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Autism: Solving the Puzzle !!! Mostafa Waly , MPH, PhD Assistant Professor

Autism: Solving the Puzzle !!! Mostafa Waly , MPH, PhD Assistant Professor Food Science and Nutrition Department College of Agriculture & Marine Sciences Sultan Qaboos University, Oman. Autism Spectrum Disorder:. Who? What risk factors? Where ? Clinical Picture & Social Impact?

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Autism: Solving the Puzzle !!! Mostafa Waly , MPH, PhD Assistant Professor

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  1. Autism: Solving the Puzzle !!! MostafaWaly, MPH, PhD Assistant Professor Food Science and Nutrition Department College of Agriculture & Marine Sciences Sultan Qaboos University, Oman

  2. Autism Spectrum Disorder: • Who? • What risk factors? • Where? • Clinical Picture & Social Impact? • Biochemical & Dietary profile? • Genetics?

  3. Brain defects in autism

  4. Autistic spectrum disorder (ASD)* Pervasive Developmental Disorder Not Otherwise Specified Childhood Disintegrative Disorder Rett’s Disorder Asperger’s Disorder Autism • * Diagnostic criteria (DSM IV & ICD 10) • No diagnostic laboratory tests are available

  5. 1. Who? • Male: female ratio is 3:1 • Breastfeeding is a protective factor • No clear relation to socio-economic status • Onset prior to age 3 years

  6. 2. What risk factors? Nutrition & Biochemical abnormalities Genetic Predisposition Infection & Vaccination Environmental Insults Timing Autism

  7. 3. Where? Autism is an epidemic disorder !

  8. Prevalence at the United States

  9. 4. Clinical picture & Social Impact • Clinical Picture: • Gut Problems • Absorptive Difficulties • Enzyme Disorders • Deficiency Syndromes • Poor Detoxification Abilities • Immune Reactivity • Allergies • Poor Blood Flow To The Brain • Hippocampus Malfunction • Social Impact: • Communication Problems • Cognitive Difficulties • Emotional Disorders • Problems With Awareness • Poor Eye Contact • Behavior Problems • Problems with Play • Poor Understanding Of Cause and Effect • Delayed Development • Sleep Problems

  10. 5. Biochemical & Dietary profile? • Autism Research in Oman: • Folate and Vitamin B12. • Oxidative Stress and Neuronal Cells Damage. • Glutathione (GSH), Intracellular Antioxidant. • Reduced Methylation Capacity in Autistic Children. • Neurodevelopmental Toxicity and GSH Depletion.

  11. SOURCES OF OXYGEN FREE RADICALS AND CELL INJURY =Oxidative Stress

  12. MECHANISMS OF FREE RADICAL-MEDIATED CELLULAR INJURY

  13. Antioxidant Defense Counterbalances Oxidative Stress Oxidative Stress Antioxidant Defense Heavy Metals Hydroxyl Radical Hydrogen Peroxide Superoxide Peroxides NO- Superoxide Dismutase GSH Peroxidase GSH Reductase Vitamin E Vitamin C Lipoic Acid GSTs GSH

  14. Oxidative Stress Antioxidant Defense Superoxide Dismutase GSH Peroxidase GSH Reductase Vitamin E Vitamin C Lipoic Acid GSTs GSH Heavy Metals Hydroxyl Radical Hydrogen Peroxide Superoxide GSSG Cell Death Damage

  15. Folate and Vitamin B12-dependent HCY- Methionine Cycle

  16. Folate and Vitamin B12 Status Control Children Autistic Children (n=30) (n=30) Serum Folate (µg/l) 6.3 2.1* Serum B12(pg/ml) 256.8185.3* Dietary Folate (µg/Day) 240.3 130.1* Diteary B12 (µg/Day) 2.7 1.8* Results are Mean ± SD, * Significantly lower than control children, P<0.05

  17. Oxidative Stress Markers Control Children Autistic Children (n=30) (n=30) Homocysteine, HCY(µmol/l) 13.3 25.7# Glutathione, GSH (µmol/l) 8.4 3.0 * Total Antioxidant Capacity 36.6 11.9* TAC, (mmol/l) Results are Mean ± SD, # Significantly higher than control children, P<0.05 * Significantly lower than control children, P<0.05

  18. 6. Genetics? • twin studies --- 90%; multiple genes in chromosomes 2 q , 7 q, 16 p, 19 p. • Chromosomal anomalies 15 and fragile X syndrome. • Recurrence risk studies- siblings of autistic people are more likely to be autistic.

  19. Acknowledgment Dr. Marwan Al-Sharabati, Behavioral Medicine Dept. Dr. Mohammed Al-Shafaee, Family Medicine& Public Health Dept. Dr. Yahya Al-Farsi, Family Medicine& public health Dept. Dr. Amanat Ali, Food Science and Nutrition Dept. Dr. Majeed Al-Ani, Food Science and Nutrition Dept.

  20. They Disserve Our Effort!! شكراً mostafa@squ.edu.om / waly.mostafa@gmail.com

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