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Review Articles

The opioid excess theory in autism spectrum disorders - is it worth investigating further?

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References

  • Adams, J. B., T. Audhya, E. Geis, E. Gehn, V. Fimbres, E. L. Pollard, J. Mitchell, J. Ingram, R. Hellmers, D. Laake, et al. 2018. Comprehensive nutritional and dietary intervention for autism spectrum disorder—A randomized, controlled 12-month trial. Nutrients 10 (3):369. doi: 10.3390/nu10030369.
  • Adams, L., and S. Conn. 1997. Nutrition and its relationship to autism. Focus on Autism and Other Developmental Disabilities 12 (1):53–8. doi: 10.1177/108835769701200107.
  • Almari, E. S. 2021. Efficacy of gluten- and casein-free diets on autism spectrum disorders in children. Saudi Medical Journal 41 (10):1041–6. doi: 10.15537/smj.2020.10.25308.
  • American Psychiatric Association. 2013. Autism spectrum disorder. In Diagnostic and statistical manual of mental disorders, 50th ed. Washington, DC: American Psychiatric Publishing.
  • Andreo-Martínez, P., N. García-Martínez, E. P. Sánchez-Samper, and A. E. Martínez-González. 2020. An approach to gut microbiota profile in children with autism spectrum disorder. Environmental Microbiology Reports 12 (2):115–35. doi: 10.1111/1758-2229.12810.
  • Baranek, G. T. 1999. Autism during infancy: A retrospective video analysis of sensory-motor and social behaviors at 9-12 months of age. Journal of Autism and Developmental Disorders 29 (3):213–24. 10.1023/A:1023080005650
  • Bashir, S., and L. Al-Ayadhi. 2014. Alterations in plasma dipeptidyl peptidase IV in autism: A pilot study. Neurology, Psychiatry and Brain Research 20 (2):41–4. doi: 10.1016/j.npbr.2014.03.001.
  • Baspinar, B., and H. Yardimci. 2020. Gluten-free casein-free diet for autism spectrum disorders: Can it be effective in solving behavioural and gastrointestinal problems? The Eurasian Journal of Medicine 52 (3):292–7. doi:10.5151/eurasianjmed.2020.19230
  • Bilgiç, A., A. Cöngöloğlu, S. Hergüner, S. Türkoğlu, K. Bahali, K. Gürkan, İ. Durukan, and T. Türkbay. 2013. Use of complementary and alternative medicine in children with autism spectrum disorders: A multicenter study. Noro Psikiyatri Arsivi 50 (3):237–43. doi: 10.4274/Npa.y6389.
  • Boukthir, S., N. Matoussi, A. Belhadj, S. Mammou, S. B. Dlala, M. Helayem, F. Rocchiccioli, S. Bouzaidi, and M. Abdennebi. 2010. Abnormal intestinal permeability in children with autism. La Tunisie Medicale 88 (9):685–6.
  • Bouvard, M. P., M. Leboyer, J. M. Launay, C. Recasens, M. H. Plumet, D. Waller-Perotte, F. Tabuteau, D. Bondoux, M. Dugas, P. Lensing, et al. 1995. Low-dose naltrexone effects on plasma chemistries and clinical symptoms in autism: A double-blind, placebo-controlled study. Psychiatry Research 58 (3):191–201. doi: 10.1016/0165-1781(95)02601-R.
  • Brudnak, M. A., B. Rimland, B. Kerry, R. E. Dailey, M. Taylor, R. Stayton, B. F. Waickman, M. Waickman, J. Pangborn, and I. Buchholz. 2002. Enzyme-based therapy for autism spectrum disorders - is it worth another look? Medical Hypotheses 58 (5):422–8. doi: 10.1054/mehy.2001.1513.
  • Buie, T. 2013. The relationship of autism and gluten. Clinical Therapeutics 35 (5):578–83. doi: 10.1016/j.clinthera.2013.04.011ER
  • Cade, R., M. Privette, M. Fregly, N. Rowland, Z. Sun, V. Zele, H. Wagemaker, and C. Edelstein. 2000. Autism and schizophrenia: Intestinal disorders. Nutritional Neuroscience 3 (1):57–72. doi: 10.1080/1028415X.2000.11747303.
  • Caio, G., U. Volta, F. Tovoli, and R. De Giorgio. 2014. Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity. BMC Gastroenterology 14:26. doi: 10.1186/1471-230X-14-26.
  • Cass, H., P. Gringras, J. March, I. McKendrick, A. E. O’Hare, L. Owen, and C. Pollin. 2008. Absence of urinary opioid peptides in children with autism. Archives of Disease in Childhood 93 (9):745–50. doi: 10.1136/adc.2006.114389.
  • Cazzullo, A. G., M. C. Musetti, L. Musetti, S. Bajo, P. Sacerdote, and A. Panerai. 1999. Beta-endorphin levels in peripheral blood mononuclear cells and long-term naltrexone treatment in autistic children. European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology 9 (4):361–6. doi: 10.1016/S0924-977X(99)00010-3.
  • Cekici, H., and N. Sanlier. 2019. Current nutritional approaches in managing autism spectrum disorder: A review. Nutritional Neuroscience 22 (3):145–55. doi: 10.1080/1028415X.2017.1358481.
  • Christison, G. W., and K. Ivany. 2006. Elimination diets in autism spectrum disorders: Any wheat amidst the chaff? Journal of Developmental and Behavioral Pediatrics: JDBP 27 (2 Suppl):S162–S71. doi: 10.1097/00004703-200604002-00015.
