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      The role of cholesterol metabolism and various steroid abnormalities in autism spectrum disorders: A hypothesis paper

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          Abstract

          Based on evidence from the relevant research literature, we present a hypothesis that there may be a link between cholesterol, vitamin D, and steroid hormones which subsequently impacts on the development of at least some of the “autisms” [Coleman & Gillberg]. Our hypothesis, driven by the peer reviewed literature, posits that there may be links between cholesterol metabolism, which we will refer to as “steroid metabolism” and findings of steroid abnormalities of various kinds (cortisol, testosterone, estrogens, progesterone, vitamin D) in autism spectrum disorder (ASD). Further research investigating these potential links is warranted to further our understanding of the biological mechanisms underlying ASD. Autism Res 2017. © 2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research. Autism Res 2017, 10: 1022–1044 . © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

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          Most cited references 134

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          Neurocircuitry of stress: central control of the hypothalamo-pituitary-adrenocortical axis.

          Integration of the hypothalamo-pituitary-adrenal stress response occurs by way of interactions between stress-sensitive brain circuitry and neuroendocrine neurons of the hypothalamic paraventricular nucleus (PVN). Stressors involving an immediate physiologic threat ('systemic' stressors) are relayed directly to the PVN, probably via brainstem catecholaminergic projections. By contrast, stressors requiring interpretation by higher brain structures ('processive' stressors) appear to be channeled through limbic forebrain circuits. Forebrain limbic sites connect with the PVN via interactions with GABA-containing neurons in the bed nucleus of the stria terminalis, preoptic area and hypothalamus. Thus, final elaboration of processive stress responses is likely to involve modulation of PVN GABAergic tone. The functional and neuroanatomical data obtained suggest that disease processes involving inappropriate stress control involve dysfunction of processive stress pathways.
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            Overview of steroidogenic enzymes in the pathway from cholesterol to active steroid hormones.

            Significant advances have taken place in our knowledge of the enzymes involved in steroid hormone biosynthesis since the last comprehensive review in 1988. Major developments include the cloning, identification, and characterization of multiple isoforms of 3beta-hydroxysteroid dehydrogenase, which play a critical role in the biosynthesis of all steroid hormones and 17beta-hydroxysteroid dehydrogenase where specific isoforms are essential for the final step in active steroid hormone biosynthesis. Advances have taken place in our understanding of the unique manner that determines tissue-specific expression of P450aromatase through the utilization of alternative promoters. In recent years, evidence has been obtained for the expression of steroidogenic enzymes in the nervous system and in cardiac tissue, indicating that these tissues may be involved in the biosynthesis of steroid hormones acting in an autocrine or paracrine manner. This review presents a detailed description of the enzymes involved in the biosynthesis of active steroid hormones, with emphasis on the human and mouse enzymes and their expression in gonads, adrenal glands, and placenta.
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              Promoting social behavior with oxytocin in high-functioning autism spectrum disorders.

              Social adaptation requires specific cognitive and emotional competences. Individuals with high-functioning autism or with Asperger syndrome cannot understand or engage in social situations despite preserved intellectual abilities. Recently, it has been suggested that oxytocin, a hormone known to promote mother-infant bonds, may be implicated in the social deficit of autism. We investigated the behavioral effects of oxytocin in 13 subjects with autism. In a simulated ball game where participants interacted with fictitious partners, we found that after oxytocin inhalation, patients exhibited stronger interactions with the most socially cooperative partner and reported enhanced feelings of trust and preference. Also, during free viewing of pictures of faces, oxytocin selectively increased patients' gazing time on the socially informative region of the face, namely the eyes. Thus, under oxytocin, patients respond more strongly to others and exhibit more appropriate social behavior and affect, suggesting a therapeutic potential of oxytocin through its action on a core dimension of autism.
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                Author and article information

                Contributors
                c.s.allely@salford.ac.uk
                Journal
                Autism Res
                Autism Res
                10.1002/(ISSN)1939-3806
                AUR
                Autism Research
                John Wiley and Sons Inc. (Hoboken )
                1939-3792
                1939-3806
                12 April 2017
                June 2017
                : 10
                : 6 ( doiID: 10.1002/aur.2017.10.issue-6 )
                : 1022-1044
                Affiliations
                [ 1 ]Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg GothenburgSweden
                [ 2 ]Barts and London School of Medicine, Queen Mary University of London, Blizard Institute 58 Turner Street E1 2ABLondon
                [ 3 ]Institute of Health and Wellbeing, University of Glasgow, RHSC Yorkhill Glasgow Scotland G3 8SJUnited Kingdom
                [ 4 ]Institut Pasteur, Human Genetics and Cognitive Functions Unit ParisFrance
                [ 5 ]CNRS UMR 3571: Genes, Synapses and Cognition, Institut Pasteur ParisFrance
                [ 6 ] Université Paris Diderot, Sorbonne Paris CitéHuman Genetics and Cognitive Functions ParisFrance
                [ 7 ]FondaMental Foundation CréteilFrance
                [ 8 ] School of Health SciencesUniversity of Salford ManchesterEngland
                [ 9 ] Honorary Research Fellow in the College of MedicalVeterinary and Life Sciences affiliated to the Institute of Health and Wellbeing at the University of Glasgow
                Author notes
                [* ]Address for correspondence and reprints: Clare S Allely, School of Health Sciences, Room L818, Allerton Building, University of Salford, Manchester, England, M6 6PU, UK. E‐mail: c.s.allely@ 123456salford.ac.uk
                Article
                AUR1777
                10.1002/aur.1777
                5485071
                28401679
                © 2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 1, Tables: 5, Pages: 23, Words: 17651
                Product
                Categories
                Literature Review
                Literature Review
                Custom metadata
                2.0
                aur1777
                June 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.2 mode:remove_FC converted:27.06.2017

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