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Otizmli Çocuklarda Glutensiz Kazeinsiz Diyet: Oftalmik ve Davranışsal Belirtilerin Klinik Sonuçları

Yıl 2023, Sayı: 21, 828 - 842, 05.01.2024
https://doi.org/10.38079/igusabder.1378810

Öz

Amaç: Otizm spektrum bozukluğunda (ASD) glutensiz kazeinsiz diyetin (GCFD) oftalmik ve davranışsal etkilerini değerlendirmektir.
Yöntem: Çalışma Kasım 2020'den Ocak 2023'e kadar gerçekleştirildi. Kornea refleksi, gözbebeği büyüklüğü, vücut kitle indeksi (BMI), ağırlık, Otistik Bozukluk İndeksi, İletişim, Sosyal Etkileşim ve Stereotip Davranış üzerinde GCFD'nin 8 haftalık bir klinik çalışması yapıldı.
Bulgular: Çalışmaya toplamda 30 çocuk dahil edildi. GCFD, BKİ'yi [%95 CI 4,8895 ile -2,1305 (P < 0,0001)], ağırlığı [%95 CI -8,5153 ila -0,0647 (P = 0,0467)], Otistik Bozukluk İndeksini [%95 CI -28.0359 to -16.2841 (P < 0.0001)], İletişim [%95 CI 3,3325 ila -1,6675 (P < 0,0001)], Sosyal etkileşim [%95 CI -4,3190 ila -2,4010 (P < 0,0001)] ve Stereotip Davranışı [%95 CI -2,3939 ila -0,2461 (P =0,01)] önemli ölçüde azalttı. GCFD ayrıca soldaki [%95 CI -2,2421 ila -1,6779 (P <0,0001)] ve sağ gözbebeği boyutunu [%95 CI -2,2999 ila -1,7201 (P <0,0001)] önemli ölçüde azalttı. Tersine, kornea refleksi önemli ölçüde arttı (%95 CI 0,2159 - 2,1241 (P = 0,01)). IPD için hiçbir fark gözlenmedi.
Sonuç: Bu çalışma, GCFD'nin OSB davranışlarını etkili bir şekilde kontrol edebileceğini ve ayrıca gözbebeği boyutu ve kornea refleksi gibi oftalmik belirteçlerle ilgili otonomik işlevleri düzenleyebileceğini göstermiştir ancak daha fazla araştırmaya ihtiyaç vardır.

Etik Beyan

Üsküdar University The Human Ethics Committee approved the protocol (number:61351342/2021-526, date: 26.11.2020). Informed consent was obtained from all participants and their parents. This study was conducted within the framework of the World Medical Association ethical rules.

Destekleyen Kurum

Üsküdar University and Dünya Bursa Göz Hospital

Teşekkür

The authors thankful for the financial support to Üsküdar University and Dünya Bursa Göz Hospital

Kaynakça

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The Gluten-Casein-Free Diet in Children with Autism: A Clinical Results of the Ophthalmic and Behavioral Manifestations

Yıl 2023, Sayı: 21, 828 - 842, 05.01.2024
https://doi.org/10.38079/igusabder.1378810

Öz

Aim: To evaluate the ophthalmic and behavioral effects of a gluten-free casein-free diet (GCFD) in autism spectrum disorder (ASD).
Method: The study was conducted from November 2020 to January 2023. We designed an 8-week clinical trial of GCFD on corneal reflex, pupil size, body mass index (BMI), weight, Autistic Disorder Index, Communication, Social interaction, and Stereotype Behavior.
Results: A total of thirty participants completed the trial. GCFD reduced BMI [%95 CI -4.8895 to -2.1305 (P < 0.0001)], weight [%95 CI -8.5153 to -0.0647 (P = 0.0467)], Autistic Disorder Index [%95 CI -28.0359 to -16.2841 (P < 0.0001)], Communication [%95 CI -3.3325 to -1.6675 (P < 0.0001)], Social Interaction [%95 CI -4.3190 to -2.4010 (P < 0.0001)], and Stereotype Behavior [%95 CI -2.3939 to -0.2461 (P =0.01)] significantly. GCFD also reduced left [%95 CI -2.2421 to -1.6779 (P <0.0001)] and right pupil size [%95 CI -2.2999 to -1.7201 (P <0.0001)] significantly. Conversely, corneal reflex was significantly increased [95% CI 0.2159 to 2.1241 (P = 0.01)]. No differences were observed for IPD.
Conclusion: This study suggested that the GCFD can effectively control ASD behaviors as well as regulate autonomic functions related to ophthalmic markers such as pupil size and corneal reflex, but more research is needed.

