Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, China.
Key Laboratory of Ethnomedicine for Ministry of Education, School of Pharmacy, Minzu University of China, Beijing, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2022 Mar 8;113:110476. doi: 10.1016/j.pnpbp.2021.110476. Epub 2021 Nov 15.
Autism spectrum disorder (ASD) might be associated with oxidative stress, and antioxidants are commonly used in the treatment of young people with ASD. However, the evidence about the effectiveness of these interventions remains debatable. We performed a meta-analysis to evaluate the effect of antioxidants on the symptoms of patients with autism.
Data sources: PubMed and Web of Science databases.
We selected placebo-controlled, double-blind, randomized clinical trials published until February 2021 to evaluate the efficacy of antioxidant interventions on ASD.
Aberrant Behavior Checklist (ABC), Repetitive Behavior Scale-Revised (RBS), Social Responsiveness Scale (SRS), Developmental Behavior Checklist (DBC) and Clinical Global Impressions Severity scale (CGIS) were used to evaluate the 22 different symptom outcomes. The Hedges-adjusted g value was used to estimate the effect of each dietary intervention relative to the placebo.
In this meta-analysis, we examined 13 double-blind randomized clinical trials, comprising a total of 570 patients with ASD: 293 in the intervention group and 277 in the placebo group. Antioxidants (N-acetylcysteine (NAC), other antioxidants) are more effective than placebos in improving the irritability among symptoms in the ABC and communication disturbance symptoms in the DBC. There was a good trend of improvement in the stereotypic behavior symptoms in the ABC. Treatment with NAC antioxidants showed a good trend of improvement in irritability in the ABC and symptoms of hyperactivity. The effect size was small, and there was a low risk of statistical heterogeneity and publication bias.
The number of studies in this meta-analysis was small and the sample size was small.
This meta-analysis suggests that antioxidant intervention has a potential role in the management of some symptoms in patients with ASD, and indicates the feasibility of using antioxidants to treat autism in the future.
自闭症谱系障碍（ASD）可能与氧化应激有关，抗氧化剂常用于治疗 ASD 青少年。然而，这些干预措施有效性的证据仍存在争议。我们进行了一项荟萃分析，以评估抗氧化剂对自闭症患者症状的影响。
数据来源：PubMed 和 Web of Science 数据库。
我们选择了安慰剂对照、双盲、随机临床试验，这些试验发表于 2021 年 2 月之前，以评估抗氧化剂干预对 ASD 的疗效。
采用异常行为检查表（ABC）、重复行为量表修订版（RBS）、社会反应量表（SRS）、发育行为检查表（DBC）和临床总体印象严重程度量表（CGIS）评估 22 种不同的症状结果。使用 Hedges 调整 g 值来估计每种饮食干预相对于安慰剂的效果。
在这项荟萃分析中，我们检查了 13 项双盲随机临床试验，共纳入了 570 名 ASD 患者：干预组 293 名，安慰剂组 277 名。抗氧化剂（N-乙酰半胱氨酸（NAC）、其他抗氧化剂）比安慰剂更能有效改善 ABC 中的易激惹和 DBC 中的沟通障碍症状。ABC 中的刻板行为症状有较好的改善趋势。NAC 抗氧化剂治疗在 ABC 中的易激惹和多动症状方面有较好的改善趋势。效应量较小，且存在低的统计学异质性和发表偏倚风险。
本荟萃分析中的研究数量较少，样本量较小。
这项荟萃分析表明，抗氧化剂干预在 ASD 患者的某些症状管理中可能具有潜在作用，并表明未来使用抗氧化剂治疗自闭症的可行性。
