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Frequency of determining markers of casein's inhability and gluten in children with disorders of autistic spectrum

Abstract

The most optimal approach to the problem of managing children with autism spectrum disorders (ASD) is a complex one that involves a pediatric gastroenterologist, a nutritionist, a neurologist, a psychiatrist. Currently, there are studies that confirm the effectiveness of diet in the correction of neuropsychiatric status and gastroenterological disorders in ASD. Evidence supporting the therapeutic value of diets is limited and inconclusive. Diet therapy should be used only if food allergy or gluten or casein intolerance is diagnosed.

Aim. To study the frequency of detection of markers of gluten and casein intolerance in children with ASD.

Material and methods. The study involved 51 children (39 boys and 12 girls) aged 3 to 15 years with a diagnosis of ASD. Among the study participants, 20 children used gluten-free diet and casein-free diet for more than 6 months. The material for the study was venous blood taken from the elbow vein in the morning on an empty stomach. Determination of specific IgG-antibodies to casein and gliadin, IgA-antibodies to deamidized gliadin peptides was carried out by enzyme immunoassay. The level of total IgA to exclude selective deficiency was also determined.

Results and discussion. Most children with ASD (795%) had increased levels of specific IgG antibodies to casein. The increase in IgG antigliadin antibodies was determined in 19.3% of children who do not follow a gluten-free diet, and antibodies to deamidized gliadin Ig peptides were not detected in any patient. Gluten intolerance in children with ASD is characterized by sensitivity to it and occurs in 40-50%.

Conclusion. According to the literature and the results of own studies, some children with ASD have gluten and casein intolerance. Before the appointment of diet therapy for children with ASD, it is necessary to conduct a survey to clarify the nature of intolerance and the choice of optimal tactics of diet therapy.

Keywords:autism, gluten intolerance, serological markers, casein intolerance, gluten-free diet

For citation: Bavykina I.A., Popov V.I., Zvyagin A.A., Bavykin D.V. Frequency of determining markers of casein's inhability and gluten in children with disorders of autistic spectrum. Voprosy pitaniia [Problems of Nutrition]. 2019; 88 (4): 41-7. doi: 10.24411/0042-8833-2019-10040 (in Russian)

References

1. Sorvacheva T.N., Pyreva E.A., Usacheva E.L. Alternative nutri- 4. tional approaches in psycho-neurological pediatric practice. Myths and reality. Voprosy detskoy dietologii [Problems of Pediatric Nutrition]. 2013; 11 (6): 45-50. (in Russian)

2. Rubenstein E., Schieve L., Bradley C., et al. The prevalence of 5. gluten free diet use among preschool children with autism spectrum disorder. Autism Res. 2018; 11 (1): 185-93.

3. Adams J.B., Audhya T., Geis E., et al. Comprehensive nutritional and dietary intervention for autism spectrum disorder-a randomized, controlled 12-month trial. Nutrients. 2018; 10 (3): 369.

4. Pusponegoro H.D., Ismael S., Firmansyah A., et al. Gluten and casein supplementation does not increase symptoms in children with autism spectrum disorder. Acta Paediatr. 2015; 104 (11): 500-5.

5. Zvyagin A.A., Bavykina I.A. The eff ectiveness of a gluten-free diet in the treatment of autistic spectrum disorders in children. Pediatriya. Zhurnal im. G.N. Speranskogo [Pediatrics Journal named after G.N. Speransky]. 2017; 96 (6): 197-200. (in Russian)

6. Bavykina I.A., Zvyagin A.A., Nastausheva T.L. Gluten intolerance and autism spectrum disorders: a pathological tandem? Voprosy detskoy dietologii [Problems of Pediatric Nutrition]. 2017. 15 (2): 42-4. (in Russian)

7. Sokolov O.Yu., Kost N.V., Andreeva O.O., et al. Possible role of casomorphins in the pathogenesis of autism. Psikhiatriya [Psychiatry]. 2010; 3 (45): 29-35. (in Russian)

8. Sun Z, Cade R. Findings in normal rats following administration of gliadorphin-7 (GD-7). Peptides. 2003; 24 (2): 321-3.

9. Sun Z., Cade J.R., Fregly M.J., Privette R.M., et al. p-Casomorphin induces fos-like immunoreactivity in discrete brain regions relevant to schizophrenia and autism. Autism. 1999; 3: 67-83.

10. Jozefczuk J., Konopka E., Bierta J.B., et al. The occurrence of antibodies against gluten in children with autism spectrum disorders does not correlate with serological markers of impaired intestinal permeability. J Med Food. 2018; 21 (2): 181-7.

11. Navarro F., Pearson D.A., Fatheree N., et al. Are "leaky gut" and behavior associated with gluten and dairy containing diet in children with autism spectrum disorders? Nutr Neurosci. 2015; 18 (4): 177-85.

12. Sausmikat J., Smollich M. Nutritional therapy for children and adolescents with autism spectrum disorders: what is the evidence? Klin Padiatr. 2016; 228 (2): 62-70.

13. Lange K.W., Hauser J., Reissmann A. Gluten-free and casein-free diets in the therapy of autism. Curr Opin Clin Nutr Metab Care. 2015; 18 (6): 572-5.

14. Nath D. Complementary and alternative medicine in the school-age child with autism. J Pediatr Health Care. 2017; 31 (3): 393-7.

15. Zvyagin A.A., Bavykina I.A., Bavykin D.V. Gastroenterological symptoms in children with autism spectrum disorders. Voprosy detskoy dietologii [Problems of Pediatric Nutrition]. 2018; 16 (2): 52-5. (in Russian)

16. Armstrong D., Don-Wauchope A.C., Verdu E.F. Testing for gluten-related disorders in clinical practice: the role of serology in managing the spectrum of gluten sensitivity. Can J Gastroenterol. 2011; 25 (4): 193-7.

17. Watanabe C., Komoto S., Hokari R., Kurihara C., Okada Y., Hozumi H., et al. Prevalence of serum celiac antibody in patients with IBD in Japan. J Gastroenterol. 2014; 49 (5): 825-34.

18. Catassi C., Elli L., Bonaz B., Bouma G., Carroccio A., Castillejo G., et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Expertsā€™ Criteria. Nutrients. 2015; 7: 4966-77.

19. Zvyagin A.A., Bavykina I.A., Gubanova A.V. Non-celiac nonallergic sensitivity to gluten. Pediatriya. Zhurnal im. G.N. Spe-ranskogo [Pediatrics Journal named after G.N. Speransky]. 2018; 97 (6): 147-51. (in Russian)

20. Yankina G.N., Kondratieva E.I., Loshkova EV, Terentyeva A.A. Features of diagnosis and treatment of various forms of intolerance to wheat protein. Voprosy detskoy dietologii [Problems of Pediatric Nutrition]. 2017; 15 (1): 13-24. (in Russian)

21. Husby S., Koletzko S., Korponay-Szabo I.R., Mearin M.L., Phillips A., Shamir R., et al. Zimmer European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of celiac disease. J Pediatr Gastroenterol Nutr. 2012; 54: 136-60.

22. Cade R., Privette M., Fregly M., et al. Autism and schizophrenia: intestinal disorders. Nutr. Neurosci. 2000; 3 (1): 57-72.


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