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Otizm spektrum bozukluğu olan çocuklarda IgA anti-endomisial antikor düzeylerinin değerlendirilmesi

Yıl 2025, Cilt: 24 Sayı: 2, 103 - 109, 20.08.2025
https://doi.org/10.17941/agd.1765324

Öz

Giriş ve Amaç: Çölyak hastalığı ile otizm spektrum bozukluğu arasındaki ilişki çelişkilidir. Bu çalışmada, otizm spektrum bozukluğu olan çocukların serum anti-endomisyum immünglobulin A antikor düzeylerini sağlıklı çocuklarla karşılaştırmayı amaçladık. Gastrointestinal şikâyetler ile anti-endomisyum immünglobulin A antikor düzeyleri arasındaki ilişki de incelendi. Gereç ve Yöntem: Çalışma ve kontrol olarak iki grup mevcut çalışmaya dâhil edildi. 2 ila 15 yaş aralığında otizm spektrum bozukluğu olan 85 çocuk çalışma grubuna ve 81 sağlıklı çocuk kontrol grubuna seçildi. Periferik venöz kan örnekleri sabah 9 ile 10 arasında toplandı. Serum anti-endomisyum immünglobulin A antikor düzeylerini ölçmek için ELISA kullanıldı. Çalışma grubundaki çocuklara otizm davranış kontrol listesi uygulandı. Bulgular: Çalışma grubu ve kontrol grubu için ortalama anti-endomisyum immünglobulin A antikor düzeyleri sırasıyla 212.8 ± 110.8 ng/ml ve 142.7 ± 98.4 ng/ml idi. Anti-endomisyum immünglobulin A antikor düzeyleri çalışma grubunda kontrol grubuna kıyasla anlamlı derecede yüksekti (p < 0.001). Gastrointestinal şikâyetlerin (örneğin ishal veya kabızlık) sıklığı çalışma grubunda anlamlı derecede yüksekti (p = 0.01). Otizm davranış kontrol listesi puanları, gastrointestinal şikâyetler ve anti-endomisyum immünglobulin A antikor düzeyleri arasında istatistiksel olarak anlamlı bir ilişki bulunmadı (p > 0.05). Çalışma grubunda yaş ile anti-endomisyum immünglobulin A antikor düzeyleri arasında negatif korelasyon tespit edildi. Sonuç: Otizm spektrum bozukluğu olan çocuklarda artmış anti-endomisyum immünglobulin A antikor düzeyleri ve gastrointestinal şikâyetler, gluten hassasiyetiyle ilgili gastrointestinal semptomları olan otizmli bireylerin çölyak hastalığı açısından değerlendirilmesinin uygun olabileceğini düşündürmektedir. Çölyak hastalığı ile otizm spektrum bozukluğu arasındaki kesin ilişkinin duodenal biyopsi ile desteklenmesi gerekir.