  • Cieślińska, A., E. Kostyra, and H. F. J. Savelkoul. 2017. Treating autism spectrum disorder with gluten-free and casein-free diet: The underlying microbiota-gut-brain axis mechanisms. Journal of Clinical Immunology & Immunotherapy 3:009. doi: 10.24966/CIIT-8844/10000.
  • Cieślińska, A., E. Sienkiewicz-Szłapka, J. Wasilewska, E. Fiedorowicz, B. Chwała, M. Moszyńska-Dumara, T. Cieśliński, M. Bukało, and E. Kostyra. 2015. Influence of candidate polymorphisms on the dipeptidyl peptidase IV and µ-opioid receptor genes expression in aspect of the β-casomorphin-7 modulation functions in autism. Peptides 65:6–11. doi: 10.1016/j.peptides.2014.11.012.
  • Costanzo, V., N. Chericoni, F. A. Amendola, L. Casula, F. Muratori, M. L. Scattoni, and F. Apicella. 2015. Early detection of autism spectrum disorders: From retrospective home video studies to prospective “‘high risk’ sibling studies”. Neuroscience and Biobehavioral Reviews 55:627–35. doi: 10.1016/j.neubiorev.2015.06.006.
  • Croall, I. D., N. Hoggard, and M. Hadjivassiliou. 2021. Gluten and autism spectrum disorder. Nutrients 13 (2):572. 10.3390/nu113020572 doi: 10.3390/nu13020572.
  • Çӧpür, M., and S. Çӧpür. 2017. Autism spectrum disorders and gluten/casein diet treatment: A systematic review (1990-2016). International Journal of Nutrition 2 (4):7–19. doi: 10.14302/issn.2379-.7835.ijn-17-1710
  • Dalton, N., S. Chandler, C. Turner, T. Charman, A. Pickles, T. Loucas, E. Simonoff, P. Sullivan, and G. Baird. 2014. Gut permeability in autism spectrum disorders. Autism Research: Official Journal of the International Society for Autism Research 7 (3):305–13. doi: 10.1002/aur.1350.
  • De Angelis, M., M. Piccolo, L. Vannini, S. Siragusa, A. De Giacomo, D. I. Serrazzanetti, F. Cristofori, M. E. Guerzoni, M. Gobbetti, and R. Francavilla. 2013. Fecal microbiota and metabolome of children with autism and pervasive developmental disorder not otherwise specified. PLoS One. 98 (10):e76993. doi: 10.1371/journal.pone.0076993.
  • de Magistris, L., V. Familiari, A. Pascotto, A. Sapone, A. Frolli, P. Iardino, M. Carteni, M. De Rosa, R. Francavilla, G. Riegler, et al. 2010. Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives. Journal of Pediatric Gastroenterology and Nutrition 51 (4):418–24. doi: 10.1097/MPG.0b013e3181dcc4a5.
  • Dettmer, K., D. Hanna, P. Whetstone, R. Hansen, and B. D. Hammock. 2007. Autism and urinary exogenous neuropeptides: Development of an on-line SPE-HPLC-tandem mass spectrometry method to test the opioid excess theory. Analytical and Bioanalytical Chemistry 388 (8):1643–51. doi: 10.1007/s00216-007-1301-4.
  • D’Eufemia, P., M. Celli, R. Finocchiaro, L. Pacifico, L. Viozzi, M. Zaccagnini, E. Cardi, and O. Giardini. 1996. Abnormal intestinal permeability in children with autism. Acta Paediatrica 85 (9):1076–9. doi: 10.1111/j.1651-2227.1996.tb14220.x.
  • Drago, S., R. El Asmar, M. Di Pierro, M. Grazia Clemente, A. Tripathi, A. Sapone, M. Thakar, G. Iacono, A. Carroccio, C. D’Agate, et al. 2006. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scandinavian Journal of Gastroenterology 41 (4):408–19. doi: 10.1080/00365520500235334.
  • El-Alameey, I. R., H. H. Ahmed, I. M. Eid, G. El-Dory, and M. Gameel. 2018. Relationship of serum dipeptidyl peptidase IV activity and anti-casein antibodies to gastrointestinal symptoms among children with autism spectrum disorder: An Egyptian study. Asian Journal of Pharmaceutical and Clinical Research 11 (4):370–4. doi: 10.22159/ajpcr.2018.v11i4.22627.
  • Elder, J. H. 2008. The gluten-free, casein-free diet in autism: An overview with clinical implications. Nutrition in Clinical Practice: Official Publication of the American Society for Parenteral and Enteral Nutrition 23 (6):583–8. doi: 10.1177/0884533608326061.
  • Elder, J. H., C. M. Kreider, N. M. Schaefer, and M. B. de Laosa. 2015. A review of gluten- and casein-free diets for treatment of autism: 2005-2015. Nutrition and Dietary Supplements 7:87–101. doi: 10.2147/NDS.S74718.
  • Elder, J. H., M. Shankar, J. Shuster, D. Theriaque, S. Burns, and L. Sherrill. 2006. The gluten-free, casein-free diet in autism: Results of a preliminary double blind clinical trial. Journal of Autism and Developmental Disorders 36 (3):413–20. doi: 10.1007/s10803-006-0079-0.
  • El-Rashidy, O., F. El-Baz, Y. El-Gendy, R. Khalaf, D. Reda, and K. Saad. 2017. Ketogenic diet versus gluten free casein free diet in autistic children: A case-control study. Metabolic Brain Disease 32 (6):1935–41. doi:10.1007/s11011-017-088-z
  • Emond, A., P. Emmett, C. Steer, and J. Golding. 2010. Feeding symptoms, dietary patterns, and growth in young children with autism spectrum disorders. Pediatrics 126 (2):e337–42. doi: 10.1542/peds.2009-2391.