Kaynakça

  • 1. Lai MC, Lombardo MV, Baron-Cohen S. Autism. The Lancet. 2014;383:896-910. doi: 10.1016/S0140-6736(13)61539-1.
  • 2. Mayer EA, Padua D, Tillisch K. Altered brain-gut axis in autism: Comorbidity or causative mechanisms? Bioessays. 2014;36(10):933–939. doi: 10.1002/bies.201400075.
  • 3. Dhaliwal KK, Orsso CE, Richard C, Haqq AM, Zwaigenbaum L. Risk factors for unhealthy weight gain and obesity among children with autism spectrum disorder. Int J Mol Sci. 2019;20(13):3285. doi: 10.3390/ijms20133285.
  • 4. Bandini LG, Curtin C, Phillips S, Anderson SE, Maslin M, Must A. Changes in food selectivity in children with autism spectrum disorder. J Autism Dev Disord. 2017;47(2):439–446. doi: 10.1007/s10803-016-2963-6.
  • 5. Maneeton N, Maneeton B, Putthisri S, Woottiluk P, Narkpongphun A, Srisurapanont M. Risperidone for children and adolescents with autism spectrum disorder: A systematic review. Neuropsychiatr Dis Treat. 2018;14:1811–1820. doi: 10.2147/NDT.S151802.
  • 6. Kang DW, Park JG, Ilhan ZE, et al. Reduced incidence of Prevotella and other fermenters in intestinal microflora of autistic children. PloS one. 2013;8(7):e68322. doi: 10.1371/journal.pone.0068322.
  • 7. Navarro F, Pearson DA, Fatheree N, Mansour R, Hashmi SS, Rhoads JM. Are 'leaky gut' and behavior associated with gluten and dairy containing diet in children with autism spectrum disorders? Nutr Neurosci. 2015;18(4):177–185. doi: 10.1179/1476830514Y.0000000110.
  • 8. Marí-Bauset S, Zazpe I, Mari-Sanchis A, Llopis-González A, Morales-Suárez-Varela M. Evidence of the gluten-free and casein-free diet in autism spectrum disorders: A systematic review. J Child Neurol. 2014;29(12):1718–1727. doi: 10.1177/0883073814531330.
  • 9. Priyatna A. Amazing Autisme. Jakarta: Elex Media Kompetindo. 2010. https://opac.perpusnas.go.id/DetailOpac.aspx?id=141789. Accessed September 29, 2023.
  • 10. Bandini LG, Anderson SE, Curtin C, et al. Food selectivity in children with autism spectrum disorders and typically developing children. J Pediatr. 2010;157(2):259–264. doi: 10.1016/j.jpeds.2010.02.013.
  • 11. Dinan TG, Cryan JF. Regulation of the stress response by the gut microbiota: Implications for psychoneuroendocrinology. Psychoneuroendocrinology. 2012;37(9):1369–1378. doi: 10.1016/j.psyneuen.2012.03.007.
  • 12. Ciéslińska A, Kostyra E, Savelkoul HFJ. Treating autism spectrum disorder with gluten-free and casein-free diet: The underlying microbiota-gutbrain axis mechanisms. HSOA J Clin Immunol Immunotherapy. 2017;3(1):9-19.
  • 13. Alamri ES. Efficacy of gluten- and casein-free diets on autism spectrum disorders in children. Saudi Med J. 2020;41(10):1041-1046. doi: 10.15537/smj.2020.10.25308.
  • 14. Piwowarczyk A, Horvath A, Łukasik J, Pisula E, Szajewska H. Gluten- and casein-free diet and autism spectrum disorders in children: A systematic review. Eur J Nutr. 2018;57(2):433-440. doi: 10.1007/s00394-017-1483-2.
