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      Identification of Unique Gene Expression Profile in Children with Regressive Autism Spectrum Disorder (ASD) and Ileocolitis

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          Abstract

          Gastrointestinal symptoms are common in children with autism spectrum disorder (ASD) and are often associated with mucosal inflammatory infiltrates of the small and large intestine. Although distinct histologic and immunohistochemical properties of this inflammatory infiltrate have been previously described in this ASD GI group, molecular characterization of these lesions has not been reported. In this study we utilize transcriptome profiling of gastrointestinal mucosal biopsy tissue from ASD GI children and three non-ASD control groups (Crohn's disease, ulcerative colitis, and histologically normal) in an effort to determine if there is a gene expression profile unique to the ASD GI group. Comparison of differentially expressed transcripts between the groups demonstrated that non-pathologic (normal) tissue segregated almost completely from inflamed tissue in all cases. Gene expression profiles in intestinal biopsy tissue from patients with Crohn's disease, ulcerative colitis, and ASD GI, while having significant overlap with each other, also showed distinctive features for each group. Taken together, these results demonstrate that ASD GI children have a gastrointestinal mucosal molecular profile that overlaps significantly with known inflammatory bowel disease (IBD), yet has distinctive features that further supports the presence of an ASD-associated IBD variant, or, alternatively, a prodromal phase of typical inflammatory bowel disease. Although we report qPCR confirmation of representative differentially expressed transcripts determined initially by microarray, these findings may be considered preliminary to the extent that they require further confirmation in a validation cohort.

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          Most cited references38

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          Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction.

          A new method of total RNA isolation by a single extraction with an acid guanidinium thiocyanate-phenol-chloroform mixture is described. The method provides a pure preparation of undegraded RNA in high yield and can be completed within 4 h. It is particularly useful for processing large numbers of samples and for isolation of RNA from minute quantities of cells or tissue samples.
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            Medical comorbidities in autism: challenges to diagnosis and treatment.

            Ever since its original description by Leo Kanner in l943, autism has been generally defined by its clinical characteristics and core symptoms that include impaired social skills, isolated areas of interest, and delayed and disordered language. Over time, it has become apparent that autism is a heterogeneous disorder with regard to its clinical presentation, etiology, underlying neurobiology, and degree of severity. As a result, the termed diagnosis of autism spectrum disorders (ASDs) has come into common usage. With advancements in clinical care, there has come the appreciation that many ASD children, adolescents, and adults may have medically relevant disorders that may negatively impact their developmental progress and behavior, but which frequently go undetected. Many of these medical conditions are treatable, often resulting in improved developmental gains and quality of life for the patient and family. In addition, the possibility exists that some of these medical conditions may suggest the presence of important genetic and/or biologic markers, which, if identified, can refine our ability to be more precise in categorizing clinical and genetic subtypes within the autism spectrum. (c) 2010. Published by Elsevier Inc.
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              Genome-wide gene expression differences in Crohn's disease and ulcerative colitis from endoscopic pinch biopsies: insights into distinctive pathogenesis.

              Ulcerative colitis (UC) and Crohn's disease (CD) are inflammatory bowel diseases (IBD) with variable, overlapping clinical features and complex pathophysiologies. To identify pathogenic processes underlying these disease subtypes, we used single endoscopic pinch biopsies to elucidate patterns of gene expression in active and inactive areas of UC and CD and compared these to infectious colitis and healthy control samples. Unsupervised classification of a total of 36 samples yielded promising separation between the affected IBD, unaffected IBD, non-IBD colitis, and normal control samples, suggesting each sample type had a distinctive gene expression pattern. Genes differentially expressed in the CD samples compared to in the controls were related to IFNgamma-inducible TH1 processes (IFITM1, IFITM3, STAT1, and STAT3) and antigen presentation (TAP1, PSME2, PSMB8). The most noticeable change in the UC samples was reduced expression of genes regulating biosynthesis, metabolism, and electrolyte transport (HNF4G, KLF5, AQP8, ATP2B1, and SLC16A). Twenty-five percent of genes down-regulated in the UC samples were also down-regulated in the infectious colitis samples. Unaffected biopsy samples of IBD patients also registered differences expression of genes compared to in the normal controls. Of these differentially expressed genes, only 2 were up-regulated, PSKH1, a regulator of mRNA processing, and PPID, a suppressor of apoptosis. The study shows that the gene expression patterns of IBD, CD in particular, are quite different from those of infectious colitis, highlighting distinctive expression of genes and pathways in UC and CD.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                8 March 2013
                : 8
                : 3
                : e58058
                Affiliations
                [1 ]Wake Forest Institute for Regenerative Medicine, Wake Forest University Health Sciences, Winston Salem, North Carolina, United States of America
                [2 ]Department of Pediatrics Section on Gastroenterology, Wake Forest University Health Sciences, Winston Salem, North Carolina, United States of America
                [3 ]Pediatric Gastroenterology Department, Dr. Miguel Perez Carreño Hospital, Caracas, Venezuela
                [4 ]Pediatric Gastroenterology Resources of New York & Texas, Far Rockaway, New York, United States of America
                Temple University School of Medicine, United States of America
                Author notes

                Competing Interests: AK served as an expert witness in the role of treating pediatric gastroenterologist in the Autism Omnibus Hearings of 2007. AK has also served as expert witness on behalf of children with ASD associated bowel disease in Child Protective Services legal actions.

                Conceived and designed the experiments: AK SJW. Performed the experiments: SJW. Analyzed the data: AK LGG SJW. Wrote the paper: AK SJW. Provided clinical samples: AK JF. Created Figures and Tables: AK LGG SJW. Supervised research: AK SJW.

                Article
                PONE-D-12-11280
                10.1371/journal.pone.0058058
                3592909
                23520485
                693e0dcd-2792-461b-b8d0-05c8c2bae667
                Copyright @ 2013

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 18 April 2012
                : 31 January 2013
                Page count
                Pages: 14
                Funding
                The authors are grateful to the Jane Botsford Johnson Foundation for financial support. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology
                Genomics
                Functional Genomics
                Medicine
                Gastroenterology and Hepatology
                Colon
                Colonoscopy
                Inflammatory Bowel Disease
                Crohn Disease
                Ulcerative Colitis
                Pediatric Gastroenterology
                Neurology
                Developmental and Pediatric Neurology
                Pediatrics
                Developmental and Pediatric Neurology

                Uncategorized
                Uncategorized

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