  • Ernst, M., L. Devi, R. R. Silva, N. M. Gonzalez, A. M. Small, R. P. Malone, and M. Campbell. 1993. Plasma beta-endorphin levels, naltrexone, and haloperidol in autistic children. Psychopharmacology Bulletin 29 (2):221–7.
  • Esnafoglu, E., S. Cirrik, S. N. Ayyıldız, A. Erdil, E. Y. Ertürk, A. Daglı, and T. Noyan. 2017. Increased serum zonulin levels as an intestinal permeability marker in autistic subjects. The Journal of Pediatrics 188:240–4. doi: 10.1016/j.jpeds.2017.04.004.
  • Fasano, A. 2012. Zonulin, regulation of tight junctions, and autoimmune diseases. Annals of the New York Academy of Sciences 1258 (1):25–33. doi: 10.1111/j.1749-6632.2012.06538.x.
  • Fields, M., and P. Fields. 1976. The relationship between problem behavior and food allergies: One family’s story. Journal of Autism and Childhood Schizophrenia 6 (1):75–91. doi: 10.1007/BF01537945.
  • Frenssen, F., J. Croonenberghs, H. Van den Steene, and M. Maes. 2015. Prolyl endopeptidase and dipeptidyl peptidase IV are associated with externalizing and aggressive behaviors in normal and autistic adolescents. Life Sciences 136:157–62. doi: 10.1016/j.lfs.2015.07.003.
  • Gannage, J. 2010. Integrative autism treatment: Foretelling medicine’s future. Journal of Orthomolecular Medicine 25 (4):166–8.
  • Garon, L., S. E. Bryson, L. Zwaigenbaum, I. M. Smith, J. Brian, W. Roberts, and P. Szatmari. 2009. Temperament and its relationship to autistic symptoms in a high-risk infant sib cohort. Journal of Abnormal Child Psychology 37 (1):59–78. doi: 10.1007/s10802-008-9258-0.
  • Genuis, S. J., and T. P. Bouchard. 2010. Celiac disease presenting as autism. Journal of Child Neurology 25 (1):114–9. doi: 10.1177/0883073809336127.
  • Ghalichi, F., J. Ghaemmaghami, A. Malek, and A. Ostadrahimi. 2016. Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: A randomized clinical trial. World Journal of Pediatrics 12 (4):436–42. doi: 10.1007/s12519-016-0040-z.
  • Gillberg, C., L. Terenius, B. Hagberg, I. Witt-Engerstrom, and I. Eriksson. 1990. CSF beta-endorphins in childhood neuropsychiatric disorders. Brain & Development 12 (1):88–92. doi: 10.1016/S0387-7604(12)80185-9.
  • Gillberg, C., L. Terenius, and G. Lonnerholm. 1985. Endorphin activity in childhood psychosis. Spinal fluid levels in 24 cases. Archives of General Psychiatry 42 (8):780–3. doi: 10.1001/archpsyc.1985.01790310042005.
  • González-Domenech, P. J., F. D. Atienza, C. G. Pablos, M. L. F. Soto, J. M. Martinez-Ortega, and L. Gutiérrez-Rojas. 2020. Influence of a combined gluten-free and casein-free diet on behavior disorders in children and adolescents diagnosed with autism spectrum Disorder: A 12-month follow-up clinical trial . Journal of Autism and Developmental Disorders 50 (3):935–48. doi: 10.1007/s10803-019-04333-1.
  • Hafid, A., and A. O. T. Ahami. 2018. The efficacy of the gluten-free casein-free diet for Moroccan autistic children. Current Research in Nutrition and Food Science Journal 6 (3):734–41. doi: 10.12944/CRNFSJ.6.3.15.
  • Hall, S. E., and C. A. Riccio. 2012. Complementary and alternative treatment use for autism spectrum disorders. Complementary Therapies in Clinical Practice 18 (3):159–63. doi: 10.1016/j.ctcp.2012.03.004.
  • Harris, C., and B. Card. 2012. A pilot study to evaluate nutritional influences on gastrointestinal symptoms and behavior patterns in children with autism spectrum disorder. Complementary Therapies in Medicine 20 (6):437–40. doi: 10.1016/j.ctim.2012.08.004.
  • Herbert, M. R., and J. A. Buckley. 2013. Autism and dietary therapy: Case report and review of the literature. Journal of Child Neurology 28 (8):975–82. doi: 10.1177/0883073813488668.
  • Horvath, K., R. H. Zielke, R. M. Collins, A. Rabsztyn, L. A. Mederios, and J. Perman. 2000. Secretin improves intestinal permeability in autistic children. Journal of Pediatric Gastroenterology and Nutrition 31 (Suppl. 2):S30–S31.
  • Hsu, C. L., C. Y. Lin, C. L. Chen, C. M. Wang, and M. K. Wong. 2009. The effects of a gluten and casein-free diet in children with autism: A case report. Chang Gung Medical Journal 32 (4):459–65.
  • Hunter, L. C., A. O’Hare, W. J. Herron, L. A. Fisher, and G. E. Jones. 2003. Opioid peptides and dipeptidyl peptidase in autism. Developmental Medicine and Child Neurology 45 (2):121–8. 10.1017/S0012162203000227 doi: 10.1111/j.1469-8749.2003.tb00915.x.
  • Hurwitz, S. 2013. The gluten-free, casein-free diet and autism: Limited return on family investment. Journal of Early Intervention 35 (1):3–19. doi: 10.1177/1053815113484807.
  • Hyman, S. L., P. A. Stewart, J. Foley, U. Cain, R. Peck, D. D. Morris, H. Wang, and T. Smith. 2016. The gluten-free/casein-free diet: A double-blind challenge trial in children with autism. Journal of Autism and Developmental Disorders 46 (1):205–20. doi: 10.1007/s10803-015-2564-9.
