Toxic Metals and Essential Elements in Hair and Severity of Symptoms among Children with Autism

Eleonor BLAUROCK-BUSCH,a Omnia R. AMIN,b Hani H. DESSOKI,c and Thanaa RABAHd


Objective: The objective of this study was to assess the levels of ten toxic metals and essential elements in hair samples of children with autism, and to correlate the level of these elements with the severity of autism.

Method: The participants were 44 children, age 3 to 9 years, with Autistic Spectrum Disorder (ASD) according to Diagnostic and Statistical Manual of Mental Disorders 4th Edition, (DSM-IV). The severity of autistic symptomatology was measured by the Childhood Autism Rating Scale (CARS). Hair analysis was performed to evaluate the long term metal exposure and mineral level.

Results: By comparing hair concentration of autistic vs nonautistic children, elevated hair concentrations were noted for aluminum, arsenic, cadmium, mercury, antimony, nickel, lead, and vanadium. Hair levels of calcium, iron, iodine, magnesium, manganese, molybdenum, zinc, and selenium were considered deficient. There was a significant positive correlation between lead & verbal communication (p = 0.020) and general impression (p = 0.008). In addition, there was a significant negative correlation between zinc & fear and nervousness (p = 0.022).

Conclusion: Our data supports the historic evidence that heavy metals play a role in the development of ASD. In combination with an inadequate nutritional status the toxic effect of metals increase along with the severity of symptoms.

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Study of some biomarkers in hair of children with autism

Elsheshtawy, Emana; Tobar, Salwaa; Sherra, Khalida; Atallah, Sohaylab; Elkasaby, Rashac

Middle East Current Psychiatry: January 2011 – Volume 18 – Issue 1 – p 6-10



Autism is a severe developmental disorder, which involves social withdrawal, communication deficits, and stereotypic repetitive behavior. The possible etiologies that precipitate autism symptoms remain controversial in many cases, but both genetic and environmental factors have been implicated. Mercury has gained much attention for a considerable period of time before other exacerbating or protective factors were suggested. The aim of this study was to investigate the relationship between autism and the level of some metals (namely mercury, lead, and copper) or zinc as a counteracting antioxidant element.


The study recruited 32 autistic children and 32 normal controls and all of them were subjected to KID-SCID, Childhood Autism Rating Scale (CARS), Stanford Binet intelligence test, and biochemical analysis of hair samples for the level of mercury, copper, lead and zinc.


There were highly significant differences between the level of these substances in the hair of children with autism compared with controls, positive correlation of CARS score with both mercury and copper, while intelligence quotient has significant negative correlation with the level of lead in the hair. The level of zinc does not correlate with either CARS score or intelligence quotient.


These preliminary results suggest a complementary role for the studied elements in the pathogenesis of autistic disorder, which should be considered in the management plane.

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A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children

Victoria Hurduc, Doina Plesca, Dimitrie Dragomir, Maria Sajin, Yvan Vandenplas

First published: 09 December 2008


Aim: The failure rate of Helicobacter pylori (H. pylori) eradication imposes the assessment of new options.

Subjects and methods: A prospective open study was performed in 90 symptomatic children (range 3–18 years) with H. pylori infection, randomized in two groups: control (42 patients) and intervention group (48 patients). Both groups were treated with the standard triple eradication therapy (omeprazole/esomeprazole, amoxicillin and clarithromycin) for 7–10 days. The intervention group was also treated with Saccharomyces boulardii (S. boulardii), 250 mg b.i.d., for 4 weeks. The eradication rate of H. pylori was assessed by the same methods (urease test and histology) 4–6 weeks after treatment. Adverse events and compliance were evaluated after 7 and 28 days of treatment. The Chi‐square test was used for statistical evaluation (p < 0.05).

Results: H. pylori infection was identified in 90 of 145 children (62%) and it correlated positively with age (p < 0.002) and inversely with socioeconomic status (p < 0.005). All infected children had chronic gastritis, with antral nodularity in 76.7%. Overall, H. pylori eradication rate was 87.7% (control 80.9%, S. boulardii group 93.3%) (p = 0.750). The incidence of side effects was reduced in the S. boulardii group: 30.9% in the control versus 8.3% in the probiotic group (p = 0.047).

Conclusion: The addition of S. boulardii to the standard eradication treatment confers a 12% nonsignificant enhanced therapeutic benefit on H. pylori eradication and reduces significantly the incidence of side effects.

