RELATIONSHIP OF SERUM DIPEPTIDYL PEPTIDASE-IV ACTIVITY AND ANTI-CASEIN ANTIBODIES TO GASTROINTESTINAL SYMPTOMS AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER: AN EGYPTIAN STUDY

Inas R El-alameey; Hanaa H Ahmed; Ihab M Eid; Ghada El-dory; Manal Gameel

doi:10.22159/ajpcr.2018.v11i4.22627

Authors

Inas R El-alameey Child Health Department, National Research Centre, Egypt. http://orcid.org/0000-0002-0168-7663
Hanaa H Ahmed Hormones Department, National Research Centre, Egypt.
Ihab M Eid Medical Childhood Studies Department, Institute of Postgraduate Childhood Studies, Ain Shams University, Egypt.
Ghada El-dory Medical Childhood Studies Department, Institute of Postgraduate Childhood Studies, Ain Shams University, Egypt.
Manal Gameel Zahira Abdeen Hospital, Ministry of Health, Egypt.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i4.22627

Keywords:

Autism spectrum disorder, Dipeptidyl peptidase-IV, Anti-casein antibodies, Gastrointestinal symptoms

Abstract

Â Objectives: The objectives of the study were to assess serum dipeptidyl peptidase-IV (DPP-IV) activity in autistic children suffering from severe gastrointestinal (GI) disorder and to examine the hypothesis that there is a link between DPP-IV activity in serum and GI disorder in a subgroup of children with autism spectrum disorder (ASD).

Subjects and Methods: Serum levels of casein antibodies and DPP-IV enzyme activity from 40 autistic children with chronic GI symptoms, and 40 of age-matched children without autism or gastrointestinal (GI) symptoms were assayed using enzyme-linked immunosorbent assay kits.

Results: In comparison with controls, developmental milestones were delayed among autistic children. The serum DPP-IV activity was significantly lower in the studied patients (p<0.05), while the mean serum levels of casein antibodies were statistically significantly higher in the studied patients (p<0.01). Multiple logistic regression analysis recorded significant association between the high serum level of antibodies to casein, food selectivity and recurrent attacks of abdominal pain (p<0.05), while the low serum DPP-IV enzyme activity was associated with recurrent attacks of abdominal pain in the studied patients with a prediction of 95% (p<0.05).

Conclusions: Serum levels of casein antibodies were higher in children with ASD, and maybe contributes to their abdominal pain, and food selectivity. Serum DPP-IV enzyme activity was lower and associated with recurrent attacks of abdominal pain in the studied patients. They may benefit from a supplemental digestive enzyme formula.

Downloads

Download data is not yet available.

Author Biography

Inas R El-alameey, Child Health Department, National Research Centre, Egypt.

Child health and nutrition, Child Health Department, National Research Centre, Giza, Egypt.

References

American Psychiatric Association. Diagnostic and Statistical Manual for Mental Disorders. 5th ed. Washington, DC, USA: American Psychiatric Association; 2013.

Lai MC, Lombardo MV, Baron-Cohen S. Autism. Lancet 2014;383:896-910.

Jyonouchi H, Geng L, Ruby A, Reddy C, Zimmerman-Bier B. Evaluation of an association between gastrointestinal symptoms and cytokine production against common dietary proteins in children with autism spectrum disorders. J Pediatr 2005;146:605-10.

HÃ¸st A, Halken S, Jacobsen HP, Christensen AE, Herskind AM, Plesner K, et al. Clinical course of cowâ€™s milk protein allergy/intolerance and atopic diseases in childhood. Pediatr Allergy Immunol 2002;13 Suppl 15:23-8.

RancÃ© F. Food allergy in children suffering from atopic eczema. Pediatr Allergy Immunol 2008;19:279-84.

Tromp IL, Jong JC, Lebon A, Renders CM, Jaddoe VW, Hofman A, et al. The introduction of allergenic foods and the development of reported wheezing and eczema in childhood: The generation study. Arch Pediatr Adolesc Med 2011;165:933-8.

Schade RP, Van Ieperen-Van Dijk AG, Versluis C, Van Reijsen FC, Kimpen JL, Bruijnzeel-Koomen CA, et al. Cell-surface expression of CD25, CD26, and CD30 by allergen-specific T cells is intrinsically different in cowâ€™s milk allergy. J Allergy Clin Immunol 2002;109:357-62.

