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Razmerje esencialnih in toksičnih kovin pri otrocih s spektrom avtističnih motenj
ID Marinč, Anja (Author), ID Osredkar, Joško (Mentor) More about this mentor... This link opens in a new window

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Abstract
Spekter avtističnih motenj (SAM) spada med razvojno, pervazivno nevrološko-biološko motnjo. Za to motnjo so značilne težave z verbalno in neverbalno komunikacijo, motnje v socialnih stikih, nenavadne, ponavljajoče in zelo omejene spretnosti ter zanimanja. To pomeni prisotnost značilnega in posebnega vzorca vedenja pri bolnikih s SAM. Prav tako je pri bolnikih s SAM tudi izrazito zanimanje za specifično aktivnost. Etiologija SAM je zelo kompleksna. Posledica kompleksnosti je, da vzrok za nastanek SAM še vedno ni povsem pojasnjen, zaradi česar ga še vedno množično preiskujejo. Prevalenca SAM se spreminja in narašča iz leta v leto, zato se v zadnjem desetletju precej razlikuje glede na starejše podatke. Razmerje med dečki in deklicami je konstantno in se giblje med 2:1 in 6,5:1. Mnoge študije, ki so jih izvedli in objavili v zadnjih 50.-60. letih, so pokazale, da so odločilni genetski dejavniki za razvoj SAM. Danes se raziskave fokusirajo predvsem na okoljske dejavnike, ki vplivajo na razvoj SAM. Med raziskovane okoljske dejavnike spadajo infekcije, zdravila, cepiva. Eden najpomembnejši okoljskih dejavnikov so zagotovo elementi težkih kovin, ki se v človeškem organizmu pojavljajo kot elementi v sledovih. Med najbolj toksične elemente kovine spadajo živo srebro, svinec, aluminij, arzen in kadmij, ki povzročajo raznorazne poškodbe v organizmu. Kljub vsem raziskavam vzroki nastanka SAM ostajajo neznani. Kljub temu, da SAM spada med nevrobiološke motnje, njegova diagnostika temelji na zbiranju natančnih anamnestičnih podatkov o razvoju otroka na številnih zdravniški pregledih. Poleg zdravniških pregledov je opravljeno tudi psihološko testiranje in spremljanje otroka v različnih, v naprej pripravljenih situacijah. Biološkega testa ali specifičnega označevalca, kljub številnim raziskavam na tem področju, še nimamo. Odkritje le tega bi olajšalo diagnostiko bolezni ter omogočilo zgodnje vključevanje otrok v specifične terapevtske skupine, ki pripomorejo k boljšemu razvoju socialnih in komunikacijskih veščin ter tako omogočajo lažje vključevanje v družbo in nadaljnje življenje bolnikov. V naši študiji smo v skupino s spektrom avtističnih motenj vključili 141 otrok. V kontrolno skupino, ki je predstavljala zdrave otroke, pa je bilo vključenih 49 otrok. Starost otrok je bila med 2 in 18 let. Želeli smo ugotoviti in pokazati ali obstajajo statistično značilne razlike v koncentraciji esencialnih in toksičnih kovin izmerjenih v urinu oziroma podanih na gram kreatinina med skupino otrok s spektrom avtističnih motenj in kontrolno skupino zdravih otrok. Toksične in esencialne kovine v urinu smo določali z metodo masna spektrometrija z induktivno sklopljeno plazmo (ICP-MS). Naši rezultati kažejo, da ima skupina otrok s SAM višje vrednosti koncentracij večine toksičnih kovin podanih na kreatinin v urinu (aluminij, arzen, kadmij in živo srebro) kot kontrolna skupina zdravih otrok ter tudi višje koncentracije esencialnih kovin/kreatinin v urinu (litij, kalcij, krom, mangan, železo, kobalt, baker, cink in selen) kot kontrolna skupina zdravih otrok. Statistično značilna razlika med otroci s SAM in kontrolno skupino zdravih otrok se je pokazala samo pri toksičnih kovinah arzen in kadmij ter esencialnih kovinah magnezij, krom in baker. Kot zanimivost smo naredili tudi ločitev znotraj skupine s SAM in sicer na skupino otrok z avtizmom in skupino otrok z visoko funkcionalnim avtizmom oziroma Aspergerjevim sindromom. V raziskavi smo ugotovili, da ima skupina otrok z visoko funkcionalnim avtizmom v primerjavi s skupino otrok z avtizmom nižje koncentracije toksičnih in esencialnih kovin/kreatinin v urinu. Izjema je bila zgolj koncentracija kadmija/kreatinina v urinu, ki je bila pri otrocih z visoko funkcionalnim avtizmom višja kot pri otrocih z avtizmom. Statistično značilna razlika med otroci z avtizmom, otroci z visoko funkcionalnim avtizmom in kontrolno skupino zdravih otrok se je pokazala pri toksičnih kovinah aluminij in svinec ter esencialnih kovinah krom, mangan in baker, pri čemer je bila razlika dokazana pri vseh kovinah med otroci z visoko funkcionalnim avtizmom v primerjavi z zdravimi otroci. Razlika pa ni bila dokazana za nobeno kovino med otroci z avtizmom v primerjavi z zdravimi otroci. Statistično značilno razliko smo dokazali tudi med skupino otrok z visoko funkcionalnim avtizmom in skupino otrok z avtizmom za toksično kovino svinec in esencialni kovini krom in baker. Na osnovi rezultatov lahko zaključimo, da je med skupino otrok s SAM in kontrolno skupino zdravih otrok prišlo do določenih statistično značilnih razlik. Vzrok za razlike je lahko v vplivih okolja, vendar bi bilo za potrditev potrebno analizirati še prehranske navade, življenjsko okolje, potek nosečnosti in ostale parametre v okolju.

