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自闭症谱系障碍中生理异常的研究趋势综述:免疫失调、炎症、氧化应激、线粒体功能障碍和环境毒物暴露。

A review of research trends in physiological abnormalities in autism spectrum disorders: immune dysregulation, inflammation, oxidative stress, mitochondrial dysfunction and environmental toxicant exposures.

机构信息

International Child Development Resource Center, Melbourne, FL 32934, USA.

出版信息

Mol Psychiatry. 2012 Apr;17(4):389-401. doi: 10.1038/mp.2011.165. Epub 2011 Dec 6.

Abstract

Recent studies have implicated physiological and metabolic abnormalities in autism spectrum disorders (ASD) and other psychiatric disorders, particularly immune dysregulation or inflammation, oxidative stress, mitochondrial dysfunction and environmental toxicant exposures ('four major areas'). The aim of this study was to determine trends in the literature on these topics with respect to ASD. A comprehensive literature search from 1971 to 2010 was performed in these four major areas in ASD with three objectives. First, publications were divided by several criteria, including whether or not they implicated an association between the physiological abnormality and ASD. A large percentage of publications implicated an association between ASD and immune dysregulation/inflammation (416 out of 437 publications, 95%), oxidative stress (all 115), mitochondrial dysfunction (145 of 153, 95%) and toxicant exposures (170 of 190, 89%). Second, the strength of evidence for publications in each area was computed using a validated scale. The strongest evidence was for immune dysregulation/inflammation and oxidative stress, followed by toxicant exposures and mitochondrial dysfunction. In all areas, at least 45% of the publications were rated as providing strong evidence for an association between the physiological abnormalities and ASD. Third, the time trends in the four major areas were compared with trends in neuroimaging, neuropathology, theory of mind and genetics ('four comparison areas'). The number of publications per 5-year block in all eight areas was calculated in order to identify significant changes in trends. Prior to 1986, only 12 publications were identified in the four major areas and 51 in the four comparison areas (42 for genetics). For each 5-year period, the total number of publications in the eight combined areas increased progressively. Most publications (552 of 895, 62%) in the four major areas were published in the last 5 years (2006-2010). Evaluation of trends between the four major areas and the four comparison areas demonstrated that the largest relative growth was in immune dysregulation/inflammation, oxidative stress, toxicant exposures, genetics and neuroimaging. Research on mitochondrial dysfunction started growing in the last 5 years. Theory of mind and neuropathology research has declined in recent years. Although most publications implicated an association between the four major areas and ASD, publication bias may have led to an overestimation of this association. Further research into these physiological areas may provide insight into general or subset-specific processes that could contribute to the development of ASD and other psychiatric disorders.

摘要

最近的研究表明,自闭症谱系障碍(ASD)和其他精神疾病存在生理和代谢异常,特别是免疫失调或炎症、氧化应激、线粒体功能障碍和环境毒物暴露(“四大领域”)。本研究旨在确定与 ASD 相关的这些主题文献的趋势。在 ASD 的这四个主要领域中,从 1971 年到 2010 年进行了全面的文献检索,目的有三个。首先,根据是否暗示生理异常与 ASD 之间存在关联,将出版物分为几个标准。大量出版物暗示 ASD 与免疫失调/炎症(437 篇出版物中有 416 篇,占 95%)、氧化应激(全部 115 篇)、线粒体功能障碍(153 篇中有 145 篇,占 95%)和毒物暴露(190 篇中有 170 篇,占 89%)之间存在关联。其次,使用经过验证的量表计算每个领域的出版物的证据强度。免疫失调/炎症和氧化应激的证据最强,其次是毒物暴露和线粒体功能障碍。在所有领域中,至少有 45%的出版物被评为为生理异常与 ASD 之间的关联提供了强有力的证据。第三,将四大领域的时间趋势与神经影像学、神经病理学、心理理论和遗传学(“四大比较领域”)的趋势进行比较。为了确定趋势的显著变化,按每 5 年一个块计算了所有八个领域的出版物数量。在四大领域中,1986 年前仅发现了 12 篇出版物,在四大比较领域中发现了 51 篇(遗传学 42 篇)。对于每 5 年一个时间段,八大领域的总出版物数量都在逐步增加。四大领域中的大部分出版物(895 篇中的 552 篇,占 62%)是在过去 5 年(2006-2010 年)发表的。对四大领域与四大比较领域之间的趋势进行评估表明,免疫失调/炎症、氧化应激、毒物暴露、遗传学和神经影像学的相对增长最大。线粒体功能障碍的研究在过去 5 年开始增长。近年来,心理理论和神经病理学研究有所减少。尽管大多数出版物暗示四大领域与 ASD 之间存在关联,但发表偏倚可能导致对这种关联的高估。对这些生理领域的进一步研究可能会深入了解可能导致 ASD 和其他精神疾病发展的一般或亚组特定过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40bd/3317062/b2114d1a9fe1/mp2011165f1.jpg

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