Hunter LC, Oâ€™Hare A, Herron WJ, Fisher LA, Jones GE. Opioid peptides and dipeptidyl peptidase in autism. Dev Med Child Neurol 2003;45:121-8.

Shattock P, Hooper M, Waring R. Opioid peptides and dipeptidyl peptidase in autism. Dev Med Child Neurol 2004;46:357.

de Theije CG, Wu J, da Silva SL, Kamphuis PJ, Garssen J, Korte SM, et al. Pathways underlying the gut-to-brain connection in autism spectrum disorders as future targets for disease management. Eur J Pharmacol 2011;668 Suppl 1:S70-80.

Onore C, Careaga M, Ashwood P. The role of immune dysfunction in the pathophysiology of autism. Brain Behav Immun 2012;26:383-92.

Bashir S, AL-Ayadhi L. Alterations in plasma dipeptidyl peptidase IV in autism: A pilot study. Neurol Psychiatry Brain Res 2014;20:41-4.

American Psychiatric Publishing. Autism Spectrum Disorder Fact Sheet. Arlington, Va, USA: American Psychiatric Publishing; 2013.

Schopler E, Reichler RJ, Renner BR. The Childhood Autism Rating Scale (CARS): For Diagnostic Screening and Classification of Autism. Los Angeles, Calif, USA: Western Psychological Services; 1994.

Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Am Diet Assoc 2010;110:238-46.

Greenberg R. Human casein. Amino acid sequence and identification of phosophrylation sites. J Biol Chem 1984;259:5132-8.

Eigsti IM, Shapiro T. A systems neurosciences approach to autism: Biological, cognitive, and clinical perspectives. Ment Retard Dev Disabil Res Rev 2003;9:205-15.

Bhagat V, Jayaraj J, Haque M. Parentâ€™s self-efficacy, emotionality, and intellectual ability impacting the intervention of autism spectrum disorders: A review proposed model for appraisal of intervention. Int J Pharm Pharm Sci 2015;7:7-12.

Arndt TL, Stodgel CJ, Rodier PM. The tetralogy of autism. Int J Dev Neurosci 2005;23:189-99.

Itzchak EB, Zachor DA, Harofeh A. Male: Female Ratio is Related to Autism Spectrum Disorder in the Family and to Maternal Age. Zerifin, Israe: Harofeh Medical Center, Franklin Hall B Level 4 (Philadelphia Marriott Downtown); 2010.

Noens I, van Berckelaer-Onnes I, Verpoorten R, van Duijn G. The com for: An instrument for the indication of augmentative communication in people with autism and intellectual disability. J Intellect Disabil Res 2006;50:621-32.

Volkmar FR, Klin A. Issues in the classification of autism and related conditions. In: Paul R, Cohen D, editors. Handbook of Autism and Pervasive Developmental, Neurobiology, and Behavior. Hoboken, NJ: Wiley; 2005. p. 5-41.

Xi CY, Ma HW, Hua TY, Zhao YJ. Behavioral patterns of autistic children during infancy. Zhongguo Dang Dai Er Ke Za Zhi 2006;8:470-2.

Filipek PA, Accordo PJ, Baranek GT. The screening and diagnosis of autistic spectrum disorders. J Autism Dev Disord 1999;29:439-84.

McPartland PJ, Klin A. Aspergerâ€™s syndrome. Adolesc Med Clin 2006;17:771-88.

Juneja M, Mukherjee SB, Sharma S. A descriptive hospital based study of children with autism. Indian Pediatr 2005;42:453-8.

Valicenti-McDermott M, McVicar K, Rapin I, Wershil BK, Cohen H, Shinnar S, et al. Frequency of gastrointestinal symptoms in children with autistic spectrum disorders and association with family history of autoimmune disease. J Dev Behav Pediatr 2006;27:S128-36.

Campbell DB, Buie TM, Winter H, Bauman M, Sutcliffe JS, Perrin JM, et al. Distinct genetic risk based on association of MET in families with co-occurring autism and gastrointestinal conditions. Pediatrics 2009;123:1018-24.

de Magistris L, Picardi A, Siniscalco D, Riccio MP, Sapone A, Cariello R, et al. Antibodies against food antigens in patients with autistic spectrum disorders. Biomed Res Int 2013;2013:729349.