Bozkurt Hasan, Şimşek Şeref, Şahin Serkan
Department of Child and Adolescent Psychiatry, Gaziosmanpasa University School of Medicine, Tokat, Turkey.
Department of Child and Adolescent Psychiatry, Dicle University School of Medicine, Diyarbakır, Turkey.
Autism Res. 2021 Oct;14(10):2078-2084. doi: 10.1002/aur.2582. Epub 2021 Jul 22.
Several studies demonstrated biological effects of cortisol, brain-derived neurotrophic factor (BDNF) and tissue plasminogen activator (tPA) on human metabolism and central nervous system. Our study investigated the serum levels of tPA along with BDNF and cortisol in children with autism spectrum disorder (ASD). Thirty three male children with ASD ranging in age from 2 to 15 years were selected for the study group and 27 age-matched healthy male children were selected for the control group. The ASD severity was determined by the score on the Autism Behavior Checklist (ABC). The mean cortisol levels for the study group and the control group were 79.1 ± 30.2 ng/ml and 60.0 ± 25.1 ng/ml, respectively. The mean BDNF levels for the study group and the control group were 5.9 ± 2.8 ng/ml and 3.7 ± 1.8 ng/ml, respectively. The mean tPA levels for the study group and the control group were 32.9 ± 18.5 ng/ml and 25.5 ± 15.1 ng/ml, respectively. Cortisol, BDNF and tPA levels were significantly higher in the study group compared to the control group (p < 0.001). There was no statistically significant effect in terms of age, ABC total and subscale scores on serum cortisol, BDNF and tPA levels in the study group (p > 0.05). It may be suggested that elevations may indicate a role in the pathogenesis of ASD or it may be the case that ASD may alter the levels or pathways of these metabolic factors. LAY SUMMARY: The underlying mechanism or a specific metabolic target relevant to autism spectrum disorder (ASD) has not yet been identified. Cortisol, brain-derived neurotrophic factor (BDNF) and tissue plasminogen activator (tPA) have biological effects on neuroplasticity but little is known about the role of cortisol and tPA-BDNF pathway in ASD. In the present study focused on male children with ASD, we have found higher blood levels of cortisol, BDNF and tPA than their healthy peers. This is the first clinical study to evaluate the serum tPA levels along with BDNF and cortisol in ASD. The results suggest that several neurotrophic and other related markers should be born in mind while examining children with ASD.
多项研究证明了皮质醇、脑源性神经营养因子（BDNF）和组织型纤溶酶原激活剂（tPA）对人体新陈代谢和中枢神经系统的生物学效应。我们的研究调查了自闭症谱系障碍（ASD）儿童的tPA血清水平以及BDNF和皮质醇水平。研究组选取了33名年龄在2至15岁之间的男性ASD儿童，对照组选取了27名年龄匹配的健康男性儿童。通过自闭症行为量表（ABC）的得分来确定ASD的严重程度。研究组和对照组的平均皮质醇水平分别为79.1±30.2 ng/ml和60.0±25.1 ng/ml。研究组和对照组的平均BDNF水平分别为5.9±2.8 ng/ml和3.7±1.8 ng/ml。研究组和对照组的平均tPA水平分别为32.9±18.5 ng/ml和25.5±15.1 ng/ml。与对照组相比，研究组的皮质醇、BDNF和tPA水平显著更高（p<0.001）。在研究组中，年龄、ABC总分及各子量表得分对血清皮质醇、BDNF和tPA水平无统计学显著影响（p>0.05）。可以推测，这些指标的升高可能表明其在ASD发病机制中起作用，或者ASD可能改变了这些代谢因子的水平或途径。简要概述：尚未确定与自闭症谱系障碍（ASD）相关的潜在机制或特定代谢靶点。皮质醇、脑源性神经营养因子（BDNF）和组织型纤溶酶原激活剂（tPA）对神经可塑性具有生物学效应，但关于皮质醇和tPA-BDNF途径在ASD中的作用知之甚少。在本项针对男性ASD儿童的研究中，我们发现他们血液中的皮质醇、BDNF和tPA水平高于健康同龄人。这是第一项评估ASD儿童血清tPA水平以及BDNF和皮质醇水平的临床研究。结果表明，在检查ASD儿童时应考虑多种神经营养及其他相关标志物。
