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A cleanroom sleeping environment's impact on markers of oxidative stress, immune dysregulation, and behavior in children with autism spectrum disorders.

Faber S, Zinn GM, Boggess A, Fahrenholz T, Kern JC, Kingston HM - BMC Complement Altern Med (2015)

Bottom Line: The younger cohort, age 5 and under, showed significantly greater mean decreases in two markers of immune dysregulation, CD3% and CD4%, than the older cohort.The younger children demonstrated significant improvements on behavioral rating scales compared to the older children.In a younger pair of identical twins, one twin showed significantly greater improvements in 4 out of 5 markers of oxidative stress, which corresponded with better overall behavioral rating scale scores than the other twin.

View Article: PubMed Central - PubMed

Affiliation: Medicine, The Children's Institute, 1405 Shady Avenue, Pittsburgh, PA, 15217, USA. sfa@the-institute.org.

ABSTRACT

Background: An emerging paradigm suggests children with autism display a unique pattern of environmental, genetic, and epigenetic triggers that make them susceptible to developing dysfunctional heavy metal and chemical detoxification systems. These abnormalities could be caused by alterations in the methylation, sulfation, and metalloprotein pathways. This study sought to evaluate the physiological and behavioral effects of children with autism sleeping in an International Organization for Standardization Class 5 cleanroom.

Methods: Ten children with autism, ages 3-12, slept in a cleanroom for two weeks to evaluate changes in toxin levels, oxidative stress, immune dysregulation, and behavior. Before and after the children slept in the cleanroom, samples of blood and hair and rating scale scores were obtained to assess these changes.

Results: Five children significantly lowered their concentration of oxidized glutathione, a biomarker of oxidative stress. The younger cohort, age 5 and under, showed significantly greater mean decreases in two markers of immune dysregulation, CD3% and CD4%, than the older cohort. Changes in serum magnesium, influencing neuronal regulation, correlated negatively while changes in serum iron, affecting oxygenation of tissues, correlated positively with age. Changes in serum benzene and PCB 28 concentrations showed significant negative correlations with age. The younger children demonstrated significant improvements on behavioral rating scales compared to the older children. In a younger pair of identical twins, one twin showed significantly greater improvements in 4 out of 5 markers of oxidative stress, which corresponded with better overall behavioral rating scale scores than the other twin.

Conclusions: Younger children who slept in the cleanroom altered elemental levels, decreased immune dysregulation, and improved behavioral rating scales, suggesting that their detoxification metabolism was briefly enhanced. The older children displayed a worsening in behavioral rating scale performance, which may have been caused by the mobilization of toxins from their tissues. The interpretation of this exploratory study is limited by lack of a control group and small sample size. The changes in physiology and behavior noted suggest that performance of larger, prospective controlled studies of exposure to nighttime or 24 hour cleanroom conditions for longer time periods may be useful for understanding detoxification in children with autism.

Trial registration: Clinical Trial Registration Number NCT02195401 (Obtained July 18, 2014).

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Related in: MedlinePlus

Differences for the SCQ, Autism Composite of PDDBI, and total ABC rating scales versus age. The results display significance or near significance for each rating scale with a p-value of 0.030 for SCQ, 0.046 for Autism Composite, and 0.054 for total ABC. Two points overlap at age 5 with a difference of +1 for total ABC.
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Fig6: Differences for the SCQ, Autism Composite of PDDBI, and total ABC rating scales versus age. The results display significance or near significance for each rating scale with a p-value of 0.030 for SCQ, 0.046 for Autism Composite, and 0.054 for total ABC. Two points overlap at age 5 with a difference of +1 for total ABC.

Mentions: The before and after cleanroom rating scale results for all 10 children are summarized in Table 3 with significant correlation coefficients (r) and p-values listed in Table 4. The younger cohort demonstrated significant decreases in SCQ means (p = 0.025). The changes in SCQ versus age were also significant, with a positive correlation (r = 0.68, p = 0.030) seen in Figure 6. Additional positive correlations with age were found in the changes in Autism Composite of the PDDBI (r = 0.64, p = 0.046) and the Sensory/Perceptual Approach Behaviors (SENSORY) subscale of the PDDBI (r = 0.64, p = 0.045). The Receptive/Expressive Social Communication Abilities Composite (REXSCA/C) showed significant negative correlations with age (r = −0.66, p = 0.037), which indicates language improvement in the younger cohort. None of the other domains or composites of the PDDBI produced significant results. The change in the total ABC by age of the ten children was nearly statistically significant with a p-value of 0.054 (r = 0.62). Furthermore, three of the five subscales of the ABC were significantly positively correlated with age (p = 0.034 for subscale III, p = 0.024 for subscale IV, and p = 0.035 for subscale V). The two remaining subscales of ABC showed no significant correlations.Table 3


A cleanroom sleeping environment's impact on markers of oxidative stress, immune dysregulation, and behavior in children with autism spectrum disorders.

