Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada.
Psychiatry Res. 2021 Dec;306:114256. doi: 10.1016/j.psychres.2021.114256. Epub 2021 Oct 31.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and patterns of restrictive and repetitive behavior. Although the neurological underpinnings of ASD remain elusive, the endocannabinoid system (ECS) may play a role in modulating social behavior in ASD. Preclinical studies have suggested that alterations in the ECS result in ASD-like phenotypes, but currently no reviews have examined ECS abnormalities in human studies. This scoping review investigated any evidence of ECS alterations in humans with ASD. A comprehensive literature search was conducted and five studies were eligible for review. Three studies reported a significant reduction of anandamide in ASD compared to controls. Other alterations included decreased 2-arachidonoylglycerol, oleoylethanolamide, and palmitoylethanolamide and elevated diacylglycerol lipase and monoacylglycerol lipase. Some discrepant findings were also noted, which included elevated or reduced CB2 receptor in three studies and elevated or reduced N-acyl phosphatidylethanolamine phospholipase D and fatty acid amide hydrolase in two studies. We conclude from this preliminary investigation that the ECS may be altered in humans with ASD. Potential limitations of the reviewed studies include medication use and psychiatric comorbidities. Further research, such as positron emission tomography studies, are necessary to fully understand the relationship between ECS markers and ASD.
自闭症谱系障碍（ASD）是一种神经发育障碍，其特征是社交沟通缺陷和限制性行为和重复行为模式。尽管 ASD 的神经基础仍难以捉摸，但内源性大麻素系统（ECS）可能在调节 ASD 中的社交行为方面发挥作用。临床前研究表明，ECS 的改变会导致 ASD 样表型，但目前尚无综述检查人类研究中 ECS 异常。这项范围综述调查了 ASD 患者中 ECS 改变的任何证据。进行了全面的文献检索，有五项研究符合审查条件。三项研究报告 ASD 患者的花生四烯酸乙醇胺水平明显降低，与对照组相比。其他改变包括 2-花生四烯酸甘油、油酰乙醇胺和棕榈酰乙醇胺减少，二酰基甘油脂肪酶和单酰基甘油脂肪酶升高。也注意到一些不一致的发现，其中包括三项研究中 CB2 受体升高或降低，两项研究中 N-酰基磷脂酰乙醇胺磷酸二酯酶和脂肪酸酰胺水解酶升高或降低。从这项初步研究中我们得出结论，ECS 可能在 ASD 患者中发生改变。综述研究的潜在局限性包括药物使用和精神共病。进一步的研究，如正电子发射断层扫描研究，对于充分了解 ECS 标志物与 ASD 之间的关系是必要的。