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Lactoferrin as Protective Natural Barrier of Respiratory and Intestinal Mucosa against Coronavirus Infection and Inflammation

by Elena Campione 1,*,Terenzio Cosio 1,Luigi Rosa 2,Caterina Lanna 1,Stefano Di Girolamo 3,Roberta Gaziano 4,Piera Valenti 2,† and Luca Bianchi 1,†


Recently, the world has been dealing with a devastating global pandemic coronavirus infection, with more than 12 million infected worldwide and over 300,000 deaths as of May 15th 2020, related to a novel coronavirus (2019-nCoV), characterized by a spherical morphology and identified through next-generation sequencing. Although the respiratory tract is the primary portal of entry of SARS-CoV-2, gastrointestinal involvement associated with nausea, vomiting and diarrhoea may also occur. No drug or vaccine has been approved due to the absence of evidence deriving from rigorous clinical trials. Increasing interest has been highlighted on the possible preventative role and adjunct treatment of lactoferrin, glycoprotein of human secretions part of a non-specific defensive system, known to play a crucial role against microbial and viral infections and exerting anti-inflammatory effects on different mucosal surfaces and able to regulate iron metabolism. In this review, analysing lactoferrin properties, we propose designing a clinical trial to evaluate and verify its effect using a dual combination treatment with local, solubilized intranasal spray formulation and oral administration. Lactoferrin could counteract the coronavirus infection and inflammation, acting either as natural barrier of both respiratory and intestinal mucosa or reverting the iron disorders related to the viral colonization.Keywords: coronavirusSARSlactoferrin

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Supplementation of Korean Red Ginseng improves behavior deviations in animal models of autism

Article: 29245 | Received 23 Jul 2015, Accepted 25 Nov 2015, Published online: 01 Feb 2016


Background: Autism spectrum disorder (ASD) is heterogeneous neurodevelopmental disorders that primarily display social and communication impairments and restricted/repetitive behaviors. ASD prevalence has increased in recent years, yet very limited therapeutic targets and treatments are available to counteract the incapacitating disorder. Korean Red Ginseng (KRG) is a popular herbal plant in South Korea known for its wide range of therapeutic effects and nutritional benefits and has recently been gaining great scientific attention, particularly for its positive effects in the central nervous system.Objectives: Thus, in this study, we investigated the therapeutic potential of KRG in alleviating the neuro-behavioral deficits found in the valproic acid (VPA)-exposed mice models of ASD. Design: Starting at 21 days old (P21), VPA-exposed mice were given daily oral administrations of KRG solution (100 or 200 mg/kg) until the termination of all experiments. From P28, mice behaviors were assessed in terms of social interaction capacity (P2829), locomotor activity (P30), repetitive behaviors (P32), short-term spatial working memory (P34), motor coordination (P36), and seizure susceptibility (P38).Results: VPA-exposed mice showed sociability and social novelty preference deficits, hyperactivity, increased repetitive behavior, impaired spatial working memory, slightly affected motor coordination, and high seizure susceptibility. Remarkably, long-term KRG treatment in both dosages normalized all the ASD-related behaviors in VPA-exposed mice, except motor coordination ability. Conclusion: As a food and herbal supplement with various known benefits, KRG demonstrated its therapeutic potential in rescuing abnormal behaviors related to autism caused by prenatal environmental exposure to VPA.

Keywords: Panax ginseng;nutraceutical;autistic behaviors;Korean Red Ginseng;prenatal VPA exposure.

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Vitamin D and autism, what’s new?

John Jacob Cannell

Rev Endocr Metab Disord (2017) 18:183–193
DOI 10.1007/s11154-017-9409-0

Published online: 20 February 2017
Springer Science+Business Media New York 2017


An increasing amount of evidence points to the possibility that gestational and early childhood vitamin D deficiency [25(OH)D < 40 ng/ml] cause some cases of autism. Vitamin D is metabolized into a seco-steroid hormone that regulates about 3% of the 26,000 genes in the coding human genome. It is also a neurosteroid that is active in brain development, having effects on cellular proliferation, differentiation, calcium signaling, neurotrophic and neuroprotective actions; it also appears to have an effect on neurotransmission and synaptic plasticity. Children who are, or who are destined to become, autistic have lower 25(OH)D levels at 3 months of gestation, at birth and at age 8 compared to their unaffected
siblings. Two open label trials found high dose vitamin D improves the core symptoms of autism in about 75% of autistic children. A few of the improvements were remarkable. The vitamin D doses used in these children were 300 IU/KG/day up to a maximum of 5000 IU/day (highest final 25(OH)D level reached was 45 ng/ml). The other study used 150,000 IU/month IM as well as 400 IU/day [highest final 25(OH)D level was 52 ng/ml]. These two open label trials were recently confirmed with a randomized controlled trial (RCT) using 300 IU/kg/day with a maximum of 5000 IU/day and resulted in effects similar to the two open label studies. In terms of prevention, a recent small study showed vita-
min D supplementation during pregnancy (5000 IU/day) and during infancy and early childhood (1000 IU/day) significantly reduced the expected incidence of autism in mothers who already had one autistic child from 20% to 5%. Vitamin D is safe; for example, over the last 15 years, Poison Control reports there have been approximately 15,000 cases of vitamin D overdose. However only three of these 15,000 people developed clinical toxicity and no one died. Given those facts, practitioners might consider treating autism with 300 IU/kg/day, and seek to prevent autism by supplementing pregnant and lactating women (5000 IU/day) and infants and young children (150 IU/kg/day) checking 25(OH)D levels every 3 months. These doses will increase 25(OH)D blood levels to those recommended by the Endocrine Society. As the American Academy of Pediatrics recommends vitamin D supplementation during infancy and childhood, pediatricians and family practitioners should evaluate the current evidence on autism and vitamin D and act accordingly.