  • 15. Alpern M, Mccready DW, Jr Barr. The dependence of the photopupil response on flash duration and intensity. J Gen Physiol. 1963;47(2):265–278. doi: 10.1085/jgp.47.2.265.
  • 16. Lowenstein O, Loewenfeld IE. The pupil: Anatomy, Physiology, and Clinical Applications. Detroit: Iowa State University Press, Ames and Wayne State University Press.1993.https://www.scirp.org/(S(351jmbntvnsjt1aadkozje))/reference/referencespapers.aspx?referenceid=2071826. Accessed September 29, 2023.
  • 17. Sahraie A, Barbur JL. Pupil response triggered by the onset of coherent motion. Graefes Arch Clin Exp Ophthalmol. 1997;235(8):494–500. doi: 10.1007/BF00947006.
  • 18. Ellis CJ. The pupillary light reflex in normal subjects. Br J Ophthalmol. 1981;65(11):754–759. doi: 10.1136/bjo.65.11.754.
  • 19. Lobato-Rincón LL, Cabanillas-Campos Mdel C, Bonnin-Arias C, Chamorro-Gutiérrez E, Murciano-Cespedosa A, Sánchez-Ramos Roda C. Pupillary behavior in relation to wavelength and age. Front Hum Neurosci. 2014;8:221. doi: 10.3389/fnhum.2014.00221.
  • 20. Ly V, Bottelier M, Hoekstra PJ, Arias Vasquez A, Buitelaar JK, Rommelse NN. Elimination diets' efficacy and mechanisms in attention deficit hyperactivity disorder and autism spectrum disorder. Eur Child Adolesc Psychiatry. 2017;26(9):1067–1079. doi: 10.1007/s00787-017-0959-1.
  • 21. Laeng B, Ørbo M, Holmlund T, Miozzo M. Pupillary stroop effects. Cogn Process. 2011;12(1):13–21. doi: 10.1007/s10339-010-0370-z.
  • 22. Nassar MR, Rumsey KM, Wilson RC, Parikh K, Heasly B, Gold JI. Rational regulation of learning dynamics by pupil-linked arousal systems. Nat. Neurosci. 2012;15(7):1040–1046. doi: 10.1038/nn.3130.
  • 23. DiCriscio AS, Troiani V. Pupil adaptation corresponds to quantitative measures of autism traits in children. Sci Rep. 2017;7:6476 doi: 10.1038/s41598-017-06829-1.
  • 24. Daluwatte C, Miles JH, Sun J, Yao G. Association between pupillary light reflex and sensory behaviors in children with autism spectrum disorders. Res Dev Disabil. 2015;37:209–215. doi: 10.1016/j.ridd.2014.11.019.
  • 25. Lynch G. Using pupillometry to assess the atypical pupillary light reflex and LC-NE system in ASD. Behav Sci. 2018;2(11):108. doi: 10.3390/bs8110108.
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Toplam 66 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Beslenme
Bölüm Makaleler
Yazarlar

Öznur Özge Özcan 0000-0001-8992-0556

İbrahim Şahbaz 0000-0002-5934-5367

Emre Taşdöndüren 0000-0002-0728-788X

Mesut Karahan 0000-0002-8971-678X

Erken Görünüm Tarihi 8 Ocak 2024
Yayımlanma Tarihi 5 Ocak 2024
Gönderilme Tarihi 20 Ekim 2023
Kabul Tarihi 11 Aralık 2023
Yayımlandığı Sayı Yıl 2023 Sayı: 21

Kaynak Göster

JAMA Özcan ÖÖ, Şahbaz İ, Taşdöndüren E, Karahan M. The Gluten-Casein-Free Diet in Children with Autism: A Clinical Results of the Ophthalmic and Behavioral Manifestations. IGUSABDER. 2024;:828–842.

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