  • Iovene, M. R., F. Bombace, R. Maresca, A. Sapone, P. Iardino, A. Picardi, R. Marotta, C. Schiraldi, D. Siniscalco, N. Serra, et al. 2017. Intestinal dysbiosis and yeast isolation in stool of subjects with autism spectrum disorders. Mycopathologia 182 (3–4):349–63. doi: 10.1007/s11046-016-0068-6.
  • Jarmołowska, B., M. Bukało, E. Fiedorowicz, A. Cieślińska, N. K. Kordulewska, M. Moszyńska, A. Świątecki, and E. Kostyra. 2019. Role of milk-derived opioid peptides and proline dipeptidyl peptidase-4 in Autism spectrum disorders. Nutrients 11 (1):87. doi: 10.3390/nu11010087.
  • Johnson, C. R., B. L. Handen, M. Zimmer, K. Sacco, and K. Turner. 2011. Effects of gluten free/casein free diet in young children with autism: A pilot study. Journal of Developmental and Physical Disabilities 23 (3):213–25. doi: 10.1007/s10882-010-9217-x.
  • Jones, W., and A. Klin. 2013. Attention to eyes is present but in decline in 2-6-month-old infants later diagnosed with autism . Nature 504 (7480):427–31. doi: 10.1038/nature12715.
  • Józefczuk, J., E. Konopka, J. B. Bierła, I. Trojanowska, A. Sowińska, R. Czarnecki, L. Sobol, P. Józefczuk, W. Surdy, and B. Cukrowska. 2018. The occurrence of antibodies against gluten in children with autism spectrum disorders does not correlate with serological markers of impaired intestinal permeability. Journal of Medicinal Food 21 (2):181–7. doi: 10.1089/jmf.2017.0069.
  • Karmel, B. Z., J. M. Gardner, L. S. Meade, I. L. Cohen, E. London, M. J. Flory, E. M. Lennon, I. Miroshnichenko, S. Rabinowitz, S. Parab, et al. 2010. Early medical and behavioral characteristics of NICU infants later classified with ASD. Pediatrics 126 (3):457–67. doi: 10.1542/peds.2009-2680.
  • Klaveness, J., J. Bigam, and K. L. Reichelt. 2013. The varied rate of response to dietary intervention in autistic children. Open Journal of Psychiatry 3 (2):56–60. 10.4236/ojpsych.2013.32A009 doi: 10.4236/ojpsych.2013.32A009.
  • Klein, N., and K. J. Kemper. 2016. Integrative approaches to caring for children with autism. Current Problems in Pediatric and Adolescent Health Care 46 (6):195–201. doi: 10.1016/j.cppeds.2015.12.004.
  • Knivsberg, A. M., K. L. Reichelt, T. Hoien, and M. Nødland. 2002. A randomised, controlled study of dietary intervention in autistic syndromes. Nutritional Neuroscience 5 (4):251–61. doi: 10.1080/10284150290028945.
  • Knivsberg, A.‐M., K. L. Reichelt, M. Nødland, and T. Høien. 1995. Autistic syndromes and diet: A follow-up study. Scandinavian Journal of Educational Research 39 (3):223–36. doi: 10.1080/0031383950390304.
  • Knivsberg, A. M., K. L. Reichelt, and M. Nødland. 1999. Dietary intervention for a seven year old girl with autistic behaviour. Nutritional Neuroscience 2 (6):435–9. doi: 10.1080/1028415X.1999.11747297.
  • Knivsberg, A. M., K. Wiig, G. Lind, M. Nødland, and K. L. Reichelt. 1990. Dietary intervention in autistic syndromes. Brain Dysfunction 3 (5–6):315–27.
  • Kushak, R. I., T. M. Buie, K. F. Murray, D. S. Newburg, C. Chen, E. Nestoridi, and H. S. Winter. 2016. Evaluation of intestinal function in children with autism and gastrointestinal symptoms. Journal of Pediatric Gastroenterology and Nutrition 62 (5):687–91. doi: 10.1097/MPG.0000000000001174.
  • Langhendries, J. P., J. Detry, J. Van Hees, J. M. Lamboray, J. Darimont, M. J. Mozin, M. C. Secretin, and J. Senterre. 1995. Effect of a fermented infant formula containing viable bifidobacteria on the fecal flora composition and pH of healthy full-term infants. Journal of Pediatric Gastroenterology and Nutrition 21 (2):177–81. doi: 10.1097/00005176-199508000-00009.
  • Leboyer, M., M. P. Bouvard, C. Recasens, A. Philippe, M. Guilloud-Bataille, D. Bondoux, F. Tabuteau, M. Dugas, J. Panksepp, and J. M. Launay. 1994. Difference between plasma N- and C-terminally directed beta-endorphin immunoreactivity in infantile autism. The American Journal of Psychiatry 151 (12):1797–801. doi: 10.1176/ajp.151.12.1797.
  • Leboyer, M., A. Philippe, M. Bouvard, M. Guilloud-Bataille, D. Bondoux, F. Tabuteau, J. Feingold, M. C. Mouren-Simeoni, and J. M. Launay. 1999. Whole blood serotonin and plasma beta endorphin in autistic probands and their first-degree relatives. Biological Psychiatry 45 (2):158–63. doi: 10.1016/S0006-3223(97)00532-5.
  • Ledford, J. R., and L. D. Gast. 2006. Feeding problems in children with autism spectrum disorders: A review. Focus on Autism and Other Developmental Disabilities 21 (3):153–66. doi: 10.1177/10883576060210030401.