Language:Slovenian
Keywords:spekter avtističnih motenj, toksične kovine, esencialne kovine
Work type:Master's thesis/paper
Organization:FFA - Faculty of Pharmacy
Year:2021
PID:20.500.12556/RUL-131344 This link opens in a new window
Publication date in RUL:25.09.2021
Views:423
Downloads:65
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Secondary language

Language:English
Title:The ratio of essential and toxic metals in children with autism spectrum disorders
Abstract:
Autism spectrum disorder (ASD) belongs to the developmental, pervasive neurological-biological disorder. This disorder is characterized by problems with verbal and nonverbal communication, social interaction, unusual, repetitive and very limited interests and skills. This means that patients with ASD have a special and characteristic pattern of behavior, interest, and activity that manifest in very limited and different ways. The etiology of ASD is very complex and still unexplained up to this day, so the causes are still being intensively investigated. The prevalence of ASD is changing and growing from year to year. Over the past decade it has varied considerably depending on the older data. However the ration between boys and girls is constant and ranges between 2:1 and 6,5:1. many studies that have been conducted and published over the last 50. - 60. years, have demonstrated the decisive genetic factors for the development of ASD. Today, however, more and more research is focusing on the environmental factors that influence ASD development. Among the studied environmental factors include infections, drugs, vaccines. One of the most important environmental factors is certainly heavy metals, which appear in the organism as trace elements. Among the most toxic metals are mercury, lead, aluminium, arsenic and cadmium, which causes various injuries in the organism. Despite all the research, the cause of ASD remain unknown. Despite the fact that ASD is neurobiological disorder, its diagnosis is based on the collection of accurate anamnestic data on the development of the child at numerous doctors examinations, observation of the child in various situations, conditions and psychological testing. We do not yet have a biological test or a specific marker, despite a lot of research in this area. The discovery of this would facilitate the diagnosis of the disease and enable the early intervention. This would allow to include children to a specific therapeutic groups, which would contribute to the better development of social and communication skills and enable the integration into society, which would further to a better life of a patients. In our study, we included 141 children in the group with the ASD, and 49 children in the control group, which represented healthy children. The age of the children was between 2 and 18 years. We wanted to determine whether there were statistically significant differences in the concentration of essential and toxic metals measured in urine between children with ASD and the control group of healthy children. The results are presented according to the creatinine concentration for easier interpretation. Toxic and essential metals in urine were determined by inductively coupled plasma mass spectrometry (ICP-MS). Our results show that children with ASD has higher urinary concentrations of most toxic metals/creatinine (aluminium, arsenic, cadmium and mercury) than healthy children, as well as higher urinary concentrations of essential metals/creatinine (lithium, calcium, chromium ,manganese, iron, cobalt, copper, zinc and selenium) as a control group of healthy children. A statistically significant difference between children with ASD and healthy children was shown only for the toxic metals arsenic and cadmium, and the essential metals magnesium, chromium and copper. As an interesting fact, we also made a separation within the group with ASD, namely the group of children with autism and the group of children with high-functioning autism or Asperger's syndrome. The study show that children with high-functioning autism had lower urinry concentrations of toxic and essential metals/creatinin compared to children with autism. The only exception was the concentration of cadmium/creatinin in the urine, which was higher in children with high-functional autism than in children with autism. A statistically significant difference between children with autism, children with high-functioning autism and a control group of healthy children was shown in the toxic metals aluminium and lead and essential metals chromium, manganese and copper, with a difference in all mentioned metals between groups of children with high-functioning autism and a control group of healthy children. However, no difference was demonstrated for any metal between the groups of children with autism and the control group of healthy children. A statistically significant difference was also demonstrated between the children with high-functional autism and the children with autism for toxic metal lead and the essential metals chromium and copper. Based on the reaults, we can conclude that certain statistically significant differences occurred between the group of children with ASD and the control group of healthy children. The reason for the differences may be in the influences of the environment, but to confirm it would be necessary to analyze environmental factors such as dietary habits, living environment, the course of pregnancy and other parameters in the environment.

Keywords:autism spectrum disorder, toxic metals, essential metals

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