Kaynakça

  • 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; American Psychiatric Association: Arlington, VA, USA, 2013.
  • 2. Shaw KA, Williams S, Patrick ME, et al. Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years - Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022. MMWR Surveill Summ. 2025;74(2):1-22.
  • 3. Rubio-Tapia A, Hill ID, Kelly CP, et al; American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108(5):656-76; quiz 677.
  • 4. Jackson JR, Eaton WW, Cascella NG, Fasano A, Kelly DL. Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity. Psychiatr Q. 2011;83(1):91-102.
  • 5. Ludvigsson JF, Leffler DA, Bai JC, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62(1):43-52.
  • 6. Genuis SJ, Bouchard TP. Celiac Disease Presenting as Autism. J Child Neurol. 2010;25(1):114-9.
  • 7. Clappison E, Hadjivassiliou M, Zis P. Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis. Nutrients. 2020;12(1):142.
  • 8. Kanthi Y, Persley KM. Endomysial and Related Antibodies. In: Johnson LR, editor. Encyclopedia of Gastroenterology. New York: Elsevier, 2004.
  • 9. Husby S, Koletzko S, Korponay-Szabó IR,et al; ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. 2012;54(1):136-60. Erratum in: J Pediatr Gastroenterol Nutr. 2012;54(4):572.
  • 10. Gujral N, Freeman HJ, Thomson AB. Celiac disease: prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol. 2012;18(42):6036-59.
  • 11. Calderoni S, Santocchi E, Del Bianco T et al. Serological screening for Celiac Disease in 382 pre-schoolers with Autism Spectrum Disorder. Ital J Pediatr. 2016;42(1):98.
  • 12. Ludvigsson JF, Reichenberg A, Hultman C, Murray JA. A nationwide study of small intestinal histopathology and risk of autistic spectrum disorders. JAMA Psychiatry. 2013;70(11):1224-30.
  • 13. Krug D, Arick J, Almond P. Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. J Child Psychol Psychiatry. 1980;21:221-9.
  • 14. Irmak T, Sütçü S, Aydın A, Sorias O. An investigation of validity and reliability of Autism Behavior Checklist (ABC). Turk J Child Adolesc Mental Health. 2007;14:13-23.
  • 15. de Magistris L, Picardi A, Siniscalco D, et al. Antibodies against food antigens in patients with autistic spectrum disorders. Biomed Res Int. 2013;2013:729349.
  • 16. Lau NM, Green PHR, Taylor AK, et al. Markers of Celiac Disease and Gluten Sensitivity in Children with Autism. PLoS ONE. 2013;8(6):e66155.
  • 17. Donaldson MR, Firth SD, Wimpee H et al. Correlation of Duodenal Histology With Tissue Transglutaminase and Endomysial Antibody Levels in Pediatric Celiac Disease. Clin Gastroenterol Hepatol. 2007;5(5):567-73.
  • 18. Józefczuk J, Konopka E, Bierła JB, 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.
  • 19. Batista IC, Gandolfi L, Nobrega YKM, et al. Autism spectrum disorder and celiac disease: no evidence for a link. Arq Neuropsiquiatr. 2012;70(1):28-33.
  • 20. Zambrano S, Parma B, Morabito V, et al. Celiac disease in autism spectrum disorder: data from an Italian child cohort. Ital J Pediatr. 2023;49(1):79.
  • 21. Prosperi M, Santocchi E, Brunori E, et al. Prevalence and Clinical Features of Celiac Disease in a Cohort of Italian Children with Autism Spectrum Disorders. Nutrients. 2021;13(9):3046.
  • 22. Leader G, Abberton C, Cunningham S, et al. Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review. Nutrients. 2022;14(7):1471.
  • 23. Kral TVE, Eriksen WT, Souders MC, Pinto-Martin JA. Eating Behaviors, Diet Quality, and Gastrointestinal Symptoms in Children with Autism Spectrum Disorders: A Brief Review. J Pediatr Nurs. 2013;28(6):548-56.
  • 24. Kotze LM, Utiyama SR, Nisihara RM, de Camargo VF, Ioshii SO. IgA class anti-endomysial and anti-tissue transglutaminase antibodies in relation to duodenal mucosa changes in coeliac disease. Pathology. 2003;35(1):56-60.
  • 25. Bai D, Brar P, Holleran S, Ramakrishnan R, Green PHR. Effect of gender on the manifestations of celiac disease: Evidence for greater malabsorption in men. Scand J Gastroenterol. 2005;40(2):183-7.
  • 26. Croen LA, Najjar DV, Fireman B, Grether JK. Maternal and paternal age and risk of autism spectrum disorders. Arch Pediatr Adolesc Med. 2007;161(4):334-40.
  • 27. Daniels JL, Forssen U, Hultman CM, et al. Parental Psychiatric Disorders Associated with Autism Spectrum Disorders in the Offspring. Pediatrics. 2008;121(5):1357-62.
  • 28. Brietzke E, Cerqueira RO, Mansur RB, McIntyre RS. Gluten related illnesses and severe mental disorders: A comprehensive review. Neurosci. Biobehav. Rev. 2018;84:368-75.
  • 29. Lebwohl B, Haggard L, Emilsson L, et al. Psychiatric Disorders in Patients With a Diagnosis of Celiac Disease During Childhood From 1973 to 2016. Clin Gastroenterol Hepatol. 2021;19(10):2093-101.

