi, Tokushima 770-8503, Japan.
Brain Dev. 2006 Mar;28(2):99-103. doi: 10.1016/j.braindev.2005.05.005. Epub 2005 Sep 15.
We evaluated the clinical effects of intravenously administered secretin in 12 children with autism (age range: 4-6 years, median age: 9 years, boy:girl=8:4). In addition, we investigated the association between improvement in symptoms and changes in the cerebrospinal fluid (CSF) homovanillic acid (HVA),5-hydroxyindole-3-acetic acid (5-HIAA), and 6R-5,6,7,8-tetrahydro-L-biopterin (BH(4)) levels after administration. After administration of secretin, the Autism Diagnostic Interview-Revised (ADI-R) score improved in 7 of the 12 children. However, the score deteriorated in 2 of the 12 children (in the item of 'restricted and repetitive, stereotyped interests and behaviors'). The HVA and BH(4) levels in CSF were increased in all children with improvement in the ADI-R score. In contrast, no patient without the elevation of the BH(4) level showed improvement in the score. These findings suggest that secretin activated metabolic turnover of dopamine in the central nervous system via BH(4), improving symptoms.
我们评估了静脉注射促胰液素对12名自闭症儿童(年龄范围:4至6岁,中位年龄:9岁,男:女 = 8:4)的临床效果。此外,我们还研究了症状改善与给药后脑脊液(CSF)中高香草酸(HVA)、5-羟色胺酸(5-HIAA)和6R-5,6,7,8-四氢-L-生物蝶呤(BH(4))水平变化之间的关联。注射促胰液素后,12名儿童中有7名儿童的自闭症诊断访谈修订版(ADI-R)评分有所改善。然而,12名儿童中有2名儿童的评分恶化(在“局限的、重复的、刻板的兴趣和行为”项目中)。所有ADI-R评分改善的儿童脑脊液中的HVA和BH(4)水平均升高。相比之下,BH(4)水平未升高的患者评分均未改善。这些发现表明,促胰液素通过BH(4)激活中枢神经系统中多巴胺的代谢转换,从而改善症状。