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Cerebral folate receptor autoantibodies in autism
spectrum disorder

RE Frye, JM Sequeira, EV Quadros, SJ James and DA Rossignol

Molecular Psychiatry (2012), 1–13
& 2012 Macmillan Publishers Limited All rights reserved 1359-4184/12

Molecular Psychiatry advance online publication, 10 January 2012; doi:10.1038/mp.2011.175


Cerebral folate deficiency (CFD) syndrome is a neurodevelopmental disorder typically caused by folate receptor autoantibodies (FRAs) that interfere with folate transport across the blood–brain barrier. Autism spectrum disorders (ASDs) and improvements in ASD symptoms with leucovorin (folinic acid) treatment have been reported in some children with CFD. In children with ASD, the prevalence of FRAs and the response to leucovorin in FRA-positive children has not been systematically investigated. In this study, serum FRA concentrations were measured in 93 children with ASD and a high prevalence (75.3%) of FRAs was found. In 16 children, the concentration of blocking FRA significantly correlated with cerebrospinal fluid 5-methyl-tetrahydrofolate concentrations, which were below the normative mean in every case. Children with FRAs were treated with oral leucovorin calcium (2 mg kg1 per day; maximum 50 mg per day). Treatment response was measured and compared with a wait-list control group. Compared with controls, significantly higher improvement ratings were observed in treated children over a mean period of 4 months in verbal communication, receptive and expressive language, attention and stereotypical behavior. Approximately one-third of treated children demonstrated moderate to much improvement. The incidence of adverse effects was low. This study suggests that FRAs may be important in ASD and that FRA-positive children with ASD may benefit from leucovorin calcium treatment. Given these results, empirical treatment with leucovorin calcium may be a reasonable and non-invasive approach in FRA-positive children with ASD. Additional studies of folate receptor autoimmunity and leucovorin calcium treatment in children with ASD are warranted.

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Cerebral Folate Deficiency in Autism Spectrum Disorders

By Richard E. Frye, MD, PhD, and Daniel A. Rossignol, MD, FAAFP

This article is a companion piece to the story of Evan Carkhuff, a child diagnosed with autism who went many years with neither a medical diagnosis nor an explanation for his medical condition. Here we explain the medical science of the underlying neurodevelopmental disorder with which he was eventually diagnosed, called cerebral folate deficiency (CFD). As you will read from the description of his disorder in the accompanying article, Evan had several atypical characteristics that led some physicians down a wrong path. Evan’s story is an excellent example of a family who would not give up, and CFD is an excellent example of a disorder that was previously thought to be rare but is now being increasingly recognized to affect some children with autism.

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Ginsenosides: A Potential Neuroprotective Agent

Mengmeng Zheng, Yizhou Xin, Yujuan Li, Fangxue Xu, Xiaozhi Xi, Hong Guo, Xiaowei Cui, Hui Cao, Xi Zhang, and Chunchao Han

BioMed Research International, Volume 2018, Article ID 8174345, 11 pages

Received 6 December 2017; Revised 6 March 2018; Accepted 2 April 2018; Published 8 May 2018


Ginseng is a traditional Chinese medicine with a wide range of pharmacological activities. Ginsenosides are the major constituents of ginseng. Ginsenosides have the unique biological activity and medicinal value, such as antitumor, anti-infammatory, antioxidation, and inhibition of cell apoptosis. With the increase of stress in life, the incidence of nervous system diseases is also increasing. Neurological diseases pose a huge burden on people’s life and health. In recent years, some studies have shown that ginsenosides have a certain role in the prevention and treatment of neurological diseases. However, the research is still in its infancy, and the relevant mechanisms are complex. In the paper, we review the effects and mechanisms of ginsenosides on epilepsy, depression, cerebral ischemia reperfusion injury, Alzheimer’s disease, and Parkinson’s disease. We hope to provide a theoretical basis for the treatment of nervous system diseases by ginsenosides.

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Bridging the Gap Between Physical Health and Autism Spectrum Disorder

Regina SalaLorene AmetNatasa Blagojevic-StokicPaul Shattock, and Paul Whiteley

. 2020; 16: 1605–1618.
Published online 2020 Jun 30. doi: 10.2147/NDT.S251394


Autism spectrum disorder (ASD) is a highly complex and heterogeneous developmental disorder that affects how individuals communicate with other people and relate to the world around them. Research and clinical focus on the behavioural and cognitive manifestations of ASD, whilst important, have obscured the recognition that ASD is also commonly associated with a range of physical and mental health conditions. Many physical conditions appear with greater frequency in individuals with ASD compared to non-ASD populations. These can contribute to a worsening of social communication and behaviour, lower quality of life, higher morbidity and premature mortality. We highlight some of the key physical comorbidities affecting the immune and the gastrointestinal systems, metabolism and brain function in ASD. We discuss how healthcare professionals working with individuals with ASD and parents/carers have a duty to recognise their needs in order to improve their overall health and wellbeing, deliver equality in their healthcare experiences and reduce the likelihood of morbidity and early mortality associated with the condition.

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