  • Lionetti, E., and C. Catassi. 2011. New clues in celiac disease epidemiology, pathogenesis, clinical manifestations, and treatment. International Reviews of Immunology 30 (4):219–31. doi: 10.3109/08830185.2011.602443.
  • Lucarelli, S., T. Frediani, A. M. Zingoni, F. Ferruzzi, O. Giardini, F. Quintieri, M. Barbato, P. D’Eufemia, and E. Cardi. 1995. Food allergy and infantile autism. Panminerva Medica 37 (3):137–41.
  • Ly, V., M. Bottelier, P. J. Hoekstra, A. A. Vasquez, J. K. Buitelaar, and N. N. Rommelse. 2017. Elimination diets’ efficacy and mechanisms in attention deficit hyperactivity disorder and autism spectrum disorder. European Child and Adolescent Psychiatry 26:1067–79. doi:10.1007/500787-017-0959-1
  • Maenner, M. J., K. A. Shaw, J. Baio, A. Washington, M. Patrick, M. DiRienzo, D. L. Christensen, L. D. Wiggins, S. Pettygrove, J. G. Andrews, et al. 2020. Prevalence of autism spectrum disorder among children aged 8 years - Autism and developmental disabilities monitoring network, 11 Sites, United States, 2016. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, DC: 2002) 69 (4):1–12. doi: 10.15585/mmwr.ss6904a1.
  • Mari-Bauset, S., I. Zazpe, A. Mari-Sanchis, A. Llopis-Gonzalez, and M. Morales-Suarez-Varela. 2014. Evidence of the gluten-free and casein-free diet in autism spectrum disorders: A systematic review. Journal of Child Neurology 29 (12):1718–27. doi: 10.1177/0883073814531330.
  • Masri, A. T., F. Khatib, A. A. Qudah, O. Nafi, M. Almomani, M. Bashtawi, F. Alomari, S. Qutifan, and A. Qutifan. 2020. Parental use of conventional and complementary therapy for autism in Jordan. Complementary Therapies in Medicine 48:102275. doi: 10.1016/j.ctim.2019.102275.
  • Millward, C., M. Ferriter, S. Calver, and G. Connell-Jones. 2008. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Systematic Reviews (2):CD003498. doi: 10.1002/14651858.CD003498.pub3.
  • Momeni, N., B. M. Nordstrom, V. Horstmann, H. Avarseji, and B. V. Sivberg. 2005. Alterations of prolyl endopeptidase activity in the plasma of children with autistic spectrum disorders. BMC Psychiatry 5 (1):27. doi: 10.1186/1471-244X-5-27.
  • Mozzi, F., G. Rollan, G. S. de Giori, and G. Font de Valdez. 2001. Effect of galactose and glucose on the exopolysaccharide production and the activities of biosynthetic enzymes in Lactobacillus casei CRL 87. Journal of Applied Microbiology 91 (1):160–7. doi: 10.1046/j.1365-2672.2001.01367.x.
  • Mulloy, A., R. Lang, M. O’Reilly, J. Sigafoos, G. Lancioni, and M. Rispoli. 2010. Gluten-free and casein-free diets in the treatment of autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders 4 (3):328–39. doi: 10.1016/j.rasd.2009.10.008.
  • Mulloy, A., R. Lang, M. O’Reilly, J. Sigafoos, G. Lancioni, and M. Rispoli. 2011. Addendum to gluten-free and casein-free diets in treatment of autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders 5 (1):86–8. doi: 10.1016/j.rasd.2010.07.004.
  • Munasinghe, S. A., C. Oliff, J. Finn, and J. A. Wray. 2010. Digestive enzyme supplementation for autism spectrum disorders: A double-blind randomized controlled trial. Journal of Autism and Developmental Disorders 40 (9):1131–8. doi: 10.1007/s/10803-010-0974-2.
  • Nagamitsu, S. 1993. CSF beta-endorphin levels in pediatric neurologic disorders. The Kurume Medical Journal 40 (4):233–41. doi: 10.2739/kurumemedj.40.233.
  • Nagamitsu, S., T. Matsuishi, T. Kisa, H. Komori, M. Miyazaki, T. Hashimoto, Y. Yamashita, E. Ohtaki, and H. Kato. 1997. CSF beta-endorphin levels in patients with infantile autism. Journal of Autism and Developmental Disorders 27 (2):155–63. doi: 10.1023/A:1025839807431.
  • Navarro, F., D. A. Pearson, N. Fatheree, R. Mansour, S. S. Hashmi, and J. M. Rhoads. 2015. Are ‘leaky gut’ and behavior associated with gluten and dairy containing diet in children with autism spectrum disorders? Nutritional Neuroscience 18 (4):177–85. doi: 10.1179/1476830514Y.0000000110.
  • Nazni, P., E. G. Wesely, and V. Nishadevi. 2008. Impact of casein and gluten free dietary intervention on selected autistic children. Iranian Journal of Pediatrics 18 (3):244–50.
  • Oh, D., and K.-A. Cheon. 2020. Alteration of gut microbiota in autism spectrum disorder: An overview. Soa-Ch’ongsonyon Chongsin Uihak = Journal of Child & Adolescent Psychiatry 31 (3):131–45. doi: 10.5765/jkacap.190039.
  • O’Hare, A. 2007. Letters to the editor” O’Hare replies. Developmental Medicine & Child Neurology 46 (5):357–8. doi: 10.1017/S0012162204220588.
  • Ozonoff, S., K. Heung, R. Byrd, R. Hansen, and I. Hertz-Picciotto. 2008. The onset of autism: Patterns of symptom emergence in the first years of life. Autism Research: Official Journal of the International Society for Autism Research 1 (6):320–8. doi: 10.1002/aur.53.