Faber S, Zinn GM, Boggess A, Fahrenholz T, Kern JC, Kingston HM - BMC Complement Altern Med (2015)

Differences for the SCQ, Autism Composite of PDDBI, and total ABC rating scales versus age. The results display significance or near significance for each rating scale with a p-value of 0.030 for SCQ, 0.046 for Autism Composite, and 0.054 for total ABC. Two points overlap at age 5 with a difference of +1 for total ABC.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4374395&req=5

Fig6: Differences for the SCQ, Autism Composite of PDDBI, and total ABC rating scales versus age. The results display significance or near significance for each rating scale with a p-value of 0.030 for SCQ, 0.046 for Autism Composite, and 0.054 for total ABC. Two points overlap at age 5 with a difference of +1 for total ABC.
Mentions: The before and after cleanroom rating scale results for all 10 children are summarized in Table 3 with significant correlation coefficients (r) and p-values listed in Table 4. The younger cohort demonstrated significant decreases in SCQ means (p = 0.025). The changes in SCQ versus age were also significant, with a positive correlation (r = 0.68, p = 0.030) seen in Figure 6. Additional positive correlations with age were found in the changes in Autism Composite of the PDDBI (r = 0.64, p = 0.046) and the Sensory/Perceptual Approach Behaviors (SENSORY) subscale of the PDDBI (r = 0.64, p = 0.045). The Receptive/Expressive Social Communication Abilities Composite (REXSCA/C) showed significant negative correlations with age (r = −0.66, p = 0.037), which indicates language improvement in the younger cohort. None of the other domains or composites of the PDDBI produced significant results. The change in the total ABC by age of the ten children was nearly statistically significant with a p-value of 0.054 (r = 0.62). Furthermore, three of the five subscales of the ABC were significantly positively correlated with age (p = 0.034 for subscale III, p = 0.024 for subscale IV, and p = 0.035 for subscale V). The two remaining subscales of ABC showed no significant correlations.Table 3

Bottom Line: The younger cohort, age 5 and under, showed significantly greater mean decreases in two markers of immune dysregulation, CD3% and CD4%, than the older cohort.The younger children demonstrated significant improvements on behavioral rating scales compared to the older children.In a younger pair of identical twins, one twin showed significantly greater improvements in 4 out of 5 markers of oxidative stress, which corresponded with better overall behavioral rating scale scores than the other twin.

View Article: PubMed Central - PubMed

Affiliation: Medicine, The Children's Institute, 1405 Shady Avenue, Pittsburgh, PA, 15217, USA. sfa@the-institute.org.

ABSTRACT

Background: An emerging paradigm suggests children with autism display a unique pattern of environmental, genetic, and epigenetic triggers that make them susceptible to developing dysfunctional heavy metal and chemical detoxification systems. These abnormalities could be caused by alterations in the methylation, sulfation, and metalloprotein pathways. This study sought to evaluate the physiological and behavioral effects of children with autism sleeping in an International Organization for Standardization Class 5 cleanroom.

Methods: Ten children with autism, ages 3-12, slept in a cleanroom for two weeks to evaluate changes in toxin levels, oxidative stress, immune dysregulation, and behavior. Before and after the children slept in the cleanroom, samples of blood and hair and rating scale scores were obtained to assess these changes.

Results: Five children significantly lowered their concentration of oxidized glutathione, a biomarker of oxidative stress. The younger cohort, age 5 and under, showed significantly greater mean decreases in two markers of immune dysregulation, CD3% and CD4%, than the older cohort. Changes in serum magnesium, influencing neuronal regulation, correlated negatively while changes in serum iron, affecting oxygenation of tissues, correlated positively with age. Changes in serum benzene and PCB 28 concentrations showed significant negative correlations with age. The younger children demonstrated significant improvements on behavioral rating scales compared to the older children. In a younger pair of identical twins, one twin showed significantly greater improvements in 4 out of 5 markers of oxidative stress, which corresponded with better overall behavioral rating scale scores than the other twin.

Conclusions: Younger children who slept in the cleanroom altered elemental levels, decreased immune dysregulation, and improved behavioral rating scales, suggesting that their detoxification metabolism was briefly enhanced. The older children displayed a worsening in behavioral rating scale performance, which may have been caused by the mobilization of toxins from their tissues. The interpretation of this exploratory study is limited by lack of a control group and small sample size. The changes in physiology and behavior noted suggest that performance of larger, prospective controlled studies of exposure to nighttime or 24 hour cleanroom conditions for longer time periods may be useful for understanding detoxification in children with autism.

Trial registration: Clinical Trial Registration Number NCT02195401 (Obtained July 18, 2014).

Show MeSH
Related in: MedlinePlus