Assessment of IgA anti-endomysial antibody levels in children with autism spectrum disorder

Yıl 2025, Cilt: 24 Sayı: 2, 103 - 109, 20.08.2025
https://doi.org/10.17941/agd.1765324

Öz

Background and Aims: The relationship between celiac disease and autism spectrum disorder is contradictory. In this study, we aimed to investigate the serum immunoglobulin A anti-endomysial antibody levels of children with autism spectrum disorder in comparison with those of healthy participants. The association between gastrointestinal symptoms and immunoglobulin A anti-endomysial antibody levels was also examined. Materials and Methods: We have included two main groups as study and control groups in the present study. Eighty five children with autism spectrum disorder ranging in age from 2 to 15 years were selected for the study group and 81 healthy children were selected for the control group. Peripheral venous blood samples were collected between 9 am and 10 am. ELISA was used to assay serum immunoglobulin A anti-endomysial antibody levels. Autism behavior checklist was applied to the children in the study group. Results: The mean immunoglobulin A anti-endomysial antibody levels for the study group and the control group were 212.8 ± 110.8 ng/ml and 142.7 ± 98.4 ng/ml, respectively. Immunoglobulin A anti-endomysial antibody levels were significantly higher in the study group compared to the control group (p < 0.001). The frequency of gastrointestinal complaints (e.g. diarrhea or constipation) were significantly higher in the study group (p = 0.01). No statistically significant relationship was found between autism behavior checklist scores, gastrointestinal symptoms and immunoglobulin A anti-endomysial antibody levels (p > 0.05). Age was found to be negatively correlated with immunoglobulin A anti-endomysial antibody levels in the study group. Conclusion: Increased immunoglobulin A anti-endomysial antibody levels and gastrointestinal complaints in children with autism spectrum disorder suggest that it may be appropriate to evaluate autistic individuals with gastrointestinal symptoms related to gluten sensitivity for celiac disease. The exact relationship between celiac disease and autism spectrum disorder needs to be supported by duodenal biopsy.