  • Ozonoff, S., A.-M. Iosif, F. Baguio, I. C. Cook, M. M. Hill, T. Hutman, S. J. Rogers, A. Rozga, S. Sangha, M. Sigman, et al. 2010. A prospective study of the emergence of early behavioral signs of autism. Journal of the American Academy of Child and Adolescent Psychiatry 49 (3):256–66. doi: 10.1016/j.jaac.2009.11.009.
  • Özyurt, G., Y. Öztürk, Y. Ç. Appak, F. D. Arslan, M. Baran, İ. Karakoyun, A. E. Tufan, and A. A. Pekcanlar. 2018. Increased zonulin is associated with hyperactivity and social dysfunctions in children with attention deficit hyperactivity disorder. Comprehensive Psychiatry 87:138–42. doi: 10.1016/j.comppsych.2018.10.006.
  • Panksepp, J. 1979. A neurochemical theory of autism. Trends in Neurosciences 2:174–7. doi: 10.1016/0166-2236(79)90071-7.
  • Panksepp, J., N. Najam, and F. Soares. 1979. Morphine reduces social cohesion in rats. Pharmacology, Biochemistry, and Behavior 11 (2):131–4. doi: 10.1016/0091-3057(79)90002-9.
  • Panksepp, J., L. Normansell, S. Siviy, J. Rossi, and A. J. Zolovick. 1984. Casomorphins reduce separation distress in chicks. Peptides 5 (4):829–31. doi: 10.1016/0196-9781(84)90030-5.
  • Park, H. J., S. J. Choi, Y. Kim, M. S. Cho, Y.-R. Kim, and J. E. Oh. 2020. Mealtime behaviors and food preferences of students with autism spectrum disorder. Foods 10 (1):49. dx.doi.org/foods100110049 doi: 10.3390/foods10010049.
  • Parmeggiani, A., A. Corinaldesi, and A. Posar. 2019. Early features of autism spectrum disorder: A cross-sectional study. Italian Journal of Pediatrics 45 (1):144. 10.1186/s13052-019-0733-8 doi: 10.1186/s13052-019-0733-8.
  • Pedersen, L., S. Parlar, K. Kvist, P. Whiteley, and P. Shattock. 2014. Data mining the ScanBrit study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders: Behavioural and psychometric measures of dietary response. Nutritional Neuroscience 17 (5):207–13. doi: 10.1179/1476830513Y.0000000082.
  • Pennesi, C. M., and L. C. Klein. 2012. Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: Based on parental report. Nutritional Neuroscience 15 (2):85–91. doi: 10.1179/1476830512Y.0000000003.
  • Pineda, R., K. Melchior, S. Oberle, T. Inder, and C. Rogers. 2015. Assessment of autism symptoms during the neonatal period: Is there early evidence of autism risk? The American Journal of Occupational Therapy 69 (4):6904220010p1–11. doi: 10.5014/ajot.2015.015925.
  • Piwowarczyk, A., A. Horvath, J. Łukasik, E. Pisula, and H. Szajewska. 2018. Gluten- and casein-free diet and autism spectrum disorders in children: A systematic review. European Journal of Nutrition 57 (2):433–40. doi: 10.1007/s00394-017-1483-2.
  • Piwowarczyk, A., A. Horvath, E. Pisula, R. Kawa, and H. Szajewska. 2020. Gluten-free diet in children with autism spectrum disorders: A randomized, controlled, single-blinded trial. Journal of Autism and Developmental Disorders 50 (2):482–90. doi: 10.1007/s10803-019-04266-9.
  • Pusponegoro, H. D., S. Ismael, A. Firmansyah, S. Sastroasmoro, and Y. Vandenplas. 2015a. Gluten and casein supplementation does not increase symptoms in children with autism spectrum disorder. Acta Paediatrica (Oslo, Norway: 1992) 104 (11):e500–5. doi: 10.1111/apa.13108.
  • Pusponegoro, H. D., S. Ismael, S. Sastroasmoro, A. Firmansyah, and Y. Vandenplas. 2015b. Maladaptive behavior and gastrointestinal disorders in children with autism spectrum disorder. Pediatric Gastroenterology, Hepatology & Nutrition 18 (4):230–7. doi: 10.5223/pghn.2015.18.4.230.
  • Reichelt, K. L., J. Ekrem, and H. Scott. 1990. Gluten, milk proteins and autism: Dietary intervention effects on behavior and peptide secretion. Journal of Applied Nutrition 42:1–11.
  • Reichelt, K. L., K. Hole, A. Hamberger, G. Saelid, P. D. Edminson, C. B. Braestrup, O. Lingjaerde, P. Ledaal, and H. Orbeck. 1981. Biologically active peptide-containing fractions in schizophrenia and childhood autism. Advences in Biochemical Psychopharmacology 28:627–43. PMID: 7010949.
  • Reichelt, K. L., and A. M. Knivsberg. 2003. Can the pathophysiology of autism be explained by the nature of the discovered urine peptides? Nutritional Neuroscience 6 (1):19–28. doi: 10.1080/1028415021000042839.
  • Reichelt, K. L., A. M. Knivsberg, G. Lind, and M. Nødland. 1991. Probable etiology and possible treatment of childhood autism. Brain Dysfunction 4 (6):308–19.
  • Reichelt, K. L., A. M. Knivsberg, M. Nødland, and G. Lind. 1994. Nature and consequences of hyperpeptiduria and bovine casomorphins found in autistic syndromes. Developmental Brain Dysfunction 7 (2–3):71–85.
  • Reichelt, K. L., E. Sagedal, J. Landmark, B. Tshumi-Sangvik, O. Eggen, and H. Scott. 1990. The effect of a gluten free diet on glycoprotein associated urinary peptide excretion in schizophrenia. Journal of Orthomolecular Medicine 5:223–39.
