Skalny Anatoly V, Skalnaya Margarita G, Bjørklund Geir, Nikonorov Alexandr A, Tinkov Alexey A
All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia; Orenburg State University, Orenburg, Russia; Yaroslavl State University, Yaroslavl, Russia.
Russian Society of Trace Elements in Medicine, Moscow, Russia.
Med Hypotheses. 2016 Jun;91:90-94. doi: 10.1016/j.mehy.2016.04.021. Epub 2016 Apr 15.
The incidence of both obesity and autism spectrum disorders (ASD) has dramatically increased during the last decades. Moreover, the most recent studies have revealed increased risk of ASD in offspring of overweight and obese women. However, the mechanisms of association between ASD and maternal obesity are unknown. Taking into account the existing data indicating the association between mercury (Hg) exposure and development of obesity and ASD, we hypothesize that Hg may serve as an additional link between maternal obesity and ASD. In particular, it is supposed that obesity is associated with excessive accumulation of Hg in the maternal organism. After conception, the fetus is developing in the conditions of Hg overload within the body of obese women thus predisposing to the development of ASD. The proposed hypothesis may be confirmed by the existing data. In particular, previous studies demonstrated that overweight and obese persons are characterized by a significantly higher level of Hg in hair, blood and urine than the lean ones. Therefore, an obese organism is characterized by elevated Hg burden that may be transferred to the fetus during pregnancy. Moreover, multiple studies have demonstrated a tight association between maternal and children Hg status being indicative of placental transfer of metal from maternal organism to offspring. Finally, a growing body of data indicates the influence of Hg exposure and Hg status on the risk of ASD in children. However, additional experimental and clinical studies are required to prove the hypothesis and provide novel data on the role of Hg in maternal obesity-associated ASD development. In particular, the contribution of Hg to ASD development in children from obese mothers should be determined. If a significant role of Hg in maternal obesity ASD risk will be confirmed, this will open additional perspectives of risk modification. Taking into account the universal mechanisms of Hg toxicity, transport, and accumulation, further preventive actions may be undertaken to reduce the risk of Hg toxicity and Hg-associated ASD development. In particular, it is supposed that the use of Hg chelators (like N,N'bis-(2-mercaptoethyl)isophthalamide, NMBI), antioxidants, and anti-inflammatory compounds prior or during pregnancy may have a beneficial effect. However, the safety of such actions should repeatedly be tested to avoid adverse health effects in a developing fetus.
在过去几十年中，肥胖症和自闭症谱系障碍（ASD）的发病率都急剧上升。此外，最近的研究表明，超重和肥胖女性的后代患ASD的风险增加。然而，ASD与母体肥胖之间的关联机制尚不清楚。考虑到现有数据表明汞（Hg）暴露与肥胖症和ASD的发展之间存在关联，我们假设汞可能是母体肥胖与ASD之间的另一个联系。特别是，据推测肥胖与母体生物体中汞的过度积累有关。受孕后，胎儿在肥胖女性体内汞过载的情况下发育，因此易患ASD。现有数据可能证实所提出的假设。特别是，先前的研究表明，超重和肥胖者头发、血液和尿液中的汞含量明显高于瘦人。因此，肥胖生物体具有较高的汞负荷，在怀孕期间可能会转移给胎儿。此外，多项研究表明母体和儿童的汞状态之间存在紧密关联，这表明金属可从母体生物体经胎盘转移给后代。最后，越来越多的数据表明汞暴露和汞状态对儿童患ASD风险的影响。然而，需要额外的实验和临床研究来证明这一假设，并提供关于汞在母体肥胖相关ASD发展中作用的新数据。特别是，应确定汞对肥胖母亲所生儿童ASD发展的影响。如果汞在母体肥胖ASD风险中的重要作用得到证实，这将为风险修正开辟新的前景。考虑到汞毒性、运输和积累的普遍机制，可以采取进一步的预防措施来降低汞毒性和汞相关ASD发展的风险。特别是，据推测在怀孕前或怀孕期间使用汞螯合剂（如N，N'-双（2-巯基乙基）间苯二甲酰胺，NMBI）、抗氧化剂和抗炎化合物可能会产生有益效果。然而，此类措施的安全性应反复进行测试，以避免对发育中的胎儿产生不良健康影响。