Kaynakça

  • 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; American Psychiatric Association: Arlington, VA, USA, 2013.
  • 2. Shaw KA, Williams S, Patrick ME, et al. Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years - Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022. MMWR Surveill Summ. 2025;74(2):1-22.
  • 3. Rubio-Tapia A, Hill ID, Kelly CP, et al; American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108(5):656-76; quiz 677.
  • 4. Jackson JR, Eaton WW, Cascella NG, Fasano A, Kelly DL. Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity. Psychiatr Q. 2011;83(1):91-102.
  • 5. Ludvigsson JF, Leffler DA, Bai JC, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62(1):43-52.
  • 6. Genuis SJ, Bouchard TP. Celiac Disease Presenting as Autism. J Child Neurol. 2010;25(1):114-9.
  • 7. Clappison E, Hadjivassiliou M, Zis P. Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis. Nutrients. 2020;12(1):142.
  • 8. Kanthi Y, Persley KM. Endomysial and Related Antibodies. In: Johnson LR, editor. Encyclopedia of Gastroenterology. New York: Elsevier, 2004.
  • 9. Husby S, Koletzko S, Korponay-Szabó IR,et al; ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. 2012;54(1):136-60. Erratum in: J Pediatr Gastroenterol Nutr. 2012;54(4):572.
  • 10. Gujral N, Freeman HJ, Thomson AB. Celiac disease: prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol. 2012;18(42):6036-59.
  • 11. Calderoni S, Santocchi E, Del Bianco T et al. Serological screening for Celiac Disease in 382 pre-schoolers with Autism Spectrum Disorder. Ital J Pediatr. 2016;42(1):98.
  • 12. Ludvigsson JF, Reichenberg A, Hultman C, Murray JA. A nationwide study of small intestinal histopathology and risk of autistic spectrum disorders. JAMA Psychiatry. 2013;70(11):1224-30.
  • 13. Krug D, Arick J, Almond P. Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. J Child Psychol Psychiatry. 1980;21:221-9.
  • 14. Irmak T, Sütçü S, Aydın A, Sorias O. An investigation of validity and reliability of Autism Behavior Checklist (ABC). Turk J Child Adolesc Mental Health. 2007;14:13-23.
  • 15. de Magistris L, Picardi A, Siniscalco D, et al. Antibodies against food antigens in patients with autistic spectrum disorders. Biomed Res Int. 2013;2013:729349.
  • 16. Lau NM, Green PHR, Taylor AK, et al. Markers of Celiac Disease and Gluten Sensitivity in Children with Autism. PLoS ONE. 2013;8(6):e66155.
  • 17. Donaldson MR, Firth SD, Wimpee H et al. Correlation of Duodenal Histology With Tissue Transglutaminase and Endomysial Antibody Levels in Pediatric Celiac Disease. Clin Gastroenterol Hepatol. 2007;5(5):567-73.
  • 18. Józefczuk J, Konopka E, Bierła JB, 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.
  • 19. Batista IC, Gandolfi L, Nobrega YKM, et al. Autism spectrum disorder and celiac disease: no evidence for a link. Arq Neuropsiquiatr. 2012;70(1):28-33.
  • 20. Zambrano S, Parma B, Morabito V, et al. Celiac disease in autism spectrum disorder: data from an Italian child cohort. Ital J Pediatr. 2023;49(1):79.
  • 21. Prosperi M, Santocchi E, Brunori E, et al. Prevalence and Clinical Features of Celiac Disease in a Cohort of Italian Children with Autism Spectrum Disorders. Nutrients. 2021;13(9):3046.
  • 22. Leader G, Abberton C, Cunningham S, et al. Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review. Nutrients. 2022;14(7):1471.
  • 23. Kral TVE, Eriksen WT, Souders MC, Pinto-Martin JA. Eating Behaviors, Diet Quality, and Gastrointestinal Symptoms in Children with Autism Spectrum Disorders: A Brief Review. J Pediatr Nurs. 2013;28(6):548-56.
  • 24. Kotze LM, Utiyama SR, Nisihara RM, de Camargo VF, Ioshii SO. IgA class anti-endomysial and anti-tissue transglutaminase antibodies in relation to duodenal mucosa changes in coeliac disease. Pathology. 2003;35(1):56-60.
  • 25. Bai D, Brar P, Holleran S, Ramakrishnan R, Green PHR. Effect of gender on the manifestations of celiac disease: Evidence for greater malabsorption in men. Scand J Gastroenterol. 2005;40(2):183-7.
  • 26. Croen LA, Najjar DV, Fireman B, Grether JK. Maternal and paternal age and risk of autism spectrum disorders. Arch Pediatr Adolesc Med. 2007;161(4):334-40.
  • 27. Daniels JL, Forssen U, Hultman CM, et al. Parental Psychiatric Disorders Associated with Autism Spectrum Disorders in the Offspring. Pediatrics. 2008;121(5):1357-62.
  • 28. Brietzke E, Cerqueira RO, Mansur RB, McIntyre RS. Gluten related illnesses and severe mental disorders: A comprehensive review. Neurosci. Biobehav. Rev. 2018;84:368-75.
  • 29. Lebwohl B, Haggard L, Emilsson L, et al. Psychiatric Disorders in Patients With a Diagnosis of Celiac Disease During Childhood From 1973 to 2016. Clin Gastroenterol Hepatol. 2021;19(10):2093-101.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Gastroenteroloji ve Hepatoloji
Bölüm Makaleler
Yazarlar

Hasan Bozkurt 0000-0002-5099-6833

Şeref Şimşek Bu kişi benim 0000-0003-0220-1204

Tuğba Yüksel Bu kişi benim

Yayımlanma Tarihi 20 Ağustos 2025
Gönderilme Tarihi 29 Haziran 2025
Kabul Tarihi 11 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 24 Sayı: 2

Kaynak Göster

APA Bozkurt, H., Şimşek, Ş., & Yüksel, T. (2025). Assessment of IgA anti-endomysial antibody levels in children with autism spectrum disorder. Akademik Gastroenteroloji Dergisi, 24(2), 103-109. https://doi.org/10.17941/agd.1765324

test-5