  • Reichelt, K. L., D. Tveiten, A. M. Knivsberg, and G. Bronstad. 2012. Peptides role in autism with emphasis on exorphins. Microbial Ecology in Health and Disease 23 (1):18958. doi: 10.3402/mehd.v23i0.18958.
  • Reissmann, A., J. Hauser, E. Makulska-Gertruda, L. Tomsa, and K. W. Lange. 2014. Gluten-free and casein-free diets in the treatment of autism. Functional Foods in Health and Disease 4 (8):349–61. doi: 10.31989/ffhd.v4i8.146.
  • Reissmann, A., J. Hauser, E. Stollberg, and K. W. Lange. 2020. Gluten-free and casein-free diets in the management of autism spectrum disorder: A systematic literature review. Movement and Nutrition in Health and Disease 4:21–38. doi: 10.5283/mnhd.9.
  • Richdale, A. L., and A. S. Kimberly. 2009. Sleep problems in autism spectrum disorders: Prevalence, nature, & possible biopsychosocial aetiologies. Sleep Medicine Reviews 13 (6):403–11. doi: 10.1016/j.smrv.2009.02.003.
  • Robertson, M. A., D. L. Sigalet, J. J. Holst, J. B. Meddings, J. Wood, and K. A. Sharkey. 2008. Intestinal permeability and glucagon-like peptide-2 in children with autism: A controlled pilot study. Journal of Autism and Developmental Disorders 38 (6):1066–71. doi: 10.1007/s10803-007-0482-1.
  • Ross, D. L., W. M. Klykylo, and R. Hitzemann. 1987. Reduction of elevated CSF beta-endorphin by fenfluramine in infantile autism. Pediatric Neurology 3 (2):83–6. 94(87)90032-4. doi: 10.1016/0887-9.
  • Rossignol, D. A. 2009. Novel and emerging treatment for autism spectrum disorders: A systematic review. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists 21 (4):213–36.
  • Rylaarsdam, L., and A. Guemez-Gamboa. 2019. Genetic causes and modifiers of autism spectrum disorder. Frontiers in Cellular Neuroscience 13:385. doi: 10.3389/fncel.2019.00385.
  • Saad, K., A. A. Eltayeb, I. L. Mohamad, A. A. Al-Atram, Y. Elserogy, G. Bjørklund, A. A. El-Houfey, and B. Nicholson. 2015. A randomized, placebo-controlled trial of digestive enzymes in children with autism spectrum disorders. Clinical Psychopharmacology and Neuroscience 13 (2):188–93. doi: 10.9758/cpn.2015.13.2.188.
  • Saxena, D., S. Jain, M. Changulani, R. Changulani, and S. K. Jayant. 2018. Gluten free casein free diet as complementary and alternative medicine (CAM) treatment for children’s with autism spectrum disorders (ASD). Integrative Food, Nutrition and Metabolism 5 (6):1–4. doi: 10.15761/IFNM.1000235.
  • Scrinivasan, P. 2009. A review of dietary interventions in autism. Annals of Clinical Psychiatry 21 (4):237–47. PMID: 19917213
  • Seung, H., Y. Rogalski, M. Shankar, and J. Elder. 2007. The gluten-and casein-free diet and autism: Communication outcomes from a preliminary double-blind clinical trial. Journal of Medical Speech Language Pathology 15 (4):337–45.
  • Sharma, S. R., X. Gonda, and F. I. Tarazi. 2018. Autism spectrum disorder: Classification, diagnosis and therapy. Pharmacology & Therapeutics 190:91–104. doi: 10.1016/j.pharmthera.2018.05.007.
  • Sharp, W. G., R. C. Berry, C. McCracken, N. N. Nuhu, E. Marvel, C. A. Saulnier, A. Klin, W. Jones, and D. L. Jaquess. 2013. Feeding problems and nutrient intake in children with autism spectrum disorders: A meta-analysis and comprehensive review of the literature. Journal of Autism and Developmental Disorders 43 (9):2159–73. doi: 10.1007/s10803-013-1771-5.
  • Shattock, P., M. Hooper, and R. Waring. 2007. Opioid peptides and dipeptidyl peptidase in autism. Letters to the editor. Developmental Medicine & Child Neurology 46 (5):357. doi: 10.1017/S0012162204210581.
  • Shattock, P., A. Kennedy, F. Rowell, and T. P. Barney. 1990. The role of neuropeptides in autism and their relationship with classical neurotransmitters. Brain Dysfunction 3 (5–6):328–45.
  • Smith, M. W., P. S. James, and M. A. Peacock. 1991. Galactose effects on enterocyte differentiation in the mouse jejunum. Biochimica et Biophysica Acta 1093 (2–3):144–6. doi: 10.1016/0167-4889(91)90115-E.
  • Sokolov, O., N. Kost, O. Andreeva, E. Korneeva, V. Meshavkin, Y. Tarakanova, A. Dadayan, Y. Zolotarev, S. Grachev, I. Mikheeva, et al. 2014. Autistic children display elevated urine levels of bovine casomorphin-7 immunoreactivity. Peptides 56:68–71. doi: 10.1016/j.peptides.2014.03.007.
  • Sponheim, E. 1991. Gluten free diet in infantile autism. Journal of Norwegian Medical Association 111:704–7.
  • Stanisławek, A. M., and M. Kozioł-Montewka. 2017. Participation of gastrointestinal microbiome in the pathogenesis and symptoms of autism according to the theory of brain-intestinal axis interaction. Journal of Pre-Clinical and Clinical Research 11 (2):153–6. doi: 10.26444/jpccr/81300.
  • Sun, Z., and R. Cade. 1999. A peptide found in schizophrenia and autism causes behavioral changes in rats. Autism 3 (1):85–95. doi: 10.1177/1362361399003001007.
  • Sun, Z., J. R. Cade, M. J. Fregly, and R. M. Privette. 1999. P-Casomorphin induces fos-like immunoreactivity in discrete brain regions relevant to schizophrenia and autism. Autism 3 (1):67–83. doi: 10.1177/1362361399003001006.
  • Tarnowska, K., E. Gruczyńska-Sękowska, D. Kowalska, M. Kozłowska, E. Majewska, and R. Winkler. 2020. Difficulties and factors influencing purchase decision. The perspective of families with children with autism spectrum disorders on a gluten-free and casein-free diet. Preliminary study. Roczniki Panstwowego Zakladu Higieny 71 (3):321–8. doi: 10.32394/rpzh.2020.0122.
  • Tordjman, S., G. M. Anderson, M. Botbol, S. Brailly-Tabard, F. Perez-Diaz, R. Graignic, M. Carlier, G. R. Schmit, A. C. Bonnot, O. Trabado, et al. 2009. Pain reactivity and plasma beta-endorphin in children and adolescents with autistic disorder. PLoS One 4 (8):e5289. 10.1371/journal.pone.0005289 doi: 10.1371/journal.pone.0005289.
  • Tordjman, S., G. M. Anderson, P. A. McBride, M. E. Hertzig, M. E. Snow, L. M. Hall, S. M. Thompson, P. Ferrari, and D. J. Cohen. 1997. Plasma beta-endorphin, adrenocorticotropin hormone, and cortisol in autism. Journal of Child Psychology and Psychiatry 38 (6):705–15. doi: 10.1111/j.1469-7610.1997.tb01697.x.
  • Trudeau, M. S., R. F. Madden, J. A. Parnell, W. B. Gibbard, and J. Shearer. 2019. Dietary and supplement-based complementary and alternative medicine use in pediatric autism spectrum disorder. Nutriens 11:1783. doi: 10.3390/nu11081783.
  • Turner, J. R., M. M. Buschmann, I. Romero-Calvo, A. Sailer, and L. Shen. 2014. The role of molecular remodeling in differential regulation of tight junction permeability. Seminars in Cell & Developmental Biology 36:204–12. doi: 10.1016/j.semcdb.2014.09.022.
  • Tveiten, D., A. Finvold, M. Andersson, and K. L. Reichelt. 2014. Peptides and exorphins in the autism spectrum. Open Journal of Psychiatry 4 (3):275–87. doi: 10.4236/ojpsych.2014.43034.
  • Vojdani, A., E. Vojdani, and D. Kharrazian. 2017. Fluctuation of zonulin levels in blood vs stability of antibodies. World Journal of Gastroenterology 23 (31):5669–79. doi: 10.3748/wjg.v23.i31.5669.
  • Weizman, R., I. Gil-Ad, J. Dick, S. Tyano, G. A. Szekely, and Z. Laron. 1988. Low plasma immunoreactive beta-endorphin levels in autism. Journal of the American Academy of Child and Adolescent Psychiatry 27 (4):430–3. doi: 10.1097/00004583-198807000-00009.
  • Weizman, R., A. Weizman, S. Tyano, G. Szekely, B. A. Weissman, and Y. Sarne. 1984. Humoral-endorphin blood levels in autistic, schizophrenic and healthy subjects. Psychopharmacology ) 82 (4):368–70. doi: 10.1007/BF00427687.
  • Whiteley, P. 2017. Food and the gut: Relevance to some of the autisms. The Proceedings of the Nutrition Society 76 (4):478–83. doi: 10.1017/S0029665117002798.
  • Whiteley, P., D. Haracopos, A. M. Knivsberg, K. Reichelt, S. Parlar, J. Jacobsen, A. Seim, L. Pedersen, M. Schondel, and P. Shattock. 2010. The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutritional Neuroscience 13 (2):87–100. doi: 10.1179/147683010X12611460763922.
  • Whiteley, P., J. Rodgers, D. Savery, and P. Shattock. 1999. A gluten-free diet as an intervention for autism and associated spectrum disorders: Preliminary findings. Autism 3 (1):45–65. doi: 10.1177/1362361399003001005.
  • Willemsen-Swinkels, S. H., J. K. Buitelaar, F. G. Weijnen, J. H. Thijssen, and H. Van Engeland. 1996. Plasma beta-endorphin concentrations in people with learning disability and self-injurious and/or autistic behaviour. The British Journal of Psychiatry: The Journal of Mental Science 168 (1):105–9. doi: 10.1192/bjp.168.1.105.
  • Winburn, E., J. Charlton, H. McConachie, E. McColl, J. Parr, A. O’Hare, G. Baird, P. Gringras, D. C. Wilson, A. Adamson, et al. 2014. Parents’ and child health professionals’ attitudes towards dietary interventions for children with autism spectrum disorders. Journal of Autism and Developmental Disorders 44 (4):747–57. doi: 10.1007/s10803-013-1922-8.
  • Zhang, J., M. R. Mayton, and J. J. Wheeler. 2013. Effectiveness of gluten-free and casein-free diets for individuals with autism spectrum disorders: An evidence-based research synthesis. Education and Training in Autism and Developmental Disabilitites 48 (2):276–87.
  • Zickgraf, H., and S. D. Mayes. 2019. Psychological, health and demographic correlates of atypical eating behaviors in children with autism. Journal of Developmental and Physical Disabilities 31 (3):399–418. doi: 10.1007/s10882-018